Little rows of upright matchsticks, stuck in felt, have appeared alongside cash machines and lift doors, offering a chance for Iranians to press the buttons without their fingers touching potentially coronavirus-contaminated metal surfaces. Guides have also appeared on how to attach metal extensions to cigarette lighters for the same purpose, and in public some men no longer shake hands or kiss as a greeting, but instead tap their shoes on one another.

Traffic jams have disappeared from Tehran’s crowded streets, even if the pollution remains due to the filth generated by power stations, and the city’s now often empty metro train carriages are sprayed with disinfectant two or three times a day. Distance working and learning has become the norm. Evening language classes, popular in Tehran, are empty. Internet traffic is up 40% as Iranians work from home.

As the official death toll has risen – authorities said a total of 77 people had succumbed to the virus in Iran – the most of any country outside China – Friday prayers were cancelled for the first time since the 1979 revolution, as have football matches.

Schools, universities, theatres and cinemas are all closed. Shopping centres have become eerily empty. Water consumption, due to the frequent washing of hands, is at the peak level normally recorded in July leading to a drop in water pressure. Even the Iranian government spokesman Ali Rabiei is holding his press conferences by video-link. The supreme leader, Ayatollah Ali Khamenei, sits a little further back from his audience. After all more than 20 senior officials or MPs have been afflicted.

Facebook Twitter Pinterest An Iranian medic treats a patient infected with the Covid-19 virus at a hospital in Tehran. Photograph: Koosha Mahshid Falahi/Mizan news agency/AFP via Getty Images

Ever since Coronavirus officially arrived in the holy city of Qom on 19 February, probably brought by an Iranian merchant who regularly traded in China, a deadly combination of forces, including the debilitating effect of years of US sanctions, a rundown health service and low levels of trust in the government, has conspired to make Iran the country suffering the highest mortality rate from the disease.

Many Iranians have adapted to the crisis around them, but the question is whether a cumbersome theocratic government has done the same, or at the speed required to outpace such a virulent epidemic.

The World Health Organization director general, Tedros Adhanom, said he had seen no evidence that Iran is covering up the scale of the catastrophe that has befallen the country, but many disagree. The Iranian government for its part accuses hostile Saudi Arabia and western media of trying, as ever, to weaken the nation.

The Iranian health department insists its figures are not being politically massaged. On Monday the ministry said 66 people had died, the number infected had reached 1,501 (a startling increase of 50% in 24 hours) and 291 had recovered. By Tuesday the number of cases had risen by a further 835, and the deaths by 11. The total recovered had reached 435. Although the mortality rate had fallen by Tuesday, the number of confirmed cases was still well below what one would project given mortality rates elsewhere.

Facebook Twitter Pinterest A pharmacist wearing a face mask works in western Tehran. Photograph: Vahid Salemi/AP

Never has the arrival of Nowruz, the Persian New Year on 20 March, seemed less of a moment to celebrate.

The health ministry admitted a difficult two weeks lay ahead, but promised the outbreak would be under control by then, partly due to warmer weather, but said this would only be the case if ordinary Iranians obeyed officials’ instructions.

It pointed to the remedial measures already being taken. Health teams have been stationed on the edge of cities to prevent reckless infected travellers spreading the disease. More than 1,000 testing stations are being established. Production of surgical masks and detergents has been stepped up. Equipment from China and Europe is on the way. As many as 300,000 volunteers are being trained to go door to door to check for undetected cases.

Other wings of government have joined in. The clergy has threatened fines, or a Dayat, for anyone passing on the disease. The judiciary on Tuesday threatened that hoarders of medical equipment faced the death penalty. Even the Islamic Revolutionary Guards Corps took to the streets using water cannons to spray disinfectant, and said it was opening field hospitals.

Facebook Twitter Pinterest A police vehicle disinfects streets against coronavirus in Tehran. Photograph: Vahid Salemi/AP

But the suspicion remains that Iran’s public services are overwhelmed, and the authorities have simply been too slow to react, especially by not quarantining the worst affected cities, a decision that is now openly criticised by media and epidemiologists. Many travelled to Qom and then shared videos of pilgrims licking the lattice windows that surround Qom’s holy tomb.

