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WASHINGTON Iran has the highest reported number of deaths from the coronavirus outside China, raising questions about how the government is handling the public health crisis and whether the often secretive regime has been fully transparent about the extent of the outbreak.

Iran's health ministry spokesman said on Friday that 34 Iranians have died out of a total of 388 positive cases. Iran has now suspended parliament indefinitely due to the outbreak.

Four doctors in Iran who are familiar with how authorities are handling the outbreak, including two who work at hospitals where infected patients have been treated, told an NBC News reporter in New York that the total number of those infected is likely substantially higher than the number released by health authorities.

Dr. Mike Ryan, executive director of the World Health Organizations emergencies program, told reporters Thursday that the virus "came unseen and undetected into Iran, so the extent of infection may be broader than what we may be seeing."

U.S. Secretary of State Mike Pompeo told Congress Friday that the U.S. had offered to help Iran respond to the virus.

Apart from China, where it was first detected in December, Iran has recorded the most deaths from the new form of coronavirus. There have been 2,747 deaths in China, out of a total of at least 78,497 confirmed cases.

But Iran's reported mortality rate now just nine under percent surpasses the rate for other countries by a wide margin. Earlier this week, it was 16 percent. China's reported mortality rate is currently at 3.5 percent. In South Korea, 13 patients have died out of 1,766 cases, for a reported mortality rate of slightly less than 1 percent. A U.S. soldier is among those infected in South Korea.

A top official in Iran, Masoumeh Ebtekar, the highest ranking woman in Irans government and a vice president for women and family affairs, has tested positive for the corona virus, state media reported, the latest senior official to contract the COVID-19 illness. Ebtekar, the English-speaking spokesperson for the group of Iranian students who seized hostages at the U.S. embassy in Tehran in 1979, was captured in a photo attending a meeting with Iranian President Hassan Rouhani on Wednesday.

Two members of Irans parliament have contracted the virus as well as the deputy health minister, who was seen wiping his brow and looking feverish at a press conference a day before he announced he had tested positive.

While the government has imposed some restrictions on holy sites and called off some Friday prayer services, President Rouhani has said there are no plans to quarantine entire cities hit by the virus.

Amid a shortage of surgical masks and hand sanitizer in shops, public health experts say Iran could become the hub of a major outbreak across the Middle East, especially given its porous borders with unstable countries at war or in turmoil.

Iranian officials reported the first case of virus in the religious city of Qom last week, and coronavirus has spread to at least seven other provinces. Other countries in the region, including Iraq, Kuwait, Oman and Afghanistan, reported their first cases this week and said the patients had recently visited Iran.

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In an echo of public reaction in China, critics of the Iranian regime in and outside the country are questioning whether officials in Tehran have given the public a full and accurate picture of the outbreak. But Iranian officials have rejected any suggestion that they are playing down the epidemic.

Full coverage of the coronavirus outbreak

The head of Medical Science University in Qom, Mohammad Reza Ghadir, said on state television that the Health Ministry had banned releasing figures on the outbreak in the city.

Asked how many people had been placed in quarantine, Ghadir said, "The Health Ministry has told us not to announce any new statistics."

Ghadir also said that "most of the tests have to be done in Tehran, and Tehran announces it." His comments suggested that diagnostic tests were mainly being conducted in the capital.

Outside medical experts said reporting on the total number of cases of infection in Iran was possibly lagging behind reporting on deaths. That could be because Iranian authorities are missing less severe cases across the country because of how they are testing and diagnosing patients, because of how information is shared or because of flawed medical equipment.

"This appears to be a reporting issue," said Yanzhong Huang, director of the Center for Global Health Studies at Seton Hall University and a senior fellow for global health at the Council on Foreign Relations. "Reporting on the cases of infections may have fallen behind the reporting on the deaths."

It's unclear whether Iran has the ability to find out how many people have been infected, which would require venturing out to towns and villages to conduct tests and not simply relying on who goes to large hospitals with severe symptoms, said Dr. William Schaffner, a professor of preventive medicine and infectious diseases at Vanderbilt University Medical Center.

