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| Power Struggle Hampers Iran’s Coronavirus Response | Power Struggle Hampers Iran’s Coronavirus Response |
| (3 months later) | |
| More senior government figures have caught the coronavirus in Iran than anywhere else. Field hospitals have been erected in parking lots, stadiums and wedding halls to handle the overflow of patients. | More senior government figures have caught the coronavirus in Iran than anywhere else. Field hospitals have been erected in parking lots, stadiums and wedding halls to handle the overflow of patients. |
| A top health official implored Iranians on Tuesday to avoid spreading the contagion by not traveling during the upcoming Persian New Year, saying anyone who ignored the advice was “inviting death.” | A top health official implored Iranians on Tuesday to avoid spreading the contagion by not traveling during the upcoming Persian New Year, saying anyone who ignored the advice was “inviting death.” |
| Iran has one of the world’s worst outbreaks, which kills at least 100 people and infects more 1,000 each day, yet with so much at stake, nobody knows who’s in charge. | Iran has one of the world’s worst outbreaks, which kills at least 100 people and infects more 1,000 each day, yet with so much at stake, nobody knows who’s in charge. |
| Iran’s strategy for fighting the pandemic has been vexed by power struggles within its hierarchy that have erupted publicly. | Iran’s strategy for fighting the pandemic has been vexed by power struggles within its hierarchy that have erupted publicly. |
| An extraordinary burst of contradictory messages in recent days has angered many of the country’s 80 million citizens, already stressed by severe American economic sanctions, unemployment and mistrust of their leaders. | An extraordinary burst of contradictory messages in recent days has angered many of the country’s 80 million citizens, already stressed by severe American economic sanctions, unemployment and mistrust of their leaders. |
| Some are even hoping the Islamic Revolutionary Guards Corps and other parts of the military will take charge and enforce quarantines. For many Iranians, such wishes were unthinkable just a few months ago, when the Guards crushed antigovernment protests and covered up the shooting down an airliner, killing 176 people. | Some are even hoping the Islamic Revolutionary Guards Corps and other parts of the military will take charge and enforce quarantines. For many Iranians, such wishes were unthinkable just a few months ago, when the Guards crushed antigovernment protests and covered up the shooting down an airliner, killing 176 people. |
| “We need leaders who know what they are doing to take control and bring order. The generals are better at this than the government,” said Mehdi, a 46-year-old restaurant owner in Tehran and father of two, who has kept his family indoors for weeks. | “We need leaders who know what they are doing to take control and bring order. The generals are better at this than the government,” said Mehdi, a 46-year-old restaurant owner in Tehran and father of two, who has kept his family indoors for weeks. |
| In phone interviews and texts, supporters and opponents of President Hassan Rouhani’s government heavily criticized what they called its poor judgment, incompetence and failure to comprehend the severity of the crisis. | In phone interviews and texts, supporters and opponents of President Hassan Rouhani’s government heavily criticized what they called its poor judgment, incompetence and failure to comprehend the severity of the crisis. |
| Many simply ignore government warnings about exposure. Siamak Ghassemi, an economic analyst in Tehran, posted a photo Tuesday on Twitter of shoppers jamming Tehran’s bazaar in a preholiday buying binge. | Many simply ignore government warnings about exposure. Siamak Ghassemi, an economic analyst in Tehran, posted a photo Tuesday on Twitter of shoppers jamming Tehran’s bazaar in a preholiday buying binge. |
| “This picture is the failure of all of Rouhani and his government’s policies and rhetoric in battling coronavirus,” he wrote. | “This picture is the failure of all of Rouhani and his government’s policies and rhetoric in battling coronavirus,” he wrote. |
| Iran’s dual power structure — a religious supreme leader controlling the armed forces, and a president heading a civilian administration — has long been a recipe for factional rivalry. Interviews with officials, medical workers and political analysts suggest that it has left management of the epidemic reeling, without a clear commander. | Iran’s dual power structure — a religious supreme leader controlling the armed forces, and a president heading a civilian administration — has long been a recipe for factional rivalry. Interviews with officials, medical workers and political analysts suggest that it has left management of the epidemic reeling, without a clear commander. |
| “It is a bit chaotic, that’s a good way to put it,” said Henry Rome, an Iran analyst at the Eurasia Group, a political risk consulting firm. While the government is not at risk of collapse, he said, officials “do not want to cause panic, or shut down what’s left of the economy, or implicitly admit they made a mistake.” | “It is a bit chaotic, that’s a good way to put it,” said Henry Rome, an Iran analyst at the Eurasia Group, a political risk consulting firm. While the government is not at risk of collapse, he said, officials “do not want to cause panic, or shut down what’s left of the economy, or implicitly admit they made a mistake.” |
