The World Health Organization recently announced the first coronavirus death outside China, with the total death toll now rising to 304; at the same time, no coherent guidance has from Iran’s Ministry of Health to deal with possible outbreaks of the virus in Iran.
"Unfortunately, no official letter, directive, or guideline on the coronavirus has yet been sent to hospitals and medical centers by the Ministry of Health and Medical Education," Saeed, an internal medicine specialist living in Tehran, told IranWire. "There are no guidelines on how to handle suspicious symptoms of the disease or how to treatment a potential patient."
Saeed added that a single leaflet and PDF file have been circulated via Telegram in Iran in recent days. "Maybe they have sent directives to specialized infectious diseases hospitals, but as far as I know, no university hospital, and not even the Tehran University Hospital, have received instructions and guidance on the coronavirus,” he said.
The latest coronavirus is in fact the seventh virus in the corona family – SARS being a notable example of an earlier outbreak China’s SARS outbreak in 2002 affected more than 8,000 people worldwide and claimed 744 lives.
Ahmed, an infectious disease specialist in Tehran, told IranWire that coronavirus symptoms are similar to a common cold, and can include fever, headache, and dry coughing, with shortness of breath developing as symptoms worsen. The SARS virus attacked respiratory systems.
Ahmed added that, in his view, the Ministry of Health was not yet seriously dealing with the global health emergency. "Patients with cold symptoms and respiratory difficulties should be isolated, and doctors and practitioners must examine them with protective clothing and masks. But the Ministry of Health has not provided any of this to hospitals."
Reports circulated in recent days that some Tehran ambulances were being equipped with protective clothing in case of a coronavirus outbreak. But Mojtaba Khaledi, a spokesperson for emergency health service, declined to speak to the Young Journalists Club, saying that “ambulances were equipped with infectious disease and acute respiratory equipment during the SARS and Ebola outbreaks. Ambulances have since carried protective clothing for two medics. This have nothing to do with the coronavirus."
The internal medicine specialist, Saeed, noted that ambulances are better equipped than Tehran hospital emergency rooms. He has worked in three hospitals and none are equipped with equipment for respiratory emergencies.
”I think the Ministry of Health, because of a reduction in tourism due to sanctions, does not take the issue seriously," Saeed said. “But … the virus may be transmitted [to Iran] through the citizens of neighboring countries. Now that the death of a coronavirus patient outside China has been confirmed, we have to prepare before we are caught off-guard.”
Saeed was referring to the death of a Chinese man in the Philippines. The 44-year-old patient was from the city of Wuhan, in Hubei province, where the coronavirus was first detected in December last year. According to the World Health Organization, the person may have contracted the virus before traveling to the Philippines.
"We just have to pray that this virus does not reach Iran because we don't really have the right infrastructure to handle the situation," Saeed said. But flights are “flying back and forth to China,” he added, noting that apparently the same aircraft are used for domestic flights. “Are there standard disinfection processes for aircrafts? While the rest of the world has canceled the entry of Chinese nationals, the Ministry of Health has only recently responded, and as far as I know, all Chinese incoming and outgoing flights continued until yesterday."
On Friday evening, Iranian Vice President Eshaq Jahangiri, at the request of the health minister, called an extraordinary government meeting to discuss tackling the coronavirus. Jahangiri added that he had ordered all Iran-China flights to be suspended.
But yesterday, Sunday February 2, Mehr News Agency reported that three flights from China arrived in Iran 48 hours after the suspension order. "Flight number 5078 of Mahan Air arrived at 4:30 on Sunday February 2 from Beijing to Tehran; flight number 5076 of Mahan Air from Shanghai to Tehran arrived at Tehran Khomeini Airport, at 4:46 on Sunday February 2, and flight number 5080 of Mahan Air from Guangzhou arrived at Khomeini Airport, at 5:19 on Sunday February 2,” the report said.
According to a number of journalists in Iran, after a number of media outlets asked the government to stop Iran’s Mahan Air flights to China, the country’s Supreme National Security Council asked journalists to refrain from warning the public about traveling to China and from criticizing Mahan Air. China is Iran’s biggest economic partner and votes regularly against United Nations resolutions condemning Iran’s actions.
Ahmed, the infectious diseases specialist, said that in the cities of Tabriz and Mashhad, “there were a number of suspected cases of coronavirus, which after tests were found to be normal flu. But he added that “we cannot say for sure that the disease will remain beyond our borders.”
A cure has not yet been found though some governments – for example Russia’s – has recommended using SARS treatments to treat the new coronavirus. Ahmed noted that Iran’s Ministry of Health has not yet issued any such guidance on treatment.
Saeed believes that, in the current situation, the media should shift from merely reporting coronavirus statistics to actively engaging in public health education and recommending measures for the general public to mitigate the risk of an outbreak.
”When the Ministry of Health, which is in charge of public health and fighting diseases, fails to do its job properly, we must act independently,” he said. He urged Iranians to temporarily "forget about the customary social habits of shaking hands or exchanging kisses. Do not forget to wash your hands and to disinfect them with alcohol. Reduce visiting indoor public places and use filter masks if you are in public places. Do not get close to people who have symptoms of colds or other suspicious symptoms." Saeed emphasized that preventive measures are simple but require general education.
Covering up an outbreak?
One worry is a lack of preparedness for a coronavirus outbreak in Iran – the other is the risk of an official cover-up of the disease breaking out in the country. Saeed recounted an experience treating patients with Crimean Congo fever in 2016 in the province of Mazandaran.
“Crimean Congo fever is transmitted to humans through tick bites,” Saeed said, "and the patient then experiences bleeding and fever. I was in an ambulance with a patient, wearing an isolation garments and a mask, and I took him to Tehran. Tests [for the fever] were positive, but [Ministry of Health] provincial officials covered up the outbreak until the disease was under control. They feared no one would travel to Mazandaran and the province's tourism industry would suffer.” He added that a coronavirus cover-up was not unthinkable.
An employee at Isfahan Airport, meanwhile, has been reported as being possibly the first case of coronavirus in Iran. Tests are being conducted to confirm the results and the patient has been placed in isolation at Farabi Hospital in Tehran. Iran’s Ministry of Islamic Guidance has also sent text messages to all citizens with basic guidance on avoiding the coronavirus disease.