"That means going to the neighborhood and knocking on doors and really aggressively trying to find cases," Schaffner said in an interview. "I don't know if they have that capacity. Many countries do not, and they don't have that tradition in their public health systems. This would be a very new thing for them to do."

Another possibility is that the patients are from an elderly, more vulnerable part of the population, Schaffner said.

If the virus "was introduced to a population that was older and as a consequence has a bunch of underlying illnesses, [that] could explain a high fatality rate," Schaffner said.

A less likely explanation is that Iran's hospitals had fallen short and patients were not getting the necessary medical care, Schaffner said. But he doubted that was the case, because Iran has a relatively advanced health care system.

Dr. John Torres, NBC News' medical correspondent, said there is no evidence of a change in the genetic profile of the virus, so the explanation for the higher mortality rate likely has to do with how the Iranians are tracking cases of infection.

"The virus has not mutated elsewhere," Torres said.

State media said Tuesday that a member of Parliament, Mamoud Sadeghi, and the country's deputy health minister, Iraj Harirchi, who lead a task force battling the virus, had tested positive. The news came a day after Harirchi appeared at a news conference looking feverish, reaching for tissues to wipe his brow. He wore no mask as the ministry spokesman standing next to him expressed confidence about the government's response to the crisis.

"I say this from the bottom of my heart. Take care of yourselves," Harirchi said in a video he took of himself that was posted after his diagnosis became public. "This is a democratic virus. It does not distinguish between rich and poor, the powerful and not powerful. It may infect a number of people."

Harirchi earlier had reacted with anger when an Iranian politician alleged that the number of deaths was much higher in Qom than the government had acknowledged. Harirchi also had appeared on television coughing during an interview.

The episode raised questions about how Iran is managing the crisis and whether officials are failing to disclose information to the public and the rest of the world. Iranian officials are already under public scrutiny over the handling of the downing of a Ukrainian airliner in January. It took the military three days to admit that the plane had been shot down by an Iranian missile in error, triggering angry street protests.

Secretary of State Pompeo said at a news conference Tuesday that "the United States is deeply concerned by information indicating the Iranian regime may have suppressed vital details about the outbreak in that country."

"All nations, including Iran, should tell the truth about the coronavirus and cooperate with international aid organizations," Pompeo added.

In Washington, top public health officials warned Tuesday that Americans should prepare for the spread of the coronavirus in communities across the country.

"It's not so much a question of if this will happen anymore but rather more a question of exactly when this will happen and how many people in this country will have severe illness," Dr. Nancy Messonnier, the head of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention, told reporters.

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Why is Iran's reported mortality rate for coronavirus higher than in other countries? - NBC News

Note: This article was supported by the Pulitzer Center.

TEHRAN The landslide victory for hardliners in Irans recent parliamentary elections confirms that whoever occupies the White House next year wont have an easy time dealing with Iran.

Many Iranians were already angry at President Donald Trumps unilateral withdrawal from the nuclear accord, imposition of harsh sanctions and the Jan. 3 assassination of the popular military leader Qassem Soleimani. And they showed that anger at the polls.

Hardliners, known here as principalists, won 220 of 290 seats in the parliament and got all 30 seats representing Tehran, usually a bastion of more reform-minded voters. The reformists, who advocate closer ties with the United States, were eliminated as a significant parliamentary force. While voter turnout was unusually low, both principalists and reformers came out swinging against Trump.

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Retiree Hasan Muhamdi, who identifies as a principalist, told Truthout, We all vote for the love of Soleimani. Its a punch in the face of Trump!

While Iranian leaders want to avoid direct military confrontation with the U.S., they are likely to encourage local armed groups to attack U.S. and allied targets in the region. Iranian allied rebels in Yemen, for example, claimed credit for the sophisticated drone and missile attack on the ARAMCO oil facility in Saudi Arabia last September.

The people who destroyed ARAMCO could do it again, said Mohammad Khodadi, deputy minister of Culture and Islamic Guidance, in an interview.