| Mr. Rouhani and his top health officials have struggled as the information they offered was publicly disputed and their strategies backfired. Even their effort to blame American sanctions, which obstruct Iran’s ability to purchase medical supplies and have weakened its health system, is seen as an excuse. | Mr. Rouhani and his top health officials have struggled as the information they offered was publicly disputed and their strategies backfired. Even their effort to blame American sanctions, which obstruct Iran’s ability to purchase medical supplies and have weakened its health system, is seen as an excuse. |
| Ayatollah Ali Khamenei, Iran’s paramount leader, issued a written order last Thursday asking Maj. Gen. Mohammad Bagheri, the commander-in-chief of the Joint Armed Forces — an umbrella for the army, the Revolutionary Guards and security forces — to take charge. | Ayatollah Ali Khamenei, Iran’s paramount leader, issued a written order last Thursday asking Maj. Gen. Mohammad Bagheri, the commander-in-chief of the Joint Armed Forces — an umbrella for the army, the Revolutionary Guards and security forces — to take charge. |
| While he told the military to work with the civilian government, Mr. Khamenei effectively authorized it to sideline Mr. Rouhani’s government if needed. | While he told the military to work with the civilian government, Mr. Khamenei effectively authorized it to sideline Mr. Rouhani’s government if needed. |
| Almost instantly the infighting and conflicting public messaging began. | Almost instantly the infighting and conflicting public messaging began. |
| In a closed meeting on Friday, the two sides clashed on strategy, according to four people with knowledge of the meeting. | In a closed meeting on Friday, the two sides clashed on strategy, according to four people with knowledge of the meeting. |
| Mr. Rouhani demanded that the armed forces adhere to his command. The generals refused and said Mr. Khamenei had authorized them to act independently. | Mr. Rouhani demanded that the armed forces adhere to his command. The generals refused and said Mr. Khamenei had authorized them to act independently. |
| The military men proposed closing off Tehran and vast swaths of the country, shutting businesses and limiting people’s movements — and using the armed forces to enforce the restrictions, as China and Italy have. | The military men proposed closing off Tehran and vast swaths of the country, shutting businesses and limiting people’s movements — and using the armed forces to enforce the restrictions, as China and Italy have. |
| Mr. Rouhani refused, arguing that his government has no resources to support millions of people under quarantine. Basic services could collapse, he said, hurtling the nation deeper into crisis. | Mr. Rouhani refused, arguing that his government has no resources to support millions of people under quarantine. Basic services could collapse, he said, hurtling the nation deeper into crisis. |
| The standoff spilled into view with conflicting comments that infuriated the public. | The standoff spilled into view with conflicting comments that infuriated the public. |
| Rebutting accusations that Mr. Rouhani was downplaying the threat, his top adviser, Hesamedin Ashena, wrote on social media, “He declared the country was running business as usual in order to prevent the collapse of the bureaucratic system and chaos.” | Rebutting accusations that Mr. Rouhani was downplaying the threat, his top adviser, Hesamedin Ashena, wrote on social media, “He declared the country was running business as usual in order to prevent the collapse of the bureaucratic system and chaos.” |
| Apparently ignoring Mr. Rouhani, General Bagheri said on Friday that the military would severely restrict traffic, close businesses and clear people off the streets in Tehran and at least 11 provinces. He said volunteers attached to the armed forces would survey every Iranian household to identify potentially infected patients and set up field hospitals for screening and treatment. | Apparently ignoring Mr. Rouhani, General Bagheri said on Friday that the military would severely restrict traffic, close businesses and clear people off the streets in Tehran and at least 11 provinces. He said volunteers attached to the armed forces would survey every Iranian household to identify potentially infected patients and set up field hospitals for screening and treatment. |
| Barely two days later, Mr. Rouhani said there would be no shutting of cities, no lockdowns, no forced closure of businesses. | Barely two days later, Mr. Rouhani said there would be no shutting of cities, no lockdowns, no forced closure of businesses. |
| “This rumor that in Tehran or other cities businesses and shops will be quarantined is not happening,” Mr. Rouhani said. He also berated governors who had sounded alarms that their provinces should be cordoned off. | “This rumor that in Tehran or other cities businesses and shops will be quarantined is not happening,” Mr. Rouhani said. He also berated governors who had sounded alarms that their provinces should be cordoned off. |
| By Monday, Mr. Rouhani appeared to have dissuaded the military from imposing strict rules. But local authorities defied him, independently closing provinces and several cities. | By Monday, Mr. Rouhani appeared to have dissuaded the military from imposing strict rules. But local authorities defied him, independently closing provinces and several cities. |
