People wear protective face masks and gloves as they visit Tajrish market, Tehran, Iran, March 2020
Ali Khara / WANA (West Asia News Agency) via REUTERS

The novel coronavirus is advancing across the Middle East, straining frail public health services and exacerbating preexisting political and sectarian tensions, both within states and between regional rivals. Most of the region’s earliest cases of COVID-19, the disease caused by the new virus, were traced to the holy city of Qom in Iran, whose renowned Shiite seminaries and Sayyida Fatimah al-Masumah shrine draw aspiring clerics and devout pilgrims from across the Shiite world.

Iranian officials have given conflicting accounts of how the virus first arrived in Qom, alternately blaming Chinese Muslim students in the city’s religious seminaries and Chinese workers building a high-speed rail line there. What has since become clear, though, is that once the virus reached Qom, a city of about 1.2 million people, it spread quickly. Iran’s government reported two deaths from COVID-19 in Qom on February 19, the first time it admitted that the virus was present in the country. By February 27, cases had been reported in 24 of Iran’s 31 provinces. And as of March 23, the virus had infected more than 23,000 people in Iran and killed more than 1,800, including at least a dozen government officials; because coronavirus testing in Iran is limited to the most severe cases, the World Health Organization has said that the true number of infected people in Iran could be up to five times higher than the official figure.

Iranian President Hassan Rouhani’s government was slow to respond to the outbreak, resisting calls for widespread quarantines and travel restrictions and downplaying the scale of the crisis. After weeks of hesitation, on March 16, Rouhani ordered many of the country’s most important shrines to close. The decision—unprecedented in Iran, where shrines are typically open 24 hours a day—was furiously denounced by clerics and sparked demonstrations by conservative Iranians. But leaving the religious sites open as long as he did could prove to have been a deadly mistake—for Iran and for the wider Middle East.


Every year, millions of Shiite pilgrims from all over the world visit a circuit of shrines in Iran, Iraq, and Syria, kissing or touching each one to obtain a blessing through the connection to the member of the Prophet Muhammad’s family that the particular shrine honors. During the early days of the coronavirus epidemic, shrines became major viral vectors, infecting Shiite pilgrims—some of whom had underlying health conditions or were elderly—who then spread the disease throughout the region.

On February 21, Lebanon confirmed its first case of COVID-19, a 45-year-old woman who had recently returned from Qom. On February 24, the governments of Iraq, Bahrain, Oman and Kuwait announced their first cases of coronavirus infection, and by March 2, Qatar and Saudi Arabia had reported cases as well; in all six countries, the earliest coronavirus patients had recently traveled to Iran.

Though the novel coronavirus originated in China, Iran’s handling of the outbreak quickly made it the target of fear and anger.

Though the novel coronavirus originated in China, Iran’s handling of the outbreak quickly made it the target of fear and anger. U.S. Secretary of State Mike Pompeo said that the United States was “deeply concerned” by reports that Iran had suppressed information about its domestic coronavirus infection rates. U.S. Marine Corps General Kenneth McKenzie, head of the U.S. Central Command, warned the Senate Armed Services Committee that the coronavirus outbreak was likely to make Iran “more dangerous rather than less dangerous.”

Iran’s neighbors were quick to cast blame on the Islamic Republic as well. Bahrain’s interior minister, General Sheikh Rashid bin Abdullah al-Khalifa, accused Iran of “biological aggression that is criminalized by international law” for covering up the outbreak and failing to stamp Bahraini travelers’ passports. On its official Twitter account, Saudi Arabia’s Ministry of Foreign Affairs condemned Iran for “creating a health threat which endangers mankind.” And a newspaper in the United Arab Emirates claimed that all coronavirus cases in the region were linked to Iran—even though the UAE’s first COVID-19 cases were Chinese tourists from Wuhan (and the cases, which were the first to be reported in the Middle East, were confirmed on January 29, weeks before the outbreak in Qom became public).


Saudi Arabia and Bahrain have cracked down heavily in recent years on political dissent among their Shiite populations, which are often politically marginalized, stigmatized for their religious beliefs and practices, and suspected of loyalty to Iran. The coronavirus crisis now appears to be amplifying anti-Shiite prejudice and discrimination. After Saudi Arabia’s first COVID-19 cases were found in the predominantly Shiite eastern region of Qatif, the region was put under quarantine, and the Saudi Health Ministry called on people who had traveled to Iran to declare themselves to the authorities. Though travel to Iran is a crime in Saudi Arabia, some Saudis travel there via third countries. Dozens of Saudi Shiites responded to the health ministry’s request by admitting that they’d traveled to Iran; as coronavirus cases in the kingdom have risen, some of their countrymen have taken to Twitter to blast them as traitors and call for their execution. Bahrain has begun using the coronavirus crisis as a pretext to track the movements of its Shiite citizens and has asked those who have traveled to Iran to identify themselves by calling a hotline (though travel to Iran is not a crime as it is in Saudi Arabia, Bahraini Shiites who admit having done so have reason to fear repercussions).

The coronavirus crisis now appears to be amplifying anti-Shiite prejudice and discrimination.

In Lebanon, which was already in a state of deep political and financial crisis, the coronavirus pandemic has also exacerbated political and sectarian tensions. The nation’s most powerful political and military force, Hezbollah, has strong ties to Iran, and Lebanon allowed flights from Iran to continue until the second week of March. Iran’s support of Hezbollah is fiercely contested, and the rival parties have politicized the virus, using it to criticize Iran’s influence in Lebanon. The recently appointed Lebanese health minister had the backing of Hezbollah in a recent government formation in the wake of large anti-government protests. The country and its capital, Beirut, have been on total lockdown since March 21, but many Lebanese fear the scale of the crisis is much bigger than the government is admitting. Lebanon’s health system is already stretched thin, with 1.5 million Syrian refugees living in the country (the highest number, per capita, in the world), and a serious outbreak in Lebanon could be calamitous.

Syria and Yemen have yet to officially report any cases of the new coronavirus to the World Health Organization (in a television interview, Syria’s health minister claimed that the country was free of COVID-19 and praised the Syrian army for cleansing the country of “germs”—a reference to the killing of Syrians who oppose the ruling Baath Party). But given Iran’s close economic and military ties to both countries, it seems unlikely that they will be spared. And after years of war, the spread of the coronavirus in Yemen or Syria, or in the camps hosting millions of Syrian refugees in Jordan, Turkey, and Lebanon, is likely to be devastating. From a security perspective as well as a humanitarian one, the coronavirus crisis in the Middle East is shaping up to be a crisis of epic proportions.

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  • TOBY MATTHIESEN is a Senior Research Fellow in the International Relations of the Middle East at the University of Oxford and is writing a global history of Sunni-Shiite relations.
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