Confusion and fear as Iran says millions may have virus

President Hassan Rouhani's recent announcement that 25 million Iranians may have been infected with the coronavirus, a figure drastically higher than the country's official tally, has left many perplexed and fearful.

The shock statement came five months after Iran announced its first COVID-19 cases: the deaths of two people in the Shiite holy city of Qom.

It was compounded by Rouhani's suggestion his government was now hoping to overcome the Middle East's worst outbreak via herd immunity.

"Our estimate is that up to now 25 million Iranians have been infected with this virus," Rouhani told a virus taskforce meeting on Saturday.

Citing the results of a health ministry study, he warned that "30 to 35 million more may face infection" in the future and added that Iran had "not yet achieved herd immunity".

The number is far higher than the 15 million cases recorded worldwide and significantly more than some hard-hit countries such as the United States and Brazil.

It was also nearly 100 times worse than Iran's official infection figure of over 270,000 cases issued at the time by the health ministry.

Iran's toll has continued to climb since, with the virus having officially claimed 221 lives between Wednesday and Thursday, while infections climbed by 2,621.

Since he announced Saturday's massively elevated estimates, Rouhani has not mentioned them again, let alone elaborated.

But a slew of officials have since come up with their own explanations, with some saying the 25 million does not refer to full-blown infection cases but to all those who were "exposed" to COVID-19 and may now have a level of immunity.

- 'Strategic mistake' -

Iran's deputy health minister for research and technology said the figure was an estimate based on research carried out in March "on about 10,000 people in 13-14 provinces".

"It's been proven so far that these people's immunity is stable, meaning that they are like those vaccinated," Reza Malekzadeh told state news agency IRNA on Monday.

He did not name the provinces where this testing had taken place. Iran's population is more than 80 million.

A second deputy health minister, Alireza Raisi, said in a television interview that the figure of 25 million had been derived from serology tests.

Such tests are for antibodies and detect whether an individual has been exposed to any type of coronavirus, not just COVID-19, he said on Tuesday.

"In Iran and the world, various studies have been done on COVID-19 and the 25 million is the result of one such study and should not be seen as anything more than that," he said.

Raisi also denied Iran was now seeking to overcome the virus through herd immunity.

"Herd immunity is in no way part of (Iran's) policy and countries that have done it eventually regretted doing so," he said.

"There will be no immunity until we have a vaccine."

Responding to a suggestion that mentioning such figures and herd immunity may alarm the public, Raisi said in a veiled criticism that "emphasizing such numbers is a strategic mistake".

Yet according to Dr Emma Hodcroft, a molecular epidemiologist at the University of Basel, the estimate of "a country-wide seropositivity rate of 30 percent, from numbers given, would be far, far higher than we've found in any other country."

In an email to AFP, she noted that numbers that high were only found in "very hard-hit areas" like New York city, which is much smaller and more densely populated than Iran.

Hodcroft also warned against extrapolating numbers from antibody tests to the whole population, especially if they were done in very hard-hit areas of the country.

- 'Frightening' -

Many on Tehran's streets appeared confused or disturbed by the president's statistics and complained of not having received an explanation.

"The way Mr. Rouhani put it, this means almost the whole population of Iran" have been or will be infected, said a 50-year-old businessman who only gave his name as Ashrafi.

"So, observing health protocols has been for nothing?" he added, saying the numbers were "frightening".

He also complained that Health Minister Said Namaki should have been the one who explained the figures and any move toward herd immunity.

Ashkan Daliri, a hairdresser in his 20s, said he believed the numbers to be real and "a bit scary".

He said he thought the announcement was meant to make "the people face reality so that they would be scared into observing health protocols more".

He added that herd immunity might be an effective way to control the outbreak, even though "it would mean more people would die".

An art teacher named Rezayi said she did not believe the numbers were actually so high.

"And even if they are, it's still hard to accept them given how the president has denied his statements before," she said.

She was referring to a comment Rouhani made days after the start of Iran's outbreak in February, when he said "everything will return to normal" within a few days.

Having come under criticism for seemingly trying to normalize the crisis, the government's spokesman later said that Rouhani meant a return to normal decision-making procedures by state bodies.

© 2020 AFP