Iran may have many more coronavirus cases than reported, Canadian research suggests

The Star – The true number of coronavirus cases in Iran may be upwards of 18,000, according to a preliminary analysis by Canadian researchers, suggesting an epidemic there nearly 200 times larger than what the country has reported — and a situation with potentially grave global consequences.

A spokesperson for Iran’s health ministry said Tuesday that the country had 95 confirmed cases of COVID-19, as the disease caused by the novel coronavirus is called, and 15 deaths.

The true extent of the outbreak is “not only concerning to people in Iran, but also to Canadians and everyone else on the planet,” said Isaac Bogoch, a co-author of the analysis and an infectious disease specialist at Toronto General Hospital and the University of Toronto.

“We’re so interconnected that this is not just an Iranian problem.”

Experts have expressed concern that the extent of the outbreak in Iran is under-reported, and that uncontrolled transmission in the country could have profound consequences for limiting the global spread of the disease. Iran shares borders with or has close ties to several countries — including Iraq, Afghanistan and Syria — that have little to no capacity to detect or contain infections.

The Canadian scientists, a group of infectious disease specialists and mathematical modellers, crunched numbers over the weekend to estimate the real size of the epidemic in Iran. The results were published Tuesday on medRxiv, a website that posts preliminary research that has not yet been peer-reviewed and published in a journal.

The team based its analysis in part on the number of international cases linked to Iran.

On Thursday, British Columbia reported a confirmed case of COVID-19 in a person who had recently travelled from Iran. At that time, Iran was reporting just five confirmed cases.

“Red flags went up,” said Bogoch.

“If you’re talking about five cases in Iran, what is the probability that one of those five cases in a population of 81 million would get on an airplane? It’s pretty small,” said Ashleigh Tuite, a co-author on the analysis and an adjunct faculty member at the Dalla Lana School of Public Health at U of T.

“When you start seeing imported cases of disease from another location, that usually means there is a fairly substantial amount of disease activity” in the country of origin, said Tuite.

The team drew on flight and tourism data, as well as estimates about the disease itself, to mathematically model how big the outbreak in Iran is likely to be for those cases to appear.

Lebanon and the United Arab Emirates have also reported Iran-linked cases.