The U.S.s harsh sanctions on Iran and the Soleimani assassination strengthen the hand of the principalists, who proudly uphold the original, hardline principles of the 1979 Iranian Revolution, including its emphasis on theocratic government and staunch opposition to U.S. imperialism.

What the American president did was unify the Iranian people and took things to a different level, said Nader Talebzadeh a principalist leader and host of an influential TV show in an interview with Truthout.

The view in Washington is quite different. Trump administration officials are convinced that harsh U.S. sanctions are working. They see Iranian leaders as weak, beset by economic problems and buffeted by anti-government demonstrations.

Tehran faces a financial crisis and its worst political unrest in its 40-year history, according to Brian Hook, the State Departments special representative on Iran.

Paul Pillar, a former CIA officer and Iran expert at the Center for Security Studies of Georgetown University, said in a phone interview with Truthout that some in the Trump administration genuinely believe this regime is teetering and the end is near. Weve heard this numerous times over 40 years. Its a mistaken impression.

Iran does indeed face an economic crisis brought on by unilateral U.S. sanctions and made worse by corruption and mismanagement. Inflation hit 25 percent as of February and the countrys economy shrank 9.5 percent last year.

And now Iran faces the spread of the coronavirus, with 77 confirmed deaths as of this writing, the second-highest tally in the world after China. One of Irans vice presidents was infected and a top advisor to the countrys Supreme Leader has died from the virus.

Iranian officials acknowledge the multiple crises facing the country, but point out that Iran suffered far more during the 1980-88 Iran-Iraq War, in which an estimated 1 million Iranians died. The Trump administration will never achieve regime change, according to Deputy Minister Khodadi.

America is a specialist in removing, but not at creating, Khodadi said in an interview, referring to the U.S.-led collapse of governments in Iraq, Afghanistan and Libya.

The Iranian people know who to blame for the current crises: Trump.

Iranians also appear to be united on the efforts of Hassan Rouhani, the centrist president, to pressure the U.S. and Europeans to live up to the nuclear accord, known as the Joint Comprehensive Plan of Action. Trump withdrew from the JCPOA in 2018 and imposed harsh, unilateral sanctions. For one year, Iranian leaders tried to convince their European counterparts to ignore the sanctions and engage in normal trade.

Britain, France and Germany even set up a special body to promote trade. But as a result of U.S. pressure, INSTEX Instrument in Support of Trade Exchanges has yet to facilitate a single trade deal.

So Iran began breaking various terms of the JCPOA, including enriching and stockpiling uranium at amounts that exceed JCPOA limits.

Principalist leader Talebzadeh said Iran is not trying to build a nuclear bomb. He notes that Supreme Leader Ali Khamenei issued a fatwa, or religious decree, against ever building a nuclear weapon. He said breaking some of the JCPOA conditions is a pressure tactic.

We will not build a bomb, he said. Its a move to intimidate the west.

While Iranians are united against Trump, they hold different views about a possible successor.

Retired truck driver David Nuri voted for the reformists in the parliamentary elections, hoping to elect leaders who could improve the economy and relations with the U.S. Nuri thinks the upcoming U.S. election could have a real impact on U.S.-Iran relations. He strongly criticized Trump for imposing unilateral sanctions that hurt ordinary Iranians.

Obama was a little better, said Nuri, because Obama agreed to the nuclear accord. Trump is much worse. Republicans are war mongers. Democrats want peace.

Reza Roosta Azad, a former chancellor at the Sharif University of Technology and prominent principalist, disagreed. I dont think theres a difference between Democrats and Republicans, only the appearance is different, he said in an interview.

Obamas views were hidden, he continued. Trump is more clear and transparent.

Iranian leaders, like people around the world, want to know who becomes the Democratic Party nominee and who wins in November. Iran elected its hardliners and Iranians are waiting to see if the U.S. does the same.

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Trump's Harsh Iran Policy Helped Hardliners Win Iran's Elections - Truthout

An Italian Finance guard (Guardia di Finanza) conducts control and gives indications to drivers at a check-point at the entrance of the small town of Zorlesco, southeast of Milan, on February 24, 2020.

