Coronavirus cases have spiked in Iran, raising fears of a second wave of infections in the region’s epicentre and threatening to spread not only to the Eastern Arab World but to Iran’s non-Arab neighbours.

Having contained the first wave by early May, Tehran had begun to lift restrictions when more than 3,000 cases were reported on consecutive days last week.  This amounted to the biggest daily peak since 3,100 cases were confirmed on March 30th. Since the first infections were reported on February 19th the number of cases has multiplied to more than 169,425 with 8,209 deaths.

The Shia pilgrimage cities of Qom and Mashad were initially infected by the virus due to connections with China’s Hubei province, where Covid-19 originated.  Tehran soon became a major centre of contagion with some provinces remaining far less infected. Lockdown and social distancing brought down the rate despite Iran’s severe lack of tests, protective gear for medical staff, and medicine for treatment, largely due to sanctions. The authorities tackled the spread province by province.

However, nine of the country’s 31 provinces are still considered “health emergencies.” These include the ethnic Arab-majority, oil-rich south-western province of Khuzestan which has been branded a “red zone.”  As this province borders on Iraq, lies near Kuwait, and is located a short distance from UAE shores, Khuzestan has become a particularly dangerous source of regional spread.

Among the other eight “hot” provinces are those which border on Turkey, Azerbaijan, Afghanistan, and Pakistan, all countries suffering from high infection rates. Turkmenistan does not report any cases but is suspected of having a coronavirus crisis like its neighbours. From the states bordering Iran, the virus can continue to spread throughout the Indian Subcontinent, Central Asia, and the Balkans. Therefore, it is essential that the virus be contained in Iran.

There are three main reasons for the current spike.  The authorities argue that Iranians have stopped observing restrictions. According to a recent poll, popular belief in physical distancing has dropped from 90 per cent to 40 per cent and trust in stay-at-home orders has fallen from 86 to 32 per cent. Health Minister Saeed Namaki warned, “People seem to think the coronavirus is over. The outbreak is not over yet, and at any moment it may come back stronger than before.” This is, of course, true everywhere if the authorities loosen their grip on the behaviour of citizens and lift restrictions too widely and too early. President Hassan Rouhani has said that restrictions can be imposed if the public does not pay attention to measures designed to contain the virus.

Mismanagement is a second cause of the spike. Iran has no consistent policy for dealing with the health crisis and the government bows to the will of influential clerics, their devout congregations, and merchants. They have pressed the authorities to lift restrictions before there was a steady decrease in cases for 14 days.  For example, mosques reopened on May 12th to celebrate the nights of Laylat al-Qadr during Ramadan. Two weeks later cases nearly doubled and fatalities almost trebled.

Finally, years of punitive sanctions have undermined Iran’s health services, denied essential medications, reduced access to food, and, by preventing Iran from exporting oil, cut funding for infrastructure projects. These sanctions have been toughened and tightened over the decades since the Iranian revolution  in 1979. Initial sanctions were imposed by Washington after the US embassy was invaded by radical Iranian students in that November and detained staff for 444 days. Their highly publicised ordeal deepened US hostility toward the Iranian revolutionary regime which had deposed Washington’s loyal ally Shah Reza Pahlavi. Consequently, subsequent rounds of sanctions adopted by Europe and the UN have been driven by US resentment and hostility toward the clerical regime which not only disrupted strategic Iran’s intimate relations with the US but also backed the Palestinians in their struggle for liberation from occupation by US ally Israel.

The main focus of sanctions since 2006 has been Iran’s nuclear programme, which Tehran argues is for peaceful purposes, but the US and Europe have viewed as a path to manufacturing nuclear weapons.  Sanctions were ramped up in 2012, markedly decreasing oil exports and making it difficult if not impossible for Iran to trade internationally due to sanctions on Iran’s Central Bank and leading firms. The country’s economy registered negative growth and the value of the currency fell vis-a-vis the US dollar. Reduction of Iran’s imports of cancer, HIV, heart and other essential drugs put thousands of Iranian lives at risk and compromised the health of Iranians suffering from fatal diseases.

The 2015 deal between Iran and the five permanent UN Security Council members plus Germany for the dismantling of 90 per cent of Iran’s nuclear programme in exchange for lifting UN (but not US) sanctions, provided considerable relief between January 2016 and May 2018.  Iranian benefits were far less than had been expected because the US, through its control of the dollar as the main global reserve currency, and threats against countries and firms seeking to do business with Iran, blunted the positive impact of the lifting of some sanctions.

In violation of the nuclear deal and despite opposition from its other five signatories, the Trump administration withdrew from the deal in May 2018, began to reinstate sanctions, and obstructed trade with Iran — even in humanitarian goods which were, and are,  meant to be exempt from sanctions. US officials made it clear sanctions were intended to harm Iranian civilians with the aim of forcing them to compel the government to change its behaviour or to rise up against the regime. At the end of 2019, Human Rights Watch argued that Trump administration sanctions have had a major negative impact on the  “human rights of the affected population, especially regarding their access to goods essential to life, including medicines and food.”

The administration has refused to relax these sanctions since the coronavirus appeared in Iran in February, making it all the more difficult for Iran’s government and international humanitarian organisations to contain the virus and prevent its spread. The second wave of infections in Iran serves as a warning to the US and the international community that as long as Iran remains an coronavirus epicentre, the greater the risk of cross-border spread in every direction — north, south, east and west. The battle against Covid-19 must be won at every and any front, however great or small. For, as long as the virus remains contagious it is a danger to us all.