On a recent evening in Tehran, apartment dwellers on lockdown inside the city’s ubiquitous concrete tower blocks threw open their windows at 8pm, and serenaded each other with the national anthem. Across the world in Washington, D.C., people have coped with isolation in much the same way, belting out songs during neighborhood dusk singalongs from the safe social distance of their front stoops.

The fact that Iran and the U.S. are both grappling with two of the world’s largest outbreaks of novel coronavirus could be a source of rare common ground for its leaders. But if anything, the barbed rhetoric between the long-time adversaries has only been made worse by the pandemic. The virus is spreading fast in both countries, but in Iran, the government’s response has been hampered by an oil-dependent economy already hobbled by U.S. sanctions, the oil price war between Saudi Arabia and Russia, and the plummeting price of crude that has accompanied the pandemic.

Iran’s dire circumstances have prompted calls from around the world for the U.S. to roll back its deep economic sanctions on the country — so far, to no avail. Iranian allies like China, Russia and Pakistan have been at the forefront of the pressure campaign, but U.S. allies, including Germany and France, as well as neutral international bodies, have publicly and privately urged administration officials to consider easing some of the Trump Administration’s continuing sanctions on Iran’s oil, banking and transport sectors. “A global pandemic requires a global response, not a piecemeal one based on local politics,” one European diplomat tells TIME, speaking anonymously to describe private discussions with U.S. officials.

Some hardline members of the Trump Administration, however, think the growing economic pressure could bring about the regime change they have long sought, or at least force Iran to negotiate a tougher nuclear agreement and an end to its support for militant groups and Iraqi militias that have attacked U.S. and allies’ forces, two U.S. officials say. In January, National Security Advisor Robert O’Brien told Fox News Sunday that the Administration’s “maximum pressure” campaign was “choking off” Iran and leaving its leaders “no choice but to come to the table.”

The U.S. has already offered Tehran tens of millions in aid, which it rejected, and U.S. officials have said it should not be rewarded for its own mishandling of the crisis. Tehran did not, for example, shut most air travel with China until early February, and failed to stop mass gatherings like Friday prayers until early March, well after the virus was detected in the country.

Officials in Tehran are using Washington’s refusal to drop sanctions during the crisis to cast the Trump Administration as heartlessly targeting the Iranian people. Iran’s Supreme Leader Ayatollah Ali Khamenei on Sunday even alleged that the U.S. was behind the creation of the virus itself, and specifically targeted Iranians with it. Rejecting the U.S. aid offer, he said, “Possibly your medicine is a way to spread the virus more.”

The Iranian government says what they really need to weather the crisis is to sell oil again on the open market. Tehran has further thrown down the gauntlet by requesting a $5 billion loan from the International Monetary Fund to fight the virus, with the backing of the European Union, a move that the U.S. officials expect the Administration to reject.

Iran might get help from an unexpected direction. Some energy executives think they have made some headway in convincing Trump that today’s low oil prices are not a good thing for him or the U.S. because they are causing growing unemployment in Texas and other states, two executives say, speaking anonymously in order to describe confidential discussions.

Because Saudi Arabia relies heavily on the U.S. for security assistance, pressure from Washington could convince the Saudis to halt or at least moderate their price war with Russia, which along with falling demand has caused the price of benchmark Brent Crude oil to fall more than 60 percent since January 1. An obstacle to that, one of the U.S. officials conceded, is the close relationship between Saudi Crown Prince Mohammed Bin Salman, and Trump’s son-in-law and senior advisor, Jared Kushner.

For now, blaming the U.S. is a clear attempt by Tehran to deflect Iranians’ attention away from its own mishandling of the virus. Nevertheless, it could work — and put the Trump Administration on the backfoot in its years-long battle with Tehran in the region. Ramped-up anti-American rhetoric could end up uniting Iranians behind a regime that many of them had come to despise. It could also fuel anti-American sentiment among Iraq’s Shi’a community that has been simmering since Trump ordered the drone strike that killed Quds Force leader Major General Qasem Solemani in January, making it harder for the U.S. to maintain its foothold in Baghdad that helps the U.S. offset Iranian influence in the country, or at least keep better track of it.