MIGUEL MEDINA

Italy's government on Wednesday announced it will temporarily close the nation's schools and universities due to the coronavirus outbreak.

State-run RAI radio and the ANSA and LaPresse news agencies reported earlier Wednesday that Italian Premier Giuseppe Conte had agreed on the closure during a Cabinet meeting.Education Minister Lucia Azzolina later said the school closures would be in effect from March 5 through March 15.

Earlier Wednesday, Italy had the dubious honor of being the worst-affected country from the coronavirus outside Asia, having overtaken Iran in terms of the number of deaths and infections from the virus.

The death toll in Italy jumped to 79 on Tuesday, up from an official total of 52 on Monday. As of Wednesday morning, there are 2,502 cases of the virus in Italy, according to Italian media reports that are updated ahead of the daily official count, published by Italy's Civil Protection Agency every evening.

Italy's coronavirus numbers had surpassed Iran's official infection count until the Islamic Republic released its latest official infection and death count. On Wednesday, it announced that 92 people had died from the coronavirus and 2,922 had been infected.There is speculation over the accuracy of Iran's tally of the epidemic.

The outbreak of the coronavirus has centered on Italy's wealthy northern regions of Lombardy (with 1,520 cases), Veneto (307 cases) and Emilia-Romagna (420 cases). But it has spread throughout the country and now only one out of Italy's 20 regions, Valle D'Aosta, is yet to record a case.

Italy's health authorities said Tuesday that they may set up a new quarantine area, a so-called red zone, to try to contain the coronavirus outbreak, Reuters reported.

"None of us can be sure about the future evolution of the disease. This is an important week to understand what will happen," Angelo Borrelli, head of the Civil Protection Agency, told a news conference Tuesday. A new quarantined area could be declared around the city of Bergamo, northeast of Milan, to try to stem a sharp rise in cases there.

Italy's government has already set up red zones in Lombardy and Veneto, in which there are a combined 11 towns quarantined with no inhabitants allowed to leave. Public life has been severely affected in those zones, as well as in "yellow zones" where free movement is allowed but schools, sports venues, and many bars and restaurants are closed.

Recommendations have also reportedly been sent to Italy's Ministry of Health for all Italians, not just those in the most-affected areas, saying that elderly people should stay at home, and that the public should avoid crowded places with no handshaking.

Italy's hospitals and particularly those in the north are stretched. One ambulance driver for hospitals in Codogno and Lodi, both in the "red zone" in Lombardy, told La Repubblica newspaper that the authorities were waiting to see if the epidemic had passed or whether "the emergency is still at the beginning." "Hours (will be) decisive, if the infection spreads it will be hard," he said.

China is now reporting cases that have come from Italy. U.S. Vice President Mike Pence said the United States was screening all travelers coming on direct flights from Italy (as well as South Korea) and Hungarian carrier Wizz Air was the latest airline to cut some flights, mainly to Italy, from March 11.

There are widespread expectations that Italy's economy will enter a recession because of the outbreak. Italy, the euro zone's third-largest economy, was a problematic member of the single currency bloc even before it became one of the countries worst hit by the coronavirus outside of China. Italy was previous only expected to grow a meager 0.5% in 2020.

Giovanni Di Lieto, lecturer in international business and economics at Australia's Monash University, said Italy could drag other countries down with it.

"The Italian economy will enter into recession, possibly dragging down the rest of Europe, particularly those countries whose manufacturing supply chains are most connected with Italy, such as Germany, France, Austria, and the Balkan nations," he said in a note Tuesday.

"This impact will be felt across Europe long after the coronavirus crisis will be quashed, particularly in terms of economic growth and capital investment."

CORRECTION: Italy is one of the countries worst hit by the coronavirus outside of China. An earlier version misstated its status.

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Italy to close all schools and universities through March 15 as coronavirus death toll rises - CNBC

DUBAI, United Arab Emirates (AP) Irans government said Monday that 12 people had died nationwide from the new coronavirus, rejecting claims of a much higher death toll by a lawmaker from the city of Qom that has been at the epicenter of the virus in the country.

