Ongoing outbreak of COVID-19 in Iran: challenges and signs of concern

摘要: Abstract Since the first outbreak in China, Coronavirus Disease 2019 (COVID-19) has rapidly spread around world. Iran was one of countries outside China to report infections with COVID-19. With nearly 100 exported cases various other countries, it since been epicentre Middle east. By examining age-stratified COVID-19 case fatality rates across country and 14 university hospitals Tehran, we find that, younger age groups, reported on 13/03/2020 only capture less than 10% symptomatic population. This indicates significant levels under-reporting Iran. Using 18 full-genome sequences from a travel history or link Iran, as well full genome sequence obtained within country, estimate time most recent common ancestor which suggests likely start 21/01/2020 (95% HPD: 05/12/2019 - 14/02/2020) an approximate doubling 3.07 1.68 16.27). Also, based known Oman, Kuwait, Lebanon, size 25 February 6 March be 13,700 CI: 7,600 33,300) 60,500 (43,200 209,200), respectively. Knowing at two points typical times associated epidemics Europe North America, can independently verify that epidemic is 15/01/2020 (27/12/2019 24/01/2020). Our assessment fate current non-pharmaceutical interventions implemented by government upward 10 million (IQR: 6.7×106 1.8×107) 100,000 ICU beds required 7.7 × 104 1.4 105) during peak more cumulative deaths 1.8 105 2.4 105). We also predict demand for 21/04/2020 06/04/2020 23/05/2020). The large span result separate peaks, occurring 15/4/2020 second approximately months time. latter expected last longer relatively relaxed social distancing measures place. exact magnitude timing peaks strictly depends change significantly upon new information policy. caution lack of, relaxed, stringent intervention measures, period highly under-reported spread, would lead healthcare system becoming overwhelmed next few months.