Citing hospital sources last week, BBC Persian, reviled by the regime, was the first to suggest a state cover-up was under way, claiming more than 2,000 people had already died, and on Twitter pictures of mass graves being dug were published, infuriating the government, and prompting renewed warning about the evils of foreign social media.

But the overwhelming odds facing Iran’s heroic doctors look anything but fake news, and is now being reported by mainstream outlets. Dr Abdolreza Fazel, the head of the health authority in Golestan province, reported 594 patients had been diagnosed with the virus and the capital of the province was being overwhelmed.

Facebook Twitter Pinterest People wearing face masks in Rasht, Gilan province. Photograph: Babak Jeddi/SOPA Images/REX/Shutterstock

Gholam Ali Jafarzadeh Emenabadi, an MP for Rasht, 185 miles (300km) north-west of Tehran in Gilan province, warned hospitals were overflowing with coronavirus victims, and were unable to take new patients.

He insisted the authorities had not been telling the truth, describing the official death toll as a joke. He claimed instructions to disinfect cities were sent out seven days late, and Razi hospital could take no more. As many as 700,000 people had travelled to the province since the outbreak began. At the Shahid Beheshti hospital, in Gashan doctors spoke of the crisis spiralling out of control.

The vice chancellor of Qom University of Medical Science and Health Services, Ali Abrazeh, said on Monday that 700 people had been treated in hospital in the city, including 100 alone on Sunday. He suggested self-isolation would be required for another month or two. A gruesome video of body bags in Qom hospital was screened. A medic at Kamkar hospital complained on video about a shortage of standard protective kits.

In Isfahan general surgeon Behrouz Kalidari warned as many as 12,000 probably had the virus and did not know it. He added: “Regrettably, an absolute disaster has taken place in Qom [city] and the story is out of control. Unfortunately, officials are still concealing the issue due to the political, economic consequences. We can handle the issue in Hamedan, Zanjan, Arak, Qazvin, Mashhad, and even here in Isfahan if we act soon.” But if the measures were not tightened, the country as a whole faced a national disaster.

Signs of tension within government have also emerged. The health minister, Saeed Namaki, felt forced to write to the president, Hassan Rouhani, after 10 days of the crisis to say that only 1m health masks had been delivered, and officials were having to work the black market to source masks at five times the official price. He has written again to complain that bandits were hoarding the face masks to profiteer, and suggestions that Iran itself could produce a million masks a day was a hollow slogan to deceive the people.

Facebook Twitter Pinterest Members of a medical team spray disinfectant at Imam Reza’s shrine in Mashhad, Iran. Photograph: Wana News Agency/Reuters

The plan for 300,000 volunteers to go door to door has also received a mixed reception. Hadi Ansari, a surgeon and a member of the Iranian Academy of Medical Sciences, said teams moving one house to another in search of victims was just as likely to spread, as contain the virus. He pointed out new gloves would be needed for each visit.

The fate of political prisoners is also being hotly debated, with judiciary officials on Tuesday dismissing rumours that the virus has got behind bars, and was ready to spread from crowded ward to ward.

Epidemics reveal deeper truths about the societies they afflict, and the Iranian government is hampered by a trust deficit that it blames on hostile western media rather than itself.

But the state’s secrecy over the killing of hundreds of street protesters in November (no official figures have been published) and the brief cover-up over the downing of the Ukrainian civilian jet over Tehran in January has only made that trust deficit more acute. A turnout of just 20% in last month’s parliamentary elections in Tehran revealed popular disillusionment with the whole world of politics.

Facebook Twitter Pinterest A man wearing face mask and protective gloves leaves a Taxi in Tehran. Photograph: Abedin Taherkenareh/EPA

Indeed the suspicion lingers that the government did not reveal the scale of the problem at the outset because it was desperate to boost the turnout in the parliamentary elections.

Khamenei himself accused Iran’s enemies of exaggerating the threat of coronavirus to scare voters away from the polls.

But on Tuesday, as state media reported that 23 members of parliament had been infected, and all politicians were told to avoid the public, the odds of repairing that broken trust – and finding a way out of the crisis – looked more remote than ever.