DUBAI, United Arab Emirates (AP) — Appearing before the cameras coughing and sweating profusely, the man leading Iran's response to the new coronavirus outbreak promised it was of no danger to his country.

"Quarantines belong to the Stone Age," Iraj Harirchi insisted.

A day later, he himself would be in quarantine from the virus.

Harirchi's story is a microcosm of what has happened in Iran amid the coronavirus pandemic. Roughly nine out of 10 cases in the Middle East come from the Islamic Republic, which has reported over 16,000 people infected and at least 988 deaths amid fears that cases may still be underreported. While most people who are infected recover, the virus spreads rapidly and can kill the elderly and those with breathing problems or other underlying illnesses.

Days of denials gave the virus time to spread in Iran as the country marked the 41st anniversary of its 1979 Islamic Revolution with mass demonstrations and then held a parliamentary election in which authorities desperately sought to boost turnout. Now, state television warns the virus could kill “millions” as its supreme leader issued a religious order Tuesday banning “unnecessary travel.”

Although Iran has one of the Mideast's best medical services, its hospitals appear to be overwhelmed and authorities have asked for 172 million masks from abroad. It also has asked the International Monetary Fund for $5 billion, the first such loan for Iran since 1962.

The Islamic Republic has an opportunity to limit the virus with the approach of the Persian New Year, Nowruz. The rare religious decree by Supreme Leader Ayatollah Ali Khamenei curtailing travel in the country could help, but it came days after Iraq and Lebanon, both allies of Iran, restricted movement while facing a fraction of the reported infections.

What happens next will not only affect Iran's civilian government and Shiite theocracy, whose officials already have fallen ill, but also the wider world.

“Judging by the fact that Iran has now asked for a $5 billion loan from the IMF, this speaks to how dire the situation is getting and them realizing that it's spun out of control,” said Dr. Amir A. Afkhami, an associate professor at George Washington University who studies Iran.

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‘PATIENT ZERO’ AND AN ELECTION

In a country like Iran, where the state controls all broadcasters and journalists face restrictions, many things about the outbreak remain unknown. Chief among them is who was “patient zero” — the person who was first infected with the coronavirus in the nation, and where.

Public comments point to the city of Qom, 125 kilometers (80 miles) southwest of Tehran, on the country's windswept central desert plateau. How the virus arrived there remains in question.

Authorities suggested that perhaps an Iranian businessman returned from China with the virus. Qom is home to major Shiite seminaries that draw Chinese students. It also is along a $2.7 billion high-speed train route that a Chinese company is building, a sign of China's outreach to Tehran amid crushing U.S. sanctions. China is also constructing a solar power plant there.

From late January, worries could be seen on the front page of the pro-reform newspaper Aftab-e Yazd.

"Mysterious virus at Iran's gates," its banner headline warned as China began a lockdown to control the outbreak.

Yet travel between China and Iran continued.

The first two coronavirus cases were reported Feb. 19, with the announcement that both died in Qom. Since it can take up to two weeks to show symptoms, they could have gotten it in early February.

Iranian authorities haven't offered any details. Iran analysts suggest it might be because the country marked the 41st anniversary of the Islamic Revolution during that period.

Iran also held parliamentary elections Feb. 21. The government desperately wanted a large turnout to boost its legitimacy after shooting down a Ukrainian passenger jet, killing all 176 people on board. Days earlier, a U.S. drone strike in Baghdad killed top Revolutionary Guard Gen. Qassem Soleimani, further shaking its credibility.

Iranian authorities already had disqualified thousands of candidates from running, ultimately tilting the election to conservatives. Supreme Leader Ayatollah Ali Khamenei even later accused foreign enemies of trying to influence turnout with the outbreak.

"The pretext of an illness and virus was used, and their media did not miss the slightest opportunity to discourage people from voting,” he said.

The election saw Iran's lowest turnout since the revolution, with some voters wearing the masks that everyone soon would want. But people already were dying and fear was spreading.

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SHRINES AND HAZMAT SUITS

Qom long has been the stronghold of Iran's Shiite clergy. A focal point of devotion is the golden-domed shrine of Fatima Masumeh, a Shiite saint. Crowds pray there 24 hours a day, seven days a week, touching and kissing the shrine.

That raises the risks for visitors. In Saudi Arabia, authorities have closed off access to the holiest sites in Islam over concerns about the virus. Churches, mosques, temples and shrines around the world have been closed or subject to stringent disinfecting campaigns.

But in Qom and elsewhere in Iran, the shrines stayed open despite civilian health authorities demanding they close. Mohammad Saidi, who oversees the Fatima Masumeh shrine, insinuated that closing shrines was part of a plot against Shiites by President Donald Trump.

“Defeating Qom is the dream of treacherous Trump and his domestic mercenaries, but this dream will not be realized even in their grave,” Saidi said on Feb. 22.

That decision likely gave the virus time to spread. Police later arrested those who posted online video of themselves licking and kissing shrines.

