By far the country worst affected by Covid-19 in the Middle East, Iran has for weeks been grappling with a fifth wave of infections—the strongest yet. Daily deaths and cases are mounting amid criticism of the government’s handling of the pandemic on social media.

According to the latest official figures, over 12,000 people, including children, have died from Covid-19 in the last two weeks, overwhelming Iran’s rundown public health service. It brings the total death toll to more than 110,000, although the state-run Shargh daily said that “experts believed the actual figure is 2.5 times more.”

Some 7,689 people are in severe condition and are being treated in intensive care units, while more than 600 people are dying every day, including members of Iran’s ruling circle. Last week, local media reported that Hassan Firouzabadi, the chief of Iran’s armed forces until 2016 and then military advisor to supreme leader Ali Khamenei, had died of coronavirus aged 70.

Hospitals are so overcrowded that patients line the floors and the most desperate lay waiting on the streets. Vital medicines are in short supply.

US sanctions on Iran targeting its oil exports, which have suffered a catastrophic loss of $100 billion in revenues, and its access to the US-dominated international banking system, have ravaged the country’s healthcare system, denying it access to pharmaceuticals and medical supplies.

At the same time, Iran’s pro-business clerical regime, by seeking to impose the full burden of the economic crisis caused by the sanctions and the pandemic on the working class and poor farmers to protect the country’s corrupt financial elite, has played a crucial role in allowing the coronavirus to sweep through the population.

Chairing his first cabinet meeting, President Ebrahim Raisi, a member of the “hardline” or “principalist” faction around Khamenei, was forced to admit the scale of the crisis confronting workers and their families. He said that Iran is “seriously lagging behind” in many areas and pledged to improve its economy and Covid response, saying that the current situation “does not befit” the Islamic republic.

However, he failed to announce any measures to reduce the transmission of the disease other than “advising” people to wear masks and maintain social distancing. Raisi lifted a six-day closure and travel ban last month, even as cases were rising.

The pandemic is all but invisible in the country’s heavily censored media, with the president calling for any public discussion of the pandemic to focus on “creating maximum hope and refraining from creating fear and anxiety in the people.” Last month, the Iranian authorities arrested six prominent human rights lawyers and activists who were reportedly preparing a complaint against the government’s mismanagement of the COVID-19 crisis. While one of them was released the next day, the rest were detained.

A health official has admitted the government spent more than $800 million on a drug with a poor record of treating the disease’s symptoms. This money could have been used to purchase more than 160 million doses of the Astra-Zeneca vaccine, more than enough to vaccinate every Iranian adult. Instead, Khamenei banned the purchase of American and British vaccines in January, claiming that the West would use them to experiment on Iranians.

As a result, Iran’s vaccination programme has been slow to get off the ground. Although Khamenei and government officials insisted that Iran was developing its own “safe and effective” vaccines, and that most of the population would be inoculated by mid-summer, problems with its development left the country dependent on the import of vaccines from Russia and China that have only recently become available. According to the Health Ministry, just 9.5 million of Iran’s 85 million population have received their second dose of a vaccine and just under 19.5 million Iranians have received their first.

Last week, 10 prominent Iranian activists, including Narges Mohammadi and Mohammad Nourizad—both of whom served time as political prisoners, and renowned filmmakers Jafar Panahi and Mohammad Rasoulof—wrote to Michelle Bachelet, the United Nations High Commissioner for Human Rights, and other international rights organization. They called for urgent action on Iran’s Covid crisis, including requiring the Iranian government to import vaccines.

They said, “We will be facing terrifying mass deaths in Iran if enough vaccines are not imported to vaccinate everyone in the country,' blaming Khamenei's vaccine ban, the lack of other vaccines and the government's promotion of large religious gatherings that acted as super-spreaders, while stressing that the official figures are not to be trusted.

Iran’s currency has fallen to nearly one tenth of its value since 2017, forcing the government to print money to make up for its loss of foreign income. Inflation is approaching 50 percent, eroding workers’ wages. Government officials have admitted that up to 60 percent of Iranians have fallen below the poverty line, far higher than the 30 percent reported in official statistics, and are unable to afford many food items. New data show that the prices of seven food items, including cooking oil, beverages, mushrooms, tomatoes, butter and carrots, rose more than 100 percent in July compared with last year, along with an increase in the cost of medications.

Real estate prices have also risen after people bought properties to protect their savings, leading to higher rents amid a massive shortage of affordable homes as workers have moved from the drought-affected rural areas to the cities.

Speaking on state television, President Raisi insisted he would deliver on his campaign promise to build one million affordable housing units for sale a year during his term in office. But the scale of the task was revealed in Iran’s business media, which reported it would cost $15 billion a year, more than last year’s oil export revenues. The reports pointed out that at $200 per square metre, even a 50 square metre apartment would cost $10,000, beyond the reach of most workers. Others questioned how electricity and water would be supplied to new homes given the existing power and water shortages.

Strikes and protests that subsided with the onset of the pandemic have now begun to reemerge, including the ongoing strike by contract workers in the state-owned petrochemical industry and protests over the shortage of electricity and water.

On Sunday, hundreds of teachers rallied outside the parliament and the budget and planning building in Tehran to protest the cancellation of a pay increase, agreed by the former Rouhani administration. They chanted, “With Masters and PhD, we are paid a small salary.” Their wages, around $120 a month, are far less than the $400 minimum needed to avoid poverty. Masoud Mirkazemi, the incoming head of the Budget and Planning Organization, dismissed the pay increase as unaffordable and criticized the previous administration for making such a pledge to teachers.

The regime came under further criticism when leaked video clips from security cameras in Tehran's Evin Prison, where many political prisoners are held, revealed the scale of the physical abuse suffered by inmates. According to the website of Iran International, one clip shows police officers attacking a handcuffed prisoner as others look on. Another shows several people trying to prevent the suicide of a fellow prisoner and a third shows inmates carrying another prisoner, presumably to the clinic, without the assistance of wardens.

While all the political factions would like to see the lifting of US sanctions and the revival of the nuclear accord with the major powers—as a way out of the economic, social and political crisis confronting the regime—it is becoming increasingly unlikely that the US will agree to lift all the sanctions reimposed by the Trump administration in 2018, as well as additional ones imposed later. While Raisi has expressed his support for the talks in Vienna to lift the sanctions, he said he would not agree to negotiate under pressure, a reference to the demands by the United States and its European allies not to further delay the talks.

Tehran is hoping to take advantage of the collapse of Washington’s puppet regime in Afghanistan—although relations with the Taliban are by no means good—to improve its bargaining position and is in no hurry to restart the talks, paused in June pending Raisi’s inauguration.

Iran’s new foreign minister Hossein Amir-Abdollahian said it was important for Iran to maintain symmetrical relations, implying that he sought to strengthen relations with Iran’s neighbours and regional countries, and underlined the importance of Asia for the new administration, including the further strengthening of ties with Russia and China, in line with Tehran’s “look to the east” policy.