| “The only way left to control the situation now is to militarize the response and force people to stay home,” said Dr. Kamiar Alaei, an Iranian health policy expert and president of the Institute for International Health and Education in Albany, N.Y. While Mr. Rouhani fights moves that undermine his power, he added, “the people here are collateral damage.” | “The only way left to control the situation now is to militarize the response and force people to stay home,” said Dr. Kamiar Alaei, an Iranian health policy expert and president of the Institute for International Health and Education in Albany, N.Y. While Mr. Rouhani fights moves that undermine his power, he added, “the people here are collateral damage.” |
| Since the outbreak in Iran began last month, officials have accused the Health Ministry of hiding the true toll. | Since the outbreak in Iran began last month, officials have accused the Health Ministry of hiding the true toll. |
| Updated June 12, 2020 | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | |
| Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission. | |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | |
| The official tallies spiked on Tuesday to 988 dead and more than 16,000 infected, but health experts and several Iranian officials say the real numbers are much higher because too few people have been tested for the virus. | The official tallies spiked on Tuesday to 988 dead and more than 16,000 infected, but health experts and several Iranian officials say the real numbers are much higher because too few people have been tested for the virus. |
| Dr. Alaei estimated that as 100,000 have been infected. | Dr. Alaei estimated that as 100,000 have been infected. |
| Mr. Rouhani’s critics have denounced his decision to permit flights to and from China, where the epidemic originated; his refusal to restrict internal travel or close off hot spots; and his delay in creating an emergency response committee. | Mr. Rouhani’s critics have denounced his decision to permit flights to and from China, where the epidemic originated; his refusal to restrict internal travel or close off hot spots; and his delay in creating an emergency response committee. |
| Many Iranians, hearing an alarming mix of fact and rumor, have sheltered at home, while others don’t know what to believe. Bodies have piled up at hospital morgues and at least one cemetery in Qom has dug mass graves, satellite photographs show. | Many Iranians, hearing an alarming mix of fact and rumor, have sheltered at home, while others don’t know what to believe. Bodies have piled up at hospital morgues and at least one cemetery in Qom has dug mass graves, satellite photographs show. |
| Mr. Rouhani has been mocked for being mostly absent from public view and downplaying the threat. His policy has appeared to center on keeping up the appearance of business as usual, to project control and ward off more economic hardship and social unrest, analysts said. | Mr. Rouhani has been mocked for being mostly absent from public view and downplaying the threat. His policy has appeared to center on keeping up the appearance of business as usual, to project control and ward off more economic hardship and social unrest, analysts said. |
| On the matter of Shiite shrines, the government drew fire from multiple directions. Mr. Rouhani refused calls to quarantine the holy city of Qom, Iran’s first hot spot. He wanted to shutter some shrines like those that draw pilgrims to Qom, but hard-line clerics balked. | On the matter of Shiite shrines, the government drew fire from multiple directions. Mr. Rouhani refused calls to quarantine the holy city of Qom, Iran’s first hot spot. He wanted to shutter some shrines like those that draw pilgrims to Qom, but hard-line clerics balked. |
| Mr. Khamenei last week approved an order shutting down two popular shrines, in Qom and Mashhad, where crowds mingled, prayed and touched the walls and tombs for blessing. | Mr. Khamenei last week approved an order shutting down two popular shrines, in Qom and Mashhad, where crowds mingled, prayed and touched the walls and tombs for blessing. |
| After they were padlocked on Monday, hundreds of men, apparently organized by hard-line factions in seminaries, stormed both shrines, breaking open the doors and overrunning security forces who pleaded with them not to enter, videos on social media showed. | After they were padlocked on Monday, hundreds of men, apparently organized by hard-line factions in seminaries, stormed both shrines, breaking open the doors and overrunning security forces who pleaded with them not to enter, videos on social media showed. |
| Iranians on social media then berated the government for what they called its double standard: Security forces shot unarmed protesters last November, but did not curb religious zealots who threaten public health. | Iranians on social media then berated the government for what they called its double standard: Security forces shot unarmed protesters last November, but did not curb religious zealots who threaten public health. |
| “Corona has peeled off the layers of skin to expose them for who they really are,” said Mohamed Javad Akbarin, a religious and political activist, in a Twitter post. | “Corona has peeled off the layers of skin to expose them for who they really are,” said Mohamed Javad Akbarin, a religious and political activist, in a Twitter post. |
| Rick Gladstone contributed reporting. | Rick Gladstone contributed reporting. |