The surprising number of Iranian government officials
succumbing to COVID-19 offers a hint that the disease is far more widespread
than the official statistics indicate.
The number of people with coronary artery disease in Iran is about 2 million
Iran Has Far More Coronavirus Cases Than It Is Letting On
The surprising number of Iranian government officials
succumbing to COVID-19 offers a hint that the disease is far more widespread
than the official statistics indicate.
March 9, 2020
Staff writer at The Atlantic
You are standing before a huge barrel of apples. You can’t
see the apples, but you can reach in and pick them out. Most are delicious, but
a very small number of them are rotten—just about one in 12,000, your friend
assures you. You reach in blindly and miraculously pick out a rotten apple. You
reach in again and withdraw a whole heaping bushel of apples, maybe 50 in all.
Most are good, but when you look closely you see them: one, two, three, four
more rotten apples. One rotten apple is an amazing coincidence. Five means your
barrel has lots of rotting apples in it and your friend was lying to you.
As of yesterday, according to Johns Hopkins University’s Coronavirus
Resource Center, Iran has reported 6,566 COVID-19 cases, or about
one in every 12,000 people in its population. The first case appeared on
February 19. Right now Iran is third behind China (80,695) and South Korea
(7,314), and just ahead of Italy (5,883). But the official Iranian number is
almost certainly an undercount, probably due to the Iranian government’s
attempt to hide a desperate situation for which it is partially responsible.
When the final history of the coronavirus epidemic of 2020 is written, it may
go something like this: The disease started in China, but it became finally and
irrevocably uncontained in Iran. Knowing that the Iranian number is much higher
than currently disclosed tells the rest of the world that the epidemic is even
further along than official statistics indicate.
The first sign of dishonesty came on February 28, when
Masoumeh Ebtekar, one of the country’s vice presidents, announced that she had
the virus. Ebtekar is one of the most famous politicians in the country, well
known even in the West for her role as a particularly sadistic
member of the group that held U.S. diplomats hostage in 1979 in Tehran. Of
course, being a notorious sociopath confers no immunity against COVID-19. But
here is where the rotting apples come in.
If COVID-19 is so rare—fewer than 400 cases had been reported
in Iran by the day she announced her diagnosis—what are the chances that one of
the afflicted would be a famous politician? Soon we learned of three other
senior officials who not only contracted the virus but were killed by it:
Mohammad Mirmohammadi, a member of a senior advisory council to Iran's supreme
leader, and Hossein Sheikholeslam and Hadi Khosrowshahi, both former high-level
diplomats. Mohammad Sadr, another member of the council, announced his
infection last week, as
did Ebtekar’s fellow cabinet member Reza Rahmani. Recently, the
speaker of parliament said
23 of his fellow members of parliament had tested positive. Two of them,
Mohammad Ali Ramezani (February 29) and Fatemeh
Rehber (March 7), have died.
That’s a lot of tainted apples, statistically speaking. Why
would Iran lie? On February 21, Iran conducted the latest in a series of sham
elections in which only government-selected candidates could run for office. To
show disapproval, many Iranians refuse to vote, and as participation has
dropped, the appearance of electoral legitimacy has dropped as well. Iran’s
government told its people that the United States had hyped COVID-19 to
suppress turnout, and Tehran vowed to punish anyone spreading rumors about a
serious epidemic. Forty-three percent of Iranians voted, unaware that the
outbreak had already begun. Quick action could have allowed quarantines to be
put in place. Instead Iran greased its own path toward the most catastrophic
outbreak in modern history.
Remember that the official number of cases is 6,566.
Yet a variety of other indicators suggest that far more people in Iran have
become infected:
- A paper
by the University of Toronto’s Ashleigh Tuite and
others noted that, by February 23, cases of Iranian origin had surfaced in
Canada, Lebanon, and the United Arab Emirates. Given the volume of air
travel between Iran and these countries, Tuite’s team estimated how many
native COVID-19 cases must have occurred in Iran to produce one case each
in these other countries. Their estimate for February 23: 18,300. Since
the epidemic reached 100 cumulative cases, the official numbers have
doubled roughly every three days. If that rate held, the estimate as of
today would be 586,000.
- On
March 3, 23 out of 290 members of parliament—about 7.9 percent—had the
disease. (Unlike ordinary people, these MPs probably had reliable access
to diagnosis. State media insisted they contracted the disease not from
one another, but from their home districts.) The rate of infection of
parliamentarians would, if applied to Iran’s total population, come to 6.4
million cases.
- Let’s
consider the other politicians. The senior advisory council has
experienced two known deaths out of 39 members; the cabinet has two known
infections out of 30. Even if no other council or cabinet members had
COVID-19, that’s an infection rate of 5.8 percent. That would mean an
estimate of 4.7
million.
- A
government website
invited Iranians to submit details of symptoms they were experiencing.
