Day 35 - #COVID19 in Iran

Picking up from yesterday https://twitter.com/aliostad/status/1245444254555660294?s=20
Read carefully before trusting what I post https://twitter.com/aliostad/status/1234023015584759808?s=20
[Analysis/0]

I feel I am entitled to put a little analysis of my own on the situation.

[TLDR; Takeaway is the same: sacrifice of the medical workers, relatively modern and prepared medical infrastructure and young population prevented a disaster]
[Analysis/1]

First of all, medical staff (doctors, nurses and non-care staff) have shown a unique sacrificial character - unseen for many years, perhaps since Iran-Iraq war. Medicine had become pretty materialistic in Iran (like US) and that is why this is very important.
[Analysis/2]

I have first-hand reports of many nurses and doctors not going home and eating/sleeping in hospital, forgetting all about duty rota. This is - as said - partly due to the sacrificial spirit in the moment of desperate need, and partly not to infect their families.
[Analysis/3]

They are all overworked, tired and keep working even when they have #COVID19.

This is Dr. Yahyavi, haematologist/oncologist in Bojnurd in one of his endless shifts. He later died of #COVID19. https://twitter.com/MahdiarSaeedian/status/1245579661880385537?s=20
[Analysis/4]

Doctor Shirin Rouhani-Rad carried on working with a drip in her veins. She later died of #COVID19. https://twitter.com/Tavaana/status/1240574582148321280?s=20
[Analysis/5]

Now authorities are making a march victory out of this sacrifice. But they have done very little. Even during the PPE shortage in Gilan province, ultimately it was the local benefactors who supplied much needed PPEs by purchasing them from the black market.
[Analysis/6]

Another point is a relatively modern medical infrastructure with up-to-date and scientific medical practices which is unparalleled in the whole region.

Iran is a favourite destination for health tourism from wealthy Gulf countries as well as Iraq, etc.
[Analysis/7]

They usually fly for elective operations such as beauty, eye, etc and there are several companies set up the provide facilities end to end - from the airport right back to the airport.

Estimates are roughly around 300K tourists a year - number 10 worldwide.
[Analysis/8]

Iran is a very young country: age median is 30.8 years (e.g. UK is 40.5) and >87% of the population are under 55.

This means the population can weather the disease better, less need for ICUs and many people will overcome #COVID19 with little or no intervention.
[Analysis/9]

Here is median age of countries for comparison:

- China: 37.4
- Iran: 30.3 (others say 30.8)
- UK: 40.5
- Spain: 42.7
- Italy: 45.5
- USA: 38.1

That can explain significant number of deaths in Italy while Iran is not doing as bad.

https://en.wikipedia.org/wiki/List_of_countries_by_median_age
[Analysis/end]

#COVID19 in Iran has reached relative stability for now since:

- Medical staff sacrifice
- Modern medical infrastructure and practices
- Very young population

Early to be fully optimistic but this explains somewhat we can be more optimistic.
[Analysis/PS]

People of Iran have been through a lot - and that is throughout the Persian history. They possess an unusual power to just carry on in the face of a difficult situation.

Witnessing this spirit first-hand made Abbas Kiarostami make this film
https://en.wikipedia.org/wiki/Through_the_Olive_Trees
President Rouhani who had said "Everything goes back to normal by Saturday" a few weeks ago, now is saying that this outbreak could last until the end of Persian Year (March 2021) https://twitter.com/IranIntl/status/1245617439955542016?s=20
There are confirmed reports of up to 15 deaths in the prison riot in Ahvaz (1.2M) which I had reported earlier. There are rumours of using military helicopter in controlling the riot. https://twitter.com/ShahedAlavi/status/1245480045415673856?s=20
Now that the Persian New Year holidays are over, the government should make a decision on when civil servants should resume their activity.

Current plan? There isn't one. https://twitter.com/Entekhab_News/status/1245628978670342144?s=20
Since very early on with the #COVID19 outbreak, the parliament had been suspended - to protect MPs. Today they were supposed to use tele-conferencing for virtual session. Enough MPs failed to show up and the session was cancelled. https://twitter.com/Entekhab_News/status/1245628978670342144?s=20
Dr Majid Farhad, a GP in Kashan (304K) has died of #COVID19.

A very high number of #COVID19 infections reported among medical staff in Kashan - a hotspot for the disease. https://twitter.com/MahdiarSaeedian/status/1245693265590079488?s=20
Doctors Without Border (MSF) in Iran still waiting for permission to do any actual work - this is after more than 2 weeks.

- They came by invitation
- After arrival told they cannot do any work
- Then told they can help foreign nationals in Iran

Not yet. https://twitter.com/dw_persian/status/1245662417348177920?s=20
Focus of the media in Iran currently is less on #COVID19 and more on the escalation of tensions between US and Iran and their close-tie Iraq Militia. While everyone had anticipated imminent military confrontation of some form, it has remained verbal so far https://twitter.com/Yossi_Mansharof/status/1245700118013186050?s=20
Head of the parliament, Ali Larijani, is now positive with #COVID19. https://twitter.com/IranIntl/status/1245733819820408838?s=20
Friday Prayer Imam of Nurabad (117K), a remote town in Fars Province (4.85M) has said if Supreme Leader allows, 'We can set up health and hygiene stations in Italy & France'.

There is a victorious mood among the hardline base thinking 'they' won vs COVID. https://twitter.com/IranIntl/status/1245748229188222978?s=20
BTW, earlier quoted tweet has been retracted https://twitter.com/Yossi_Mansharof/status/1245747209951498241?s=20
Roots of this victorious mood among the hardline base, summarised all in this picture.

Everything is just a show of presence and an illusion of control. This is what Baseej (popular mobilisation) and IRGC been doing.

While the real fight was being fought by the medical staff.
More on MSF crew in Iran. As I said they have not got yet any permission to help with #COVID19 for Iranians or even foreign nationals.

Apparently IRGC has presented a court case against MSF to the Attorney General. https://twitter.com/beehnam/status/1245766139097030656?s=20
#IMPORTANT About to share some important experimental trial that has provided great result so far.

Essentially this draft of a paper from Farid Jalali, a clinician (GI) in California suggests micro-thrombosis is what kills in #COVID19...
(cont.)

http://farid.jalali.one/covid19emailpdf.pdf
... as such, anti-thrombotic treatment can be life-saving in severe cases. Dr. Jalali has pleaded with me that this is a vital information for the medical staff.

If you need to reach out to Dr. Jalali you can find him here

http://www.saddlebackmedicalgroup.com/MeetOurDoctors/MedicalStaff/DrFaridJalali.aspx
... anyway, this is an experimental treatment with anti-coagulants and it is being argued that it is NOT ARDS that kills but micro-thrombosis due to endothelial damage as a result of cytotoxic activity.

SO READ AND SHARE THE LINK BELOW [saving lives]:
http://farid.jalali.one/covid19emailpdf.pdf
Dr. Jalali also explained his view on the collapsed cases seen in Iran, China, etc. He believes these are advanced #COVID19 cases with CVA-like incidents. We are unsure of the fate of such patients to know exactly what the cause is but seems plausible.
Dr. Amjadi, Dentist in working for State TV in Tehran (9M), has died of #COVID19. https://twitter.com/aliostad/status/1245790350368702464?s=20
Leaving you with the news that according to Reuters, hackers linked to Iranian regime had tried to hack emails of the staff working for WHO, sometime in March

Stay safe. https://twitter.com/IranIntl/status/1245740815344979973?s=20
Thread continues here: https://twitter.com/aliostad/status/1246014371454767104?s=20
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