As the world hunkers down to face the global outbreak of COVID-19, also called the coronavirus (or “Wuhan virus,” depending on one’s political inclinations), the focus of world attention has shifted from its origin point of China—where aggressive containment measures have seemingly worked to counter the exponential growth of those infected—to Italy, where a swift eruption of cases in the north has led to an effective shutdown of the entire country. Lost in this frantic and spastic global attention span is how hard the virus has been hitting Iran. Exclusive reports from doctors inside the country reveal a state of disorganized chaos, little to no accurate information, and scarce resources that limit the ability of the health-care system to cope with the flood of new cases.Iran currently has the third-worst outbreak of COVID-19 following China and Italy, with as of Friday 514 official deaths since the first reported case on Feb. 19. Speculation that the situation there is far, far worse than official accounts indicate has been bolstered by the relatively large number of Iranian upper echelons—regime officials, clerics, and members of the Islamic Revolutionary Guard Corps (IRGC)—who have contracted the disease, some of them fatally.Additionally, several countries have discovered cases of COVID-19 that originated with travelers from Iran in the early days of March. One of the first cases in New Zealand came from a family who had recently traveled to the Islamic Republic. At least three of the first 12 cases in Canada came via Iran, as did all 33 initial cases in Iraq. In the United States, the first confirmed COVID-19 case in New York City was a health-care worker who had returned from Iran, and Los Angeles also identified a coronavirus patient from Iran who passed through LAX. India evacuated hundreds of Indian Muslim pilgrims from affected areas in Iran, many of whom tested positive for the coronavirus. And in Lebanon, reports indicate—difficult to confirm—that Hebzollah officials (possibly including Secretary-General Hassan Nasrallah himself) had contracted the virus from an Iranian delegation that visited the country headed by the speaker of Iran’s parliament, Ali Larijani. There are also reports of new cases in China that were transmitted there by travelers from Iran.According to one doctor in Tehran, accurate figures on infection and death rates are nonexistent. The situation in cities like Rashat in Guilan province and Kashan in Isfahan province, both close to the outbreak epicenter of Qom, is especially severe, with full hospitals and patients being sent home without being admitted. Hospitals in Guilan, he said, are admitting upwards of 200 patients a day with a 2% to 3% mortality rate and not enough kits to test new arrivals. “Unfortunately, both the government and the Ministry of Health were in a state of shock due to the rapid and surprising outbreak,” a second doctor told Tablet.There are also rumors circulating that the regime was burying the bodies of anti-regime protesters killed in riots last November together with coronavirus victims in order to mask their causes of death.As a result, the natural instinct is to blame Iran’s totalitarian and secretive nature for the fact that the crisis there is likely much worse than is being reported. The same happened in China, which initially tamped down news of the outbreak for weeks, and later provided falsely reassuring statements regarding both its scope and the virus’ transmission potential. Additionally, the breadth and nature of emergency measures that can be brought to bear by police states like China and Iran, with little to no regard for civil liberties or legal structures, would imply that the latter could have found itself in a position to counter the spread similarly to the former. Indeed, some reports even indicate that the close ties between the two countries could be to blame for the initial spread of COVID-19 to the Islamic Republic.So, why is Iran so different?First off, there is the Iranian regime itself and its modus operandi: The ayatollahs painted themselves into a corner by initially downplaying the severity of the virus due to the legislative election held on Feb. 21—two days after the first reported case in the country. Graeme Wood, who estimates the number of potential cases in Iran could be in the millions, writes in The Atlantic that “Iran’s government told its people that the United States had hyped COVID-19 to suppress turnout, and Tehran vowed to punish anyone spreading rumors about a serious epidemic.”And so, the paranoia frequently wielded by the ayatollah regime as a psychological cudgel made the still-developing story a convenient tool to convince Iranians to head to the polls. Despite the reported turnout in the election sitting at 43%—the lowest since the 1979 revolution—the regime’s dismissal of the risk in order to drive higher turnout rates may have ended up acting as a catalyst for the outbreak. In an ironic twist, officials later blamed the virus for lower turnout rates.There is also evidence to indicate that the regime was well aware of the danger at that point, following reports that Tehran began digging massive burial pits on Feb. 21 in the Shia holy city of Qom—the epicenter of Iran’s outbreak and the site of several Chinese infrastructure projects, which could have served as the initial conduit of transmission. China is investing heavily in Iran due to the economic sanctions imposed on it, which also play a part in the country’s weakened health-care system and its inability to deal with the outbreak.The problem is additionally compounded by a general lack of public trust in the regime, which initially scoffed at containment measures, only to reverse course shortly afterward, leading to panic buying and distrust of subsequent official updates provided by the government. The paranoia so carefully cultivated in Iranians by their leaders had risen up against its makers, to the detriment of containment efforts. Other acts of defiance were also tied to Iran’s religious traditionalism, such as the licking of shrines in Qom, and public objections from clerics to a lockdown, citing an American conspiracy to undermine Iran’s religious establishment by tying the virus to the holy city.Thus, despite sharing the Chinese Communist Party’s paranoia-wielding, autocratic police state proclivities, the Iranian regime, fearing widespread panic, did not initiate a lockdown in Qom in the same way that China had for the 60 million residents of Hubei province once matters got out of hand. Instead, it focused on stemming the flow of information by, among other measures, threatening health-care providers into silence. On top of this, the regime’s ability to deploy resources to combat the virus is apparently so lacking that it has requested a $5 billion loan from the International Monetary Fund—Iran’s first such request since the early 1960s. The ayatollahs—whose message of steadfast resistance to United States-led Western aggression has maintained a psychological stranglehold on their population for decades—have been reduced to publicly groveling for financial assistance from international organizations in order to deal with the crisis.The real scope of Iran’s COVID-19 outbreak has not yet become clear, and it remains to be seen whether the ayatollahs can maintain stability in the face of such a public health crisis, which has only been made worse by the theocratic regime’s totalitarian tactics, whiplash policies, and the state of international isolation and economic sanctions that it has brought on its own people by its pursuit of nuclear weapons, development of ballistic missiles, threats against neighboring and regional countries, and genocidal warfare in Syria—policies that the regime is continuing even as it buries its own people in open pits.***Additional reporting by Avideh Motmaen-Far. Read Tablet’s continuing coverage of the coronavirus pandemic here.