The conflicting reports raised questions about the Iranian governments transparency concerning the scale of the outbreak.

Five neighboring countries reported their first cases of the virus, with those infected all having links to Iran, including direct travel from a city where authorities have not even reported a confirmed case.

Irans Health Ministry said the total number of infections have risen to 61 while deaths stood at 12. But a lawmaker from Qom, Ahmad Amirabadi Farahani, was quoted by the semi-official ILNA news agency as saying that the death toll was 50.

Even with the lower toll of 12, the number of deaths compared to the number of confirmed infections from the virus is higher in Iran than in any other country, including China and South Korea, where the outbreak is far more widespread.

The World Health Organization said last week that in 2% of infected cases, the virus has been fatal. In Iran, according to the Health Ministrys figures, the death toll represents nearly 20% of total infections.

There are concerns that clusters of the new coronavirus in Iran, as well as in Italy and South Korea, could signal a serious new stage in its global spread.

Authorities in Iraq and Afghanistan, which closed their borders with Iran, announced their first confirmed coronavirus cases on Monday. Kuwait, Bahrain and Oman also announced their first cases. In all five countries, the infected patients had links with Iran.

Farahani, the lawmaker, said the 50 deaths in Qom date back to Feb. 13. Iran first officially reported cases of the virus and its first deaths on Feb. 19.

He did not provide supporting evidence but said more than 250 people are quarantined in Qom, which is known for its Shiite seminaries that attract students from across Iran and other countries. Schools there have been closed.

I think the performance of the administration in controlling the virus has not been successful, Farahani said, referring to the government of President Hassan Rouhani. His comments represent the most public criticism levied yet against the government for its handling of the virus, which originated in China in December.

None of the nurses have access to proper protective gear, Farahani said, adding that some health care specialists had left the city. So far, I have not seen any particular action to confront corona by the administration.

He spoke following a session in parliament in Tehran. His comments, first published by ILNA, were later carried by other news agencies in Iran.

While such harsh criticism is rare in the country, it reflects deep public mistrust of the government, particularly since a Ukrainian passenger jet was shot down by Iran on Jan. 8, killing 176 on board amid heightened tensions with the U.S. Iranian government officials at first tried to conceal the cause of the crash before acknowledging that Revolutionary Guard forces had shot it down, mistaking it for an enemy target.

Health Ministry spokesman Iraj Harirchi rejected the lawmakers comments, but said about 900 other suspected cases are being tested.

No one is qualified to discuss this sort of news at all, Harirchi said, adding that lawmakers have no access to coronavirus statistics and could be mixing figures on deaths related to other diseases like the flu with the new virus.

Mohammad Tavakoli, a representative of the health minister in Qom, said 320 people suspected to have the infection have been hospitalized, the semi-official Mehr news agency reported. He added that 21 people who had been infected had recovered and were released from hospitals.

Asked about the spike in cases in Iran, WHOs emergencies program director Michael Ryan cautioned that in the first wave reported from a country, only the deaths may be being picked up and therefore are over-represented.

The virus may have been there for longer than we had previously suspected, Ryan said. Sometimes when you see an acceleration of cases and a spread from that, it doesnt necessarily represent the natural transmission dynamics of the virus.

He added that it is very much driven by the context, such as whether theres been a religious gathering.

The virus, which causes the COVID-19 illness, has infected more than 79,000 people globally, and caused more than 2,600 deaths, most of them in China.

Ian Mackay, who studies viruses at Australias University of Queensland said the latest figures reported mean that Iran could become the hot spot for seeding countries that have travel with Iran ... a source outside of China.

Travelers from Iran with the virus have been confirmed in Canada, Lebanon and the United Arab Emirates.

The outbreak of the virus in Iran comes as its economy buckles under pressure from U.S. economic sanctions. The virus threatens to isolate Iran even further as several countries began halting flights and barring Iranians from entry.

The head of the WHO expressed concern over the virus spread in Iran, as well as in Italy where more than 200 have tested positive and five have died.