After 2 million responses, about 9 percent reported COVID-19 symptoms. In
the United States, among those whose symptoms and history have led them to
be tested for COVID-19, about 10 percent have eventually tested positive.
If that rate holds, Iran would have 730,000
cases.
- On
March 4 and 5, two evacuation flights of Chinese citizens were allowed
to leave Tehran for China’s Gansu province. Chinese authorities were of
course wary of introducing more coronavirus carriers into the country, so
they tested passengers and found 11 COVID-19 cases out of 311 passengers.
If Chinese people in Iran got the disease at the same rate as Iranians,
that suggests a rate of 3.5 percent, for a total of 5.7
million at the time of the flight. Tuite, the researcher who
studied earlier flights, cautions that this number would undercount total
cases, because it represents the number of cases on that plane at that
time (the “point prevalence”) and not total cumulative cases—which would
be higher, about 8 million. “It’s alarming, and I have a hard time
wrapping my head around the implications of this,” she told me. “But I
think it’s possible.”
- Seven of the 21 COVID-19 patients in British Columbia
had traveled recently in Iran. Finding a denominator for this number is
difficult, but we can try. British Columbia has about 50,000 Iranian
Canadians, and let’s assume they visit Iran, say, once every four years on
average and stay for a month. That means in any given month, about 1,000
return from Iran. That suggests a total COVID-19 burden of 590,000
cases.
- On
March 8, health authorities in Golestan province declared that hospitals
there were full. Golestan has about 2.2 percent of Iran’s population, and
if we assume it has the same percentage of its hospital beds,
the province should have 2,600
hospital beds. Let’s assume that at least some people with other
conditions are already in those beds and that roughly 2,000 beds are now
filled with COVID-19 patients. About 15 percent of COVID-19 patients need
a hospital stay. That suggests that 13,000 people—or about 0.8 percent of
the province’s population—have COVID-19 in Golestan. If that rate applies
countrywide, it yields 610,000
infections, which suggests a cumulative total of about 1 million
infections—if we include those who have already recovered. Finally,
because hospitalizations are a lagging indicator, double that number to
account for growth in the past week: 2 million.
The average of these estimates is about 2
million, which is about 250 times the official number and 15
times the total cases acknowledged worldwide. According to models, Tuite told
me, the point-prevalence of COVID-19 in Canada could rise to 5 to 10 percent of
the total population when the epidemic reaches its peak. These numbers, which I
have shown to experts, suggest that Iran might be at or near that point.
Does Iran really have 2 million citizens with COVID-19?
Perhaps politicians spend more time in public, and are therefore more
susceptible to infection; if so, some of the estimates above would overstate
the number of cases. Then again, it’s also possible that they were aware of the
epidemic earlier and took precautions. In that case, those estimates would understate
the number of cases. Edward Kaplan, who studies epidemics at Yale, looked at my
numbers and noted that many of Iran’s politicians are old men—the average age
of senior
advisory council members is 70—who are therefore especially likely
to show symptoms of COVID-19, leading to a higher share of sufferers in
political circles than in the general population. It’s also possible—perhaps
likely—that these numbers over-sample for Tehran and Qom, both cities hammered
by the epidemic. COVID-19 is in every Iranian province, but some provinces are
earlier in their cycle than others.
Many similar unknowns make these estimates difficult to
assess—which is why experts have to attack the problem from multiple angles,
with the assumption that errors in one approach do not correlate to errors in
the others, and get rounded out in the average. Even if the estimates are off
by a lot, they still reveal an outbreak completely out of control, beyond the
capacity of Iran or perhaps any country to manage.
The messages coming out of Iran on social media, especially
from health-care workers, do little to convince me that my doomsday figures are
inaccurate. David N. Fisman, a colleague of Tuite’s at the University of
Toronto, notes that the virus reportedly spread after panicked residents of Qom
and Tehran fled to smaller cities, thereby sowing COVID-19 all over the
country. Circulating on social media are reports that some provinces, such as
Mazandaran, have set up roadblocks to keep more people with the infection from
spilling into their territory.
The situation the doctors describe is desperate, with nurses
wrapping themselves in tablecloths because they have long since run through
their supply of proper gear. They swear that the official numbers are wrong.
“Just stay overnight in the hospital to find out what I'm talking about,” one
wrote. Or if you want to live, go home, and don’t come out until the plague
passes. “[Our] society now needs fear more than hope.”
پیش بسوی قیام سراسری ، ما بر اندازیم# کانونهای شورشی در شهرهای ایران #
اعتصاب واعتراض و تظاهرات# سرنگونی رژیم # اتحادوهمبستگی
مرگ_بر_دیکتاتور #IranRegimeChange
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بر اندازیم#
#ایران #کروناویروس
#coronavirus
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#COVID2019
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#درود_بر_کانونهای_شورشی
