TEHRAN, IRAN -- Months into Iran's fight against the coronavirus, doctors and nurses at Tehran's Shohadaye Tajrish Hospital still don a mask, a disposable hazmat suit and a double layer of latex gloves every day to attempt to contain a pandemic that shows no signs of slowing.
The hiss of high-flow oxygen to wheezing patients, the beeps of equipment monitoring vital signs and the crinkling rustle of passing medics have become a daily symphony here and in other hospitals across the Islamic Republic.
Iran reported its first coronavirus cases and deaths on the same day in February -- the Middle East's first and biggest outbreak of the virus -- yet it only recently saw its highest single-day spike in reported cases, followed soon by the highest daily death toll in months.
The spikes, which came after a major Muslim holiday last month, have renewed fears about a potential second wave of infections sweeping across Iran. As businesses open and people begin to move around more after weeks of closures of most stores, offices and public spaces, health experts worry that growing complacency among the country's 80 million people may further allow the virus to spread.
Health Minister Saeed Namaki said he realized the extent of the challenge when he took a domestic flight. "Many people have become careless, frustrated with wearing masks," he said. "They did not observe (social) distancing in the flight's seating and the airliner's ventilation system was not working."
Iran saw its highest single-day total of reported new cases -- 3,500 -- on June 5. The number dropped in the days afterward but remain in the low 2,000s a day, around twice the lows in the last week of April and the first week of May.
The daily death tolls in Iran also broke the 100 mark for the first time since mid-April on Sunday, Monday and Tuesday this week.
The spike in cases occurred largely in Iran's oil-rich southwestern Khuzestan province, as well as the western provinces of Kermanshah and Kurdistan. Officials link it to the Eid al-Fitr holiday that came in late May, during which families often travel to visit friends and relatives to mark the end of the Islamic holy month of Ramadan, when Muslims fast from dawn to dusk.
Ali Reza Zali, who is leading the campaign against the outbreak in Tehran, said last week that "some 60% of hospitalized patients travelled to other provinces before they became sick."
Authorities also have reported concerns about Iran's eastern Sistan and Baluchistan province bordering Pakistan.
The spike also reflects an increase in testing, Health Ministry official Ehsan Mostafavi said. Iran now has 130 labs across the country, running as many as 25,000 tests a day. Some 1.3 million tests have been conducted, up from 500,000 just a month ago.
While the country is opening up, some restrictions still stand. Friday prayers in major cities remain closed, as do schools and universities, except for a few courses. Authorities have imposed rules to keep people spread out at indoor locations and ordered people to wear masks there and on public transportation.
But Iranian President Hassan Rouhani said Saturday that only 18% of people are observing social distancing and other measures, down from 80% about a month ago.
Yet Rouhani also said that, starting Saturday, kindergartens, coffee shops and libraries can resume activities while applying protective measures. He said the country still could revert to stricter measures if needed.
Before Iran reported its first cases in February, authorities denied it had reached the country for days, allowing the virus time to spread as the nation marked the 41st anniversary of its 1979 Islamic Revolution with mass demonstrations and then held a parliamentary election in which authorities desperately sought to boost turnout.
Today, the country has reported over 192,000 confirmed cases, with 9,065 deaths.
Even as Iran now acknowledges the crisis, questions remain over its figures from the outbreak.
A parliamentary report in April said Iran's death toll is likely nearly double the officially reported figures. Given undertesting, the report said the number of people infected at the time was probably "eight to 10 times" higher than the reported figures.
Even today, Iranian death tolls remain based on those who died in coronavirus wards in hospitals. However, it's believed that many more died at home, and some families have reportedly asked doctors not to mention their loved ones died of the virus to avoid the stigma associated with COVID-19, the illness caused by the virus.
The Tehran municipality recently said it has prepared an extra grave site with capacity for 15,000 bodies, though it said it was intended in case of a natural disaster. It said Tehran's main cemetery had some 10,000 grave sites ready for use.
But there's a sense that Iran's government, once overwhelmed by the crisis, has adjusted. In a sign of business as usual, Iranian officials have resumed their rhetoric against the U.S., which under President Donald Trump withdrew from Tehran's nuclear deal with world powers and implemented crushing sanctions.
The public too seems to want some normalcy. On the streets of Tehran, several people who spoke to The Associated Press acknowledged they no longer followed safety measures.
"I stopped wearing a mask," said Soheila Fazli, a 48-year-old mother of two who suffers from diabetes. "I cannot breathe easily when I wear it."
Authorities largely are only enforcing mask wearing and other rules in Tehran's subway.
"I don't like wearing a mask," said Gholam Reza Sarrafi, a 24-year-old air conditioner technician. "Why should I wear one even though I haven't seen anyone get the disease?"
That attitude has health officials worried about a new increase in infections. Health official Mohammad Mehdi Gouya warned the public that Iran has not "passed the first wave."
"We still have a heavy fight with corona," he said recently. "We are not in a position to have an optimistic view."
Associated Press journalists Vahid Salemi in Tehran, Iran, and Jon Gambrell in Dubai, United Arab Emirates, contributed to this report.