The past few weeks has demonstrated just how quickly a new virus can spread around the world and cause widespread fear and disruption, WHO chief Tedros Adhanom Ghebreyesus told reporters.

Ryan said a team from WHO would arrive in Iran on Tuesday.

The outbreak in Iran has centered mostly in the city of Qom, but spread rapidly in recent days as Iranians voted Friday in a parliamentary election. Many people wore masks and stocked up on hand sanitizer.

Iranian health officials have not said whether health workers in Qom who first came in contact with infected people had taken precautions. Iran also has not said how many people are quarantined overall.

To prevent the spread of the virus, schools across much of the country were closed for a second day. Soccer matches and movie screenings have been suspended. Tehrans metro, which is used by about 3 million people in the capital, and public buses are being sanitized daily.

Iran has confirmed cases in five cities, including Tehran. A local mayor in Tehran is among those quarantined.

While Iran has not reported any cases in its northeastern city of Mashhad, authorities in Kuwait on Monday said three travelers returning from there had tested positive for the virus, raising more questions about the Iranian government response.

Iraq said the virus was confirmed in a 22-year-old Iranian student in Najaf, home to Shiite seminaries and shrines. Separately, a person in Afghanistans western province of Herat who had returned from Iran tested positive for the virus.

Bahrains Health Ministry said an infected citizen who returned Friday from Iran had transited through the worlds busiest international airport in Dubai, United Arab Emirates. The ministry said the person is a school bus driver, and that students are being checked and related schools will be closed for two weeks.

Oman said two of its citizens returning from Iran have the virus and are in quarantine.

Armenia also closed its border with Iran for two weeks and suspended flights between the two countries. Azerbaijan temporarily closed two border checkpoints with Iran. Georgia restricted movement of individuals to and from Iran and halted direct flights.

___

Associated Press writers Nasser Karimi and Amir Vahdat in Tehran, Iran; Rahim Faiez and Tameem Akhgar in Kabul, Afghanistan; Qassim Abdul-Zahra in Baghdad; Frank Jordans in Berlin; Jan M. Olsen in Copenhagen, Denmark; Aniruddha Ghosal in New Delhi, India; and Sophiko Megrelidze in Tbilisi, Georgia, contributed.

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Iran says 12 dead from new virus, rejects higher death toll - The Associated Press

On Friday Iran held its 11th parliamentary elections since the foundation of the Islamic Republic in 1979, and the first since the Trump administration renewed sanctions on Iran and battered its economy.

The voting turnout 42.5 percent was the lowest since 1979, and a loose alliance of conservative candidates won. In Tehran, the capital, where about 75 percent of the voters chose not to vote, all 30 seats were won by the conservative candidates loyal to the supreme leader, Ayatollah Khamenei.

The Iranian electorate faces a perpetual dilemma on whether to participate or boycott the elections as the choice of candidates is limited and the Guardian Council a constitutional committee made up of six clerics and six jurists that vets the electoral candidates bars those seen as critical of the regime or deviating from its positions.

More than 7,000 candidates, most of them reformists and moderates, including 90 members of the current Iranian Parliament, were disqualified from Fridays elections by the Guardian Council for having insufficient ideological loyalty, a move that reduced voter participation.

The turnout was higher than Tehran in smaller cities, where citizens have more incentive to vote if the candidates promise better schools and hospitals, improved roads, faster internet, more ethnic inclusion and even individual patronage. As the American sanctions have debilitated the Iranian economy, greater participation in parliamentary elections offers the provinces an opportunity to bargain for a better share of the shrinking pie from Tehran.

In Tehran and other major cities, the parliamentary elections signal not only the citizens preferences for particular factions within the regime but also its legitimacy as a whole. Participation rates in the major cities fluctuate more often and reflect the political diversity of the candidates.

In the 2016 parliamentary elections, a high turnout enabled moderate reformist candidates to secure Tehrans 30 seats in the Parliament. The conservative winners in Tehran, this weekend, were led by Mohammad Bagher Qalibaf, the former head of the Islamic Revolutionary Guard Corps air force wing, who is expected to be the speaker of the incoming Parliament. Victories like Mr. Qalibafs demonstrate that the Revolutionary Guard is ensuring its presence and domination of the Parliament as well.