Some critics of the Administration’s policy say its unwillingness to budge on the Iran issue could lead to greater loss of life. UN High Commissioner for Human Rights Michelle Bachelet on Tuesday called for an easing of sanctions on Iran, and other heavily sanctioned countries like Venezuela, noting that more than 50 Iranian medics have died since the first cases of the COVID-19 coronavirus were detected there five weeks ago. She said sanctions should be lifted “to avoid the collapse of any country’s medical system – given the explosive impact that will have on death, suffering and wider contagion.”

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The Trump Administration withdrew from the Obama-era 2015 Iran nuclear deal and re-imposed sanctions on Iran’s oil, banking and transportation sectors in November 2018. Tehran’s oil sales dwindled, as did hope for international investment as the EU, Britain, German and France failed to come up with a financial workaround to protect interested companies from U.S. retribution. Prices for basic goods and services inside Iran started to rise, and in November 2019, the Tehran government abruptly raised gasoline prices, a move that triggered massive popular protests that the regime brutally crushed.

The two countries have been engaged in an escalating proxy war ever since. Tehran fought back by hitting the U.S. and its allies through the proxy militias it supports around the region, attacking oil tankers, shooting down a U.S. drone in the Persian Gulf, and launching a combined drone and missile attack that devastated a key Saudi oil facility.

In Iraq, Iranian proxies harassed U.S. bases with rocket fire, ultimately killing a U.S. contractor in the northern city of Kirkuk. The U.S. hit back with military strikes in Iraq and Syria that killed more than two dozen Iraqi militia fighters, leading angry militia members tried to storm the U.S. embassy in Baghdad. The Trump Administration answered with its extraordinary drone strike on Baghdad’s airport road on January 3 that killed Soleimani, as well as senior Iraqi commander Abu Mahdi al-Muhandis, a member of government as well as chief of the Iran-allied Kataib Hezbollah militia.

Iran answered that with a missile strike on U.S. personnel inside Iraq that failed to kill any soldiers, but caused brain injuries to dozens of troops. Then on March 12, rockets killed two Americans and a British soldier at Camp Taji, north of Baghdad, and the U.S. launched multiple strikes on weapons storage depots belonging to Kataib Hezbollah near the Shia holy city of Karbala. The U.S. has been slower to respond to yet another round of strikes that wounded three U.S. troops on March 14, partly distracted by its own COVID-19 fight back home, but also worried that an embattled Tehran might escalate the violence to distract Iranians from its own mishandling of the pandemic.

Instead, the U.S. has been taking steps to limit the number of targets in Iranian sites. U.S. officials announced on March 19th that they will be shrinking their footprint in Syria and Iraq, painting the move as a successful milestone after training Iraqi forces to defend their own borders and to protect troops against coronavirus.

But they are losing strategic ground in the process. One of the places they are withdrawing from is the key base of El Qaim, Syria, which gave U.S. forces a perch at the midway point of the Syrian-Iraq border. Last year, senior Trump Administration officials described the spot as crucial for keeping tabs on Iranian forces inside Syria and for tracking the illicit smuggling of missiles and GPS-guidance kits from Iran, across Iraq, bound for Iranian proxies in Syria and Lebanese Hezbollah in Lebanon.

And fury over the U.S. drone strike that killed Soleimani and Iraqi militia leader al-Muhandis has empowered Iranian-backed politicians in Iraq, making it harder for Iraq to form a new government that’s willing to cooperate with Washington, Iraqi officials say, speaking anonymously to describe the fractious process. Without that moderating force inside the Iraqi government, so far unsuccessful attempts by Iraq’s Parliament to expel U.S. forces could pick up steam.

Some U.S. military and intelligence officials fear U.S. backpedaling in Syria, Iraq, and Afghanistan could encourage Iran to act more aggressively in the region to distract attention from the crisis at home and fuel centuries-old Persian nationalism.