“The city’s religious epithet — ‘the nest of the Prophet and his family’ — was intended to reassure believers worldwide that it was insulated against epidemics and other disasters,” wrote Mehdi Khalaji, a Qom-trained Shiite theologian who is an analyst at the Washington Institute for Near-East Policy. “If early reports about the spread of the coronavirus prove correct, Qom’s status as the ideological capital of the Islamic Revolution helped make it the pathogen’s transmitting center to the rest of Iran and at least seven other countries.”

Since then, hazmat-suited workers have fogged disinfectant and cleaned the shrines. Some mosques even hand out alcohol as a disinfectant to the poor despite Islam forbidding its consumption.

The Fatima Masumeh shrine and another one in Mashhad had closed by Monday night, only to see online videos purporting to show hard-line faithful storming the shrines' courtyard, demanding they open.

By that point, the virus had spread, reaching the highest levels of Iran's theocracy.

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‘THE SITUATION IS TERRIBLE HERE AND I HOPE GOD HELPS US’

Like blood from a beating heart, the infections in Qom coursed out across Iran in maps later shared by the Health Ministry. In Tehran, the virus began moving through the government and the Shiite theocracy.

Among those first infected was Harirchi, the deputy health minister who tested positive only a day after he downplayed the virus in a televised news conference.

It didn't stop there.

The virus killed Expediency Council member Mohammad Mirmohammadi, described as a close confidant of Khamenei. Hadi Khosroshahi, Iran’s former ambassador to the Vatican, and Ahmad Tuyserkani, an adviser to Iran’s judiciary chief, also died along with several lawmakers and a member of the country's Assembly of Experts.

The sick included Vice President Masoumeh Ebtekar, better known as “Sister Mary,” the English-speaking spokeswoman for the students who seized the U.S. Embassy in Tehran in 1979 in the 444-day hostage crisis. The virus also infected senior Vice President Eshaq Jahangiri and two other Cabinet members, along with Revolutionary Guard members and doctors.

Soon, even 80-year-old Khamenei was seen wearing disposable gloves at a tree-planting ceremony. President Hassan Rouhani, 71, was pictured at a teleconference with the nearest official a few meters (several feet) away.

The numbers soared. Iran's death rate from the virus now is higher than in other hard-hit nations.

That could be from the initial lack of testing kits and facilities. It also could be from what outside experts, Tehran lawmakers and other local leaders have alleged from the start: Iran was hiding the true number of infections and deaths.

Authorities initially denied that, especially after the BBC's Persian service said deaths far exceeded those reported at the beginning of the crisis. But that denial appeared to weaken over time.

“We found out a little late that the coronavirus had entered Iran because we mistook it for the flu,” Reza Malekzadeh, a deputy health minister, later said.

A man in Qom filmed rows of bodies in black bags and caskets awaiting burial for days in a trench lined with lime. He alleged all had tested positive for the coronavirus, although officials later said the bodies had been held pending test results.

“The situation is terrible here and I hope God helps us,” he said while walking through the mortuary.

Authorities later arrested him.

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PAST EXPERIENCES, NEW WORRIES

Diseases have influenced Iranian history. Cholera outbreaks plagued its Qajar dynasty, long indebted to British and Russian powers. The chaos and debt set the stage for Iran's 1906 Constitutional Revolution and the creation of parliament.

That cholera outbreak saw Shiite religious leaders lash out at the West. Now, Iranian leaders, such as the head of its Revolutionary Guard and Khamenei himself, traffic in the baseless conspiracy theory that the coronavirus is a biological weapon created by the U.S., something echoed by Chinese officials as well.

“The psychology of the leadership in Iran has sort of an almost self-destructive need to double down on a lie just to sort of portray itself as competent,” Afkhami said.

That's contrasted with the response to the El Tor strain of cholera that caused a pandemic through the 1960s. Iran produced millions of vaccine doses and inoculated its people, controlling its spread. It even gave broad-range antibiotics from the U.S. to pilgrims visiting Shiite shrines, Afkhami said.

“This rapid mobilization and this rapid response allowed the country to control the epidemic," he said.

That was under Iran's shah, toppled in the 1979 revolution. But even after, Iran fought off other outbreaks, and its hospitals, doctors and nurses are known as some of the best in the wider Middle East, with a network of clinics from villages to big cities.

However, the system appears to be stretching at the seams, with online videos purporting to show field hospitals going up. Meanwhile, Iran's 80 million people, whose sense of high risk has been dulled by years of international isolation, crowd into grocery stores and butcher shops, suspicious of anything in the state media.

Nowruz, the Persian New Year, looms on Friday, a holiday when millions travel. The government repeatedly had stopped short of ordering any major travel restrictions. It didn't explain why, but there could be worry about further angering its people or slowing down its anemic, sanctions-hurt economy.

Online videos showed Iranians ignoring government demands to stay home and moving instead toward the coast of the Caspian Sea and the Persian Gulf. Residents of hard-hit Rasht, on Iran's coast, have threatened to attack out-of-towners.

“We expect that, God willing, we can contain the rising trend of the disease, not the disease itself, by March 26," said Harirchi, the health official who is recovering from COVID-19. "But I say this very frankly: if the great people don’t cooperate, the disease will continue to be there until late May or even in June, and turn into a huge crisis.”

And the man who once called quarantines a thing of the past added: "I beg the people to minimize their trips and contacts, and isolate the infected people from others completely.”

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