Iranians who refused to vote expressed their anger and their disappointment with the Revolutionary Guards bloody crackdown on protesters in November, and its cover-up of the accidental shooting of a civilian airplane near Tehran in January. But the trouble with boycotting the elections is that it opens the doors of the Parliament for the most conservative wing of the political system.

Iranian society stands at an uncharted crossroad and the regime is bringing the apparatus of the state under the control of what it considers to be its most loyal elites, one election at a time. In a politically, economically and regionally tumultuous environment, doing so would allow an orderly transition to the next supreme leader.

The brutal response to the November protests across the country showed the will and the capacity of the security apparatus to put down unrest. And a multinational army of proxies under the banner of the Revolutionary Guards Quds Force operating from Lebanon and Syria to Iraq and Yemen, have demonstrated Tehrans will and effectiveness in defending its sphere of influence and fighting threats from hostile states to nonstate participants.

Irans constitutional design places the Islamic Republic in a win-win position. High voter participation helps legitimize the regime and a boycott invariably leads to a conservative victory. Elections also serve as a convenient device for the state to learn about and manage popular sentiments before they turn into a mass revolt.

Despite these institutional constraints, Iranian citizens have often outmaneuvered their leaders and stunned the world by using elections as a tool to coordinate nationwide social and political movements.

After the 1989 death of Ayatollah Ruhollah Khomeini, the founder of the Islamic Republic, and with the gradual decline of revolutionary fervor, competition among Mr. Khomeinis followers provided a narrow political opportunity for Iranian citizens.

By choosing candidates who appeared furthest from the establishment, Iranians revealed their preference for radical change not only to the ruling elites but also to each other. Far from strengthening the regime, elections often turned into national protests, deepening the gap between the state and the society and further polarizing factional politics.

The student uprising in 1999 over the governments crackdown on the media and the Green Movement against what millions viewed as a rigged re-election of Mahmoud Ahmadinejad in 2009 were direct results of electoral politics and popular frustrations with the regimes suppression of the peoples struggle for civil rights.

The ruling elites managed this 30-year cycle of elections and protests through a sequence of crackdowns, concessions and more crackdowns. Disillusioned citizens sometimes boycotted elections only to return to the ballot box with vehemence.

Parliamentary elections in Iran have become a consistent predictor of relations between the state and the society. The low turnout in the 2004 parliamentary elections signaled popular disillusionment after the failure of the reform movement that started in the 1997 presidential election to protect civic rights, which led to the 2005 election of Mr. Ahmadinejad to the presidency.

The high turnout in the 2016 parliamentary elections confirmed the high approval rate of President Hassan Rouhani and the nuclear agreement he signed with the United States and other world powers, predicting his landslide re-election the following year.

The conservative victory in the recent parliamentary elections indicates that the Iranian people are disenchanted with electoral politics that deliver nothing. It sets the stage for the ascendance of a hard-line president in the 2021 election if the populations apathy persists. And the absence of public pressure and elite bargaining will determine the appointment of a possibly even more hawkish supreme leader after Ayatollah Khamenei.

Yet after this electoral cycle, Iranian voters may not easily return to the ballot box. Fridays election could be the beginning of the death of Irans limited electoral politics.

Frustrations against the political system run deep in the country. So do anxieties over external threats to the nations security and territorial integrity. It is unclear which direction Iranian society will take.

Elections in the past have laid the ground for cultural exchanges, diplomatic negotiations and a nuclear agreement between Iran and the United States. After the starkly low turnout and the conservative victory, we might be inching toward a more turbulent phase between the two countries.

Mohammad Ayatollahi Tabaar is an associate professor of international affairs at Texas A&M Universitys Bush School of Government and Public Service and a fellow at Rice Universitys Baker Institute for Public Policy.

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What Does the Iranian Election Tell Us? - The New York Times