The northern province of Gilan was the second Iranian province where coronavirus was detected, and Dr. Reza Koochekinia from the city of Kia Shahr was that province’s first fatality.
It has been reported that Dr. Koochekinia, the head of the Health Network in the city of Astaneh, caught the virus from a patient and died on February 20. Influenza was announced as the official cause of death, amid widespread doubts among the public. His colleagues told IranWire that he was infected with the coronavirus. Public burial ceremonies for victims of viral infectious diseases such as coronavirus are banned, but Dr. Koochekinia’s body was buried in his family’s plot in the city of Lahijan in a public ceremony.
Since February 26, Iranian social media has been dominated by dozens of images of Narges Khanalizadeh, a young smiling woman who died of lung obstruction after contracting the coronavirus because of her work as a nurse. She was 25 and died three days after contracting coronavirus. Khanalizadeh worked for the emergency department of Lahijan Milad Hospital and it is very likely that she contracted coronavirus from patients at the hospital. However, her death was initially blamed on flu. Officials’ tendency so far to treat the coronavirus outbreak with secrecy, on the one hand, and the shortage of test kits and proper medical equipment, on the other hand, has exacerbated the situation.
“The Situation is Critical”
A nurse working at a private hospital in the provincial capital of Rasht who asked to remain anonymous told IranWire: “Before our shift starts, they give us a N95 mask [a mask that covers the nose and mouth and which is designed to help protect the wearer from ingesting hazardous substances]. These masks must be changed at least once every eight hours but they remain on our faces until the end of the shift, which, these days, lasts 12 to 20 hours. We have no special coveralls. They can only be found at the hospital that they have designated as the center for coronavirus infections, but the virus has spread so much that they have been forced to evacuate one or two wards in every hospital and give the wards to coronavirus patients. The situation in Rasht is critical.”
She says that before the official announcement of coronavirus cases in Iran, a number of patients at Rasht’s Golsar Hospital had died; the cause of death for all of them was announced to be influenza. According to her, two doctors in the hospital, one a specialist in pulmonary diseases and the other a general surgeon, called the hospital and said that they were starting their Norooz [Iranian new year holiday] vacations early.
“Not only in Rasht but everywhere in the province the situation is a disaster,” the nurse says. “There are no masks and there is a shortage of detergent, not just for the people but even in the hospitals. Whenever we request special clothing, they tell us that we do not need them except for ‘special occasions’! A few days before the official announcement of coronavirus outbreak, 10 patients who were suspected of having flu or coronavirus have died.”
It is, of course, not possible to arrive at even a somewhat accurate estimate of the number of coronavirus infections in Iran as a whole or Gilan in particular. But based on the testimonies by the medical staff of Gilan hospitals, the shortage of necessary medical equipment and, most importantly, the lack of official transparency in past potential health crises, it is safe to assume that the number of coronavirus cases in the province is at least a few times higher than the official toll.
Officials Threaten Medical Staff
The death of Narges Khanalizadeh, however, has upended the situation in eastern Gilan. A number of nurses have resigned, despite the fact that medical staff have been threatened that they will never be able to find a job again if they leave.
According to nurses in Lahijan, Saeed Sabahi, the president of Lahijan Milad Hospital, has said that Narges Khanalizadeh’s test results are not yet back, yet the results were due in the morning of Wednesday, February 26. In the meantime, Ms. Jafari, the head nurse at the hospital, has also been hospitalized. The nurses cite lack of transparency by hospital officials as the reason for the resignations in eastern Gilan.
“We told you that in your hospital the nurses face problems and that nothing has been done to solve these problems,” the board of directors of the Nursing Organization of Eastern Gilan wrote in an open letter addressed to the Milad Hospital president. “Since the outbreak of coronavirus, we have acted according to our conscience and our oath and have announced all medical shortages in all medical centers.”
“In performing our nursing duties,” said the letter, “we have no shortage of nurses like Narges [Khanalizadeh]. We might be exhausted and we might be coughing but we have stayed. So, dear doctor, be as good as you are in denials and, please, get to work and do something about our colleagues’ requests and problems.”
In the city of Lahijan, Pirouz Hospital has been dedicated to coronavirus cases but, under pressure from the high volume of visitors, other hospitals, including Shafa and Milad, have also dedicated a number of their wards to coronavirus patients.
At Least 48 Hours for Test Results
“When they admit a patient suspected of coronavirus, they don’t provide us with basic sanitary necessities such as special coveralls or masks, even if the patient displays the early symptoms of infection,” a nurse in Lahijan who asked to remain anonymous says, adding that when they asked for answers they were admonished for wanting “special accessories.” She says that hospitals in Gilan do not have test kits for coronavirus. “It takes at least 48 hours for the test results to come back from Tehran.”
So why haven’t the staff protested against the lack of equipment they so badly need? “We cannot protest,” she says. “They say that they have a letter from the prosecutor’s office that tells them to send the names of nurses who quit working to the governor so that they will not be allowed to work for any hospital in Gilan province. This threat has been sent to all hospitals in the province.”
The official toll for coronavirus cases in Gilan province stood at 17 by the end of Wednesday, February 26. One nurse described this figure as “ridiculous” and tells IranWire, “In China, when patients with coughs, fever, sore throat or difficulty in breathing go to medical centers they are immediately tested for coronavirus. At this stage, they can easily separate those with a simple flu from coronavirus cases.”
“Iran has a limited number of coronavirus test kits,” she says. “They do not test patients who cough or have fever. So many of those infected are not identified at this preliminary stage. Only after this sensitive stage, when the patient’s health deteriorates and cannot breath properly, do they send a sample to Tehran for testing. The figures that they announce is the number of people whose health has deteriorated so much that they need to be hospitalized. Believe me: many people are infected but since the symptoms are mild and no test has been done, they are sent away and become carriers of the virus. This is what is happening in Gilan now. If you ask me, I would say a few hundred people are infected with coronavirus in Gilan, and the number keeps rising.”
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While the Government Was in Denial, She Contracted Coronavirus and Died, 26 February 2020