The new coronavirus kills at least one person every 10 minutes in Iran, the country’s health ministry has warned, as shortages force medics to treat the sick without protective gear, while families say they are burying their loved ones in makeshift pits.

Nearly 18,500 have been infected and at least 1,284 people have died of Covid-19 in the country, the highest death toll outside of China and Italy.

The official body count increased by 149 on Thursday, the largest one day jump since the crisis, showing how quickly the effects of the pandemic were accelerating in Iran.

The World Health Organisation, however, has warned Iran’s toll was potentially five times higher as the testing has been restricted to the “most severe cases”. The authorities have also struggled to enforce measures like quarantine and self-isolation.

On Thursday Kianush Jahanpur, the health ministry spokesman, said the crisis was so severe that Covid-19 was killing at least half a dozen an hour.

"Based on our information, every 10 minutes one person dies from the coronavirus and some 50 people become infected with the virus every hour in Iran," he tweeted.

This rate could soar: a computer simulation conducted by Tehran’s Sharif University of Technology this week concluded that in the best-case scenario the death toll could exceed 12,000 and reach a peak in mid-May.

In a worst-case scenario, if people keep travelling and ignoring health guidance, the report warned as many as 3.5 million could die.

As of Thursday, more than 9,000 people have died globally with more than 200,000 cases.

As the outbreak has spread medical professionals described unsafe conditions while they rush to treat patients with dwindling supplies.

A nurse working in Karaj, a city 25km northwest of Tehran, told The Independent protective masks are only available for those working in the emergency units, increasing the risk that those working in other sections of the hospitals could be infected and pass on the virus to other patients.

“We are really short of equipment. Our hospitals are all full and the medical teams are already exhausted. Yet some people still don’t take this seriously,” the nurse said.

“In the first days there were masks and protective gowns for the medical staff at our hospital. But now it is getting more scarce as the number of infected people across the country is increasing.”

A lab technician in Tehran said each medical staffer is given two masks per shift, which is not sufficient.

“Infection cases among the doctors, nurses and the medical staff in general are increasing rapidly,” he said. “We're very worried about our own families since we might get infected … and carry the virus to our family.”

Civilians in Tehran told The Independent that bodies are massing in morgues and when the authorities bury the dead they have started to do so with lime to further prevent the spread of the disease.

In more rural areas, where citizens are largely on their own, one man said worried locals have been hastily burying bodies in makeshift graves without ceremony.

“A few days ago one of my relatives in a far off city noticed a neighbour had died likely from coronavirus. His family feared getting close to the body."

“My relative used a blanket to pack and move the body and finally just threw him in a grave, without any ceremony – