As Iran faces what looks like its worst wave of the coronavirus pandemic yet, Tehran commuters still pour into its subway system and buses each working day, even as images of the gasping ill are repeatedly shown on state television each night.

After facing criticism for downplaying the virus last year, Iranian authorities put partial lockdowns and other measures back in place to slow its spread.

But in this nation of 84 million people, which faces crushing US sanctions, many struggle to earn enough to feed their families.

Economic pressure, coupled with the growing uncertainty over when vaccines will be widely available in the country, have many simply giving up on social distancing, considering it an unaffordable luxury. That has public health officials worried the worst of the pandemic still may be yet to come.

Worst-hit

Iran is now reporting its highest-ever new coronavirus case numbers — more than 25,000 a day. Its daily death toll has surged to about 400, still below the grim record of 486 it reached in November.

During the peak of Iran’s last surge, about 20,000 coronavirus patients were hospitalised across the country. Today, that figure has topped 40,000. The health ministry warns the number will climb to 60,000 in the coming weeks. Iran remains among the hardest-hit countries in the world and the worst-hit in the Middle East.

President Hassan Rouhani blames the current surge on the fast-spreading variant of the virus first found in Britain, which the government says arrived from neighbouring Iraq. Travel between the countries has been restricted since March, though people continue to cross each day.

Overall, Iran has seen 2.2 million reported cases and 67,000 deaths.

Iran has administered more than 500,000 vaccine doses, according to the WHO. Supplies, however, remain limited.

Iran’s Supreme Leader Ayatollah Ali Khamenei has banned the US and British-made coronavirus vaccines, saying their import is “forbidden” because he does not trust those nations.

Khamenei has approved the import of vaccines from “safe” countries, such as China and Russia, and backed national efforts to produce a homegrown vaccine with help from Cuba.