Iran ranks third, after Italy and China, for the number of coronavirus deaths worldwide. As of March 19, 1,284 people have died and 18,407 have been infected, according to the Iranian Ministry of Health. The World Health Organization (WHO), however, suspects the actual numbers could be five times higher. As in many other countries struggling with the coronavirus pandemic, a paucity of tests means the actual extent of the crisis is unknown. Iran, moreover, suffers of another vulnerability: as the new coronavirus is particularly lethal among people with chronic respiratory illnesses, there is an estimated 100,000 Iranians who suffer of such conditions as a result of having been exposed to chemical-weapons attacks by Saddam Hussein during the 1980-88 Iran-Iraq War.
As the government appears to be digging mass graves in order to cope with an out-of-control number of deaths, the hospital system – usually performing well on the regional average – struggles to take care of the infected, as doctors and nurses fight on the frontline while also trying to keep the spirits up. Among the population, many are self-quarantined, many others try to keep calm and carry on, others again gather to protest against measures such as the closure of the mosques imposed by the government early this week. While there is not a single and unified reaction, what seems to be prevailing in these days is a sense of uncertainty and suspension: that edge-of-the-cliff sensation that Iran has been experimenting for multiple times in the last months.
But apparently the worst has yet to come: researchers at the Sharif University of Technology in Tehran elaborated three scenarios for the spread of the coronavirus: in the best-case scenario – i.e. the government quarantines all high-risk areas, people strictly obey these rules, and access to sufficient medical supplies is guaranteed – the peak of the pandemic would be reached in one week, with the death toll exceeding 12,000. If people half-cooperate, the death toll would increase to 110,000. In the worst-case scenario, i.e. the government being unable or unwilling to enforce a full quarantine, people not cooperating, and medical supplies being unreachable, the peak would be reached only at the end of May, and the death toll would rise to 3.5 million. It seems quite clear at this stage that the best-case scenario is fully out of reach: the government has not – yet – imposed a full quarantine, and medical supplies are off-limits due to persisting US sanctions.
The Iranian response
But how did we get there? As other governments worldwide, Iran too was taken by surprise, coming up with a delayed response. In the initial stage, Tehran did not take precautionary measures to restrict and monitor travellers from China, as Beijing is currently providing an important lifeline to Iran’s struggling economy. Nevertheless, it is impossible to correctly assess the difference those measures could have made, as the coronavirus can have reached the country way before the global alarm rang. In the following stage, however, what caused the virus to spread was the restrain to impose a full national lockdown, mainly for fear of further harming an already battered economy. The initial restrain at closing shrines, for fear of alienating religious devotees, also caused the epidemic to grow. The government has thus tried to contain the spread of the virus by restricting access to severely hit cities and provinces – such as Qom and Gilan –, by promoting social distancing, and by undertaking severe sanitation efforts. More recently it took the unprecedented step of closing shrines and cancelling the Friday prayer in major cities. It also released on temporary furlough 85,000 prisoners, among which the Iranian-British dual national Nazanin Zaghari-Ratcliffe and the American citizen Michael White.
Most of all, the current crisis has revealed in all its urgency the dramatic humanitarian implications of the strict US sanctions regime: Iranian Foreign Minister Mohammad Javad Zarif called for the suspension of such sanctions, also providing a list of the medical material Iran urgently needs and is prevented access to. As a matter of fact, anyone seeking to trade via the recently established Swiss channel is required to receive a written undertaking from the US that they will not be sanctioned for sending medical supplies to Iran. Tehran also took the unprecedented step of requesting a 5$ bn loan to the International Monetary Fund (IMF), although it is unclear if it will ever receive it, as the United States may use its veto on the IMF board to block the transfer of funds to Iran.
Moreover, a lack of clarity and some competition among different power centres in Iran further complicates the picture. While President Hassan Rouhani rejects the hypothesis of a full national lockdown, the military seems prone to impose a curfew. Mohammad Bagheri, the chief of staff of the armed forces, said he intends to bring the situation under control within 10 days. Iran’s Supreme Leader, ayatollah Khamenei, seems to be trying to manage these contrasts, by stressing the need for coordination and national unity.
A perfect storm gathering
While it is unclear what will come next, it seems like Iran is in the midst of a perfect storm. A storm which began in May 2018, when the USA unilaterally withdrew from the Joint Comprehensive Plan of Action (JCPOA) and imposed punitive sanctions on the country, which severely hurt the Iranian economy. Since then, the Iranian population has been caught in the middle of this storm: the growing confrontation between Washington and Tehran that over the last months has repeatedly brought the two countries to the brink of war; the massive demonstrations that erupted in Iran following the government’s decision to raise gasoline prices and the bloody suppression that followed; the US killing of Qassem Soleimani and the Iranian accidental shoot-down of a Ukrainian airliner.
While the coronavirus pandemic is a tragedy worldwide, it is clear that for Iran it comes at the worst-possible moment. While other countries, as in the European Union, are trying to mitigate the devastating impact of the economic crisis that will follow by providing social safety nets and by adopting macroeconomic policies to prevent economic collapse, Iran will struggle to provide a safety net for its population, further aggravating the legitimacy crisis the Islamic Republic is currently going through.
This is exactly the chaos scenario which the US administration seems to be betting upon. The decision, early this week, to introduce further sanctions exactly as Iranian leadership and the international community call for a relaxation of existing measures, indicates that the Trump administration still considers “maximum pressure” as the best strategy to achieve its goals, despite the evident failure of such a strategy over the last months.
Conclusion: A time for Health Diplomacy
Instead, this would be the time for some health diplomacy, just like the one the US found in the past with China during the SARS outbreak (but escapes Sino-American relations today). Diplomacy, in this moment, could prove useful in de-escalating tensions between Iran and the US and could give Iranian people some relief from the daily suffering they are subject to. The medical furlough Iran has granted to US citizen Michael White could represent a first step in this direction. It is up to the United States now to correspond with some sanction relief which could offer temporary respite and provide a basis for future negotiations.
A little diplomatic breakthrough seems to be currently undergoing in the Gulf, as four members of the Gulf Cooperation Council (Qatar, the UAE, Kuwait, and Oman) have so far expressed solidarity and delivered aid to Iran. While this was somehow expected from Qatar, Kuwait, and Oman, the Emirates response seems to be corroborating the de-escalation efforts carried out by the UAE towards Iran over the last months. Still missing, however, is Saudi Arabia (and Bahrain). For Riyadh, too, this could be an occasion to mitigate tensions with Tehran, while opening up a pathway for regional cooperation on specific, this time health-related, common concerns. As the global nature of the pandemic has revealed, there are no borders, no walls, and most of all no armies which can substitute for inter-states cooperation.
Lastly, as far as the European Union is concerned, an increased and twofold diplomatic effort would be welcomed. While Europe struggles with the coronavirus pandemic itself by closing its external borders, it should not abdicate its aspiration to play a global role: this should translate in this moment in pressuring the United States to provide Iran with sanctions relief and in trying to facilitate a regional initiative in the Gulf bringing together Iran and the GCC in coordinating a common response to the shared coronavirus threat.
If there is one lesson the coronavirus pandemic is teaching us, this is that as we are all sailing in uncharted waters, we should all be looking for opportunities to try to get the best out of the current crisis.