At first, the spread of COVID 19 seemed like it might offer an opening for Washington and Tehran to finally step away from this brinkmanship. The U.S. offered Iran aid from the nearly $274 million the Trump Administration has set aside for international emergency health and humanitarian funding. And Iran released U.S. Navy veteran and cancer patient Michael White from prison into the care of Swiss diplomats on humanitarian grounds. As Iran furloughed some 85,000 prisoners to try to keep prisons from becoming an incubator of the virus, U.S. diplomats pushed for the release at least four other Americans believed to be detained by Tehran, Secretary of State Mike Pompeo told reporters on March 19.

But Tehran rejected the medical aid and no more American prisoners have been freed. The Trump Administration, for its part, doubled down on its economic punishment of the country, leveling even more sanctions last week that blacklisted several companies on charges of doing business with Iran’s petrochemical sector.

The U.S. has insisted from the start of the pandemic that its sanctions do not target items Iranians impacted by COVID-19 need. They point out that Iran rejected its aid money, and on Monday, Pompeo reiterated in a tweet that U.S. sanctions do not target imports of food, medicine and medical equipment, or other humanitarian goods, and claimed Iranian health companies have been able to import testing kits without obstacle.

They also point out that Washington has set up a humanitarian channel via Switzerland that enables the delivery of non-sanctioned supplies, like food and medicine, to the country. U.S. Special Representative for Iran Brian Hook said it has already been successfully used to get cancer and transplant medicines to patients, but it only applies to companies based in Switzerland, a narrow channel for the massive amount of aid Iran likely needs.

That misses the point, says the European diplomat. Without greater access to the international banking system and markets for the oil that is the lifeblood of its economy, Iran is unable to buy all the supplies it needs to weather the pandemic, the official said.

A 2019 Human Rights Watch report concluded that U.S. sanctions were hampering Iran’s ability to get medicine and medical equipment before coronavirus struck. And while there are no limitations on purchases of food and medicine, there are sanctions in place against Iranian shipping and insurance on whatever is shipped, including food and medicine, says former State Department official Mark Fitzpatrick, now an Associate Fellow at the International Institute for Strategic Studies.

And the damage already done to Iran’s economy by U.S. sanctions has left it ill-prepared for the crisis, according to Henry Rome, Iran specialist at the Eurasia Group, with gross domestic product shrunk by 9.5 percent, inflation near 40 percent, and oil exports down by 80 percent since sanctions returned. He tells TIME that small gains that Iran started to make in the last year by increasing trade of non-sanctioned goods with neighbors could now be undone by the pandemic.

“The underlying weaknesses of the Iranian economy are being magnified by sanctions in limiting Iran’s ability to import the things that it needs,” says Richard Nephew, program director at the Center on Global Energy Policy at Columbia University. “They don’t have supply chains, banking connections, transportation links, and even telecommunications to manage the crisis. Some of this — a lot of this — is on Iranian mismanagement. But sanctions are making these problems worse.”

That economic spiral is intended to make Iranians so unhappy and ungovernable that Tehran gives in to U.S. demands, and curtails its malign activity in the region, senior U.S. administration officials say, speaking anonymously as a condition of sharing their analysis.

But it hasn’t yet worked that way, and has instead driven the regime to grip its own people harder, and lash out at its American tormentor. It’s hard to know with any certainty who Iranians hold most responsible for their plight, in a country where criticizing the government can lead to jailing and death. Mass demonstrations indicate they are unhappy with their government, but their opinion of the Trump Administration is surely lower. In January, hundreds of thousands of Iranians mourned Soleimani’s killing in one of the largest mass demonstrations the country has ever seen. Not everyone revered Soleimani, who supported a campaign of extending Iranian influence with proxy wars in Lebanon, Syria and Yemen, but assassinating him by drone strike was a blow to national pride.

Now the Trump Administration’s steadfast insistence on keeping the sanctions boot on Tehran’s neck is playing further into the ayatollahs’ hands, says Eric Brewer, who served as a senior intelligence officer in both Trump and Obama administrations.

“They are clearly trying to use COVID 19 as this messaging opportunity and lay the blame on the feet of the Iranian government,” says Brewer, who is now with the Center for Strategic and International Studies. That’s not entirely wrong, he says. “But…this idea that we are going to convince the Iranian people to rise up is incredibly unlikely.”

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