The coronavirus outbreak in Iran is among the most severe in the world and by far the largest in the Middle East, with official figures saying some 500 people have died and more than 11,000 are infected.
But there are several indications the outbreak in the Islamic republic -- whose government is known for its opaqueness and censorship -- is far worse than authorities are admitting.
Since the start of the crisis, parliament members and local officials in some of the major epicenters of coronavirus in the country have said the real number of dead and those infected is being grossly understated by the clerical regime that rules Iran.
There are also numerous reports of hospital staffs being warned not to discuss the numbers of deaths and infections from coronavirus with the media.
Amid widespread public distrust of the government, the authorities have given daily updates on the number of coronavirus deaths and infections in Iran while reassuring the public they're acting swiftly to contain the crisis.
But many Iranians believe officials failed to take decisive measures from the beginning of the outbreak, which has claimed the lives of several state officials -- including an adviser to Supreme Leader Ayatollah Ali Khamenei -- and infected many others, including two vice presidents, more than 20 parliament deputies, and former Foreign Minister Ali Akbar Velayati, a top foreign-policy adviser to Khamenei.
Velayati, a pediatrician, is also president of Tehran's Masih Daneshvari Hospital, a leading center for the treatment of people infected with the coronavirus.
Iran reported its first two deaths on February 19, indicating that the outbreak erupted days earlier and that the authorities failed to inform the public about it as it was trying to get voters to take part in the February 21 parliamentary elections.
Well-known Iranian public-health expert Kamiar Alaei, the co-founder and co-president of the New York-based Institute for International Health and Education, said the real number of coronavirus infections in Iran could be five times higher than official figures.
Alaei, who helped implement an HIV-prevention program in Iran before he was arrested with his brother and sentenced to prison on accusations of spying, said a mix of state secrecy as well as poor data collection were behind Iran's underreported figures.
"If you look at the numbers -- and a deputy health minister also said a few days ago -- most of the reported cases are those [who are] hospitalized while about 80 percent of those infected with coronavirus have light symptoms and only about 15 percent go to the hospital," Alaei told RFE/RL, citing a Chinese study. "Therefore, the figures that are being released only represent about 20 percent of the reality of the society."
According to such reasoning -- that the actual figures are some five times higher than the Health Ministry is reporting -- the March 13 official figure of 11,364 people infected would mean there could be some 56,000 coronavirus infections in Iran.
That would make it second in the world after China, which has registered 80,815 cases.
Disparity In Numbers
On March 8, a news site affiliated with Iran's state-controlled television quoted Mohammad Hossein Ghorbani, a Health Ministry official in Gilan Province, one of Iran's worst-hit regions, as saying that 200 people had died from coronavirus just in Gilan.
The same day, a Health Ministry spokesman said the countrywide death toll stood at 194.
Shortly after publishing Ghorbani's comments, which were widely quoted by other media, the Young Journalists Club issued a "correction" that said Ghorbani actually said 21 had died in Gilan from the coronavirus and that the 200 dead included people who had died from other illnesses, including heart and respiratory problems.
That incident follows accusations the government has covered up the extent of the disease's spread in the country amid reports that hospitals and health-care workers have been overwhelmed by the crisis.
On March 9, Kashan Governor Alireza Mortezai said in an interview that in just his city and Aran Bigdol -- both in Isfahan Province -- 88 people had died from the coronavirus and more than 1,000 people had been infected.
The same day, the Health Ministry reported only 601 infections in the entire province of Isfahan. It listed the death toll for the entire country as 237.
Earlier, on February 24, Qom lawmaker Ahmad Amirabadi-Farahani claimed that the death toll from the disease in the holy Shi'ite city he represents was about 50 people -- four times higher than the official number of dead from coronavirus for the entire country.
Deputy Health Minister Iraj Harirchi, who a day later announced he had contracted the coronavirus, insisted the death toll in the country was only 12.
Ali Vaez, the director of the Iran Project at the International Crisis Group (ICG), said that while Iran's response was catching up with the standard results issued on the coronavirus by the World Health Organization (WHO), "[Iranian officials'] numbers are still unreliable at best, untrue at worst."
"The Islamic republic has institutionalized mendacity in ways that the people no longer trust the government, even if their lives depended on it," Vaez told RFE/RL, adding that "the culture of lies has cultivated widespread cynicism throughout society."
Failure To Quantify
Alaei said in that order to contain the outbreak, Iran needed to improve its data-collection ability and be transparent about the outbreak. "More people need to be tested," he said. "When only about one-fifth of the real cases are being reported, how can the situation be controlled as [many] of those infected don't even know it themselves."
"WHO said it has provided Iran with 100,000 test kits while Russia also announced it will give Iran 50,000 [test kits]," said Alaei, who added that Western countries should provide Iran -- which is facing crippling U.S. economic sanctions -- with more tests.
Prominent analyst Abbas Abdi, one of the Iranian students who stormed the U.S. Embassy in 1979, wrote in a piece published in the reformist Etemad daily this week that the Health Ministry did not want to admit that it doesn't have enough tests. "As a result, they are silent, and they satisfy themselves with releasing the official figures, which they know do not match reality," he said.
The coronavirus outbreak has exacerbated the country's economic woes, prompting a request to the International Monetary Fund for a $5 billion loan to help fight the virus.
On March 9, health officials reportedly issued a directive telling hospitals that all deaths with strong clinical signs of the coronavirus should be registered as definitive fatal cases of the disease. Since then the number of reported deaths has increased.
A tally by RFE/RL's Radio Farda, based on statements by local officials and local news reports, found that since the beginning of the outbreak in Iran until March 9, 927 people had died after contracting the coronavirus.
Health Ministry spokesman Kianush Jahanpur, who gives daily updates to the media about the crisis, has denied accusations that Tehran has been hiding real figures.
Asked about the inconsistencies between official numbers and figures by local officials, Kianpur said his ministry did not have any reason to cover up the extent of the outbreak in the country, claiming that "misunderstandings" were among the reasons for the discrepancies in numbers.
"But of course we can't consider someone to be infected without testing [them] and having laboratory evidence," he said on March 10.