With a new victim of the coronavirus dying every two minutes, deaths are soaring in Iran, with infections from the new Delta variant skyrocketing and hospitals overfilled.
There are also widespread shortages of oxygen cylinders and other materials as many Iranians are furious with their leaders over a vaccination campaign that lags far behind other countries.
"The situation is catastrophic," says Amir Ali Savadkuhi, the president of Iran's Intensive Care Association. "Hospitals have reached their limit.... Sometimes they just wait for patients to die because there is no treatment [available] for this [number] of admissions."
With the daily official death toll surpassing a record 500 people for the past several days, health experts say the real number of dead and infected is likely to be significantly higher than the reported figures.
Iran has officially recorded over 4 million coronavirus cases since the start of the pandemic and more than 96,000 deaths, numbers that analysts say are underreported.
Many hospitals have run out of beds and overflow areas have been converted to deal with the rise in new cases. With some patients being cared for on the floor, there are warnings that the country's health system is on the verge of collapse.
"We have to reject many patients as we really have no place to hospitalize them. They may lose their lives," Savadkuhi said in an interview with the Khabaronline news site.
Another physician, Hadi Yazdani, said many hospitals were unable to properly treat patients. "At the same time we are facing a shortage of some pharmaceutical items and essentials such as IVs," Yazdani said to the news site Emtedad, warning that health-care workers are suffering from burnout due to the tremendous pressure they face.
Additionally, he said, many hospital workers "have become infected and are in a worrying condition even after receiving two doses of a coronavirus vaccine."
Ritual Spreading
Yazdani was also critical of the ceremonies marking the holy Islamic month of Muharram, in which hundreds or even thousands of people congregate to take part in rituals. While the events are being permitted as long as health safeguards are followed, the guidelines are almost impossible to observe due to the "passion and excitement" of the mourning rituals during Muharram.
A video of a religious event that went viral shows a packed hall where mourners are beating their chests and jumping up and down without masks and no social distancing.
Journalist Yashar Soltani warned of a "massacre" as the result of the gathering and accused the authorities of committing a crime for giving the green light to such events amid a surge of the Delta variant.
The dire situation prompted Supreme Leader Ayatollah Ali Khamenei to declare on August 11 that the pandemic was the country's most urgent issue.
It was in stark contrast to his statements in the early weeks of the coronavirus outbreak last year, when he accused the country's "enemies" of exaggerating the threat of the virus in an attempt to stop people from voting in parliamentary elections.
Khamenei, who in January banned Western coronavirus vaccines after claiming they were not trustworthy, said vaccines must be made accessible to Iranians "in every way possible" through imports and domestic production.
He said some of the countries who had promised to supply the Islamic republic with vaccines had failed to deliver.
Critics say Khamenei's intervention following the deaths of tens of thousands of Iranians came too late.
"Isn't it time for him to be accountable over his contradictory statements? Endangering the lives of 85 million people and the death of hundred thousand is not worth being responsive? prominent film director Jafar Panahi said on Instagram.
Iranian officials have said in the past that U.S. sanctions have made it difficult for them to transfer money to buy vaccines.
The head of Tehran's coronavirus task force, Alireza Zali, was quoted by the media this week as saying that the authorities had not allowed the purchase of vaccines because they thought they were too expensive.
A medical technician works on the production line of Iran's COVIran Barekat vaccine.
Officials said about 21 million doses of vaccines have been imported, mostly from China as well as India and Russia. But Moscow has reportedly only delivered over 1 million doses of the 60 million Sputnik V shots that Russian officials had promised. Japan recently donated about 3 million doses of its locally produced AstraZeneca to Tehran.
Iran has also worked on several domestic vaccines, including COVIran Barekat, which was developed by the state Setad conglomerate amid criticism that the funds spent on the homemade vaccines should have been used to buy Western shots that have proven effective against the deadly virus.
"Every single person who gambled with people's lives for the sake of politics and financial interests, who denied and concealed, lied, remained silent, and gave an unprofessional opinion is a partner to this human tragedy," former reformist lawmaker Parvaneh Salahshouri said on Twitter on August 12, comparing the COVID-19 death toll to the number of Iranians killed in the 1980-88 Iraq war.
Only about 3 percent of Iran's 80 million people -- less than 4 million -- have been fully vaccinated while about 14 million have received their first shot, health officials said.
'Tsunami Of Death'
In a move that raised many eyebrows, new hard-line President Ebrahim Raisi nominated ophthalmologist Bahram Eynollahi -- a signatory to a January letter calling for a ban on Western vaccines -- as his health minister.
"The person who wrote a letter saying vaccines should not be imported is set to become health minister??!!" surgeon Hamid Ahmadi tweeted. "You're kidding, right?"
The situation is said to be particularly alarming in Iran's second-largest city, Mashhad, home to the Imam Reza Shrine, where virus cases have filled so many hospitals that ambulances are straining to respond to emergencies and taxis are being used to help transfer coronavirus patients to health facilities.
Grim videos and photos of the crowded cemetery in Mashhad have been circulating on social media amid reports that hospital morgues are filled with dead bodies.
"This is a tsunami of death," says a reporter in a video at Mashhad's Ghaem Hospital morgue, where bodies are seen outside the coolers and on the floor, with more expected to arrive.
A man who lost four family members to the Delta variant in Mashhad told RFE/RL that the family had struggled to find oxygen cylinders and IVs for his grandmother and three other relatives who had been hospitalized. He said his 86-year-old grandma had received two doses of the Chinese Sinopharm vaccine. But his aunt and two cousins had not been eligible for vaccination when they became sick.
"None of this would have happened if they had been vaccinated," said the man, who said he could not describe the pain his family has been through. "I felt helpless seeing my family members dying one by one. No one cared."
A deputy health minister has warned that the COVID-19 deaths are expected to rise for the next few weeks, while there is no plan for a lockdown despite a recommendation by the outgoing health minister for a two-week shutdown of businesses and other safety measures.
Iran has failed to impose such tight restrictions on society due to the fragile state of its economy, which has been devastated by U.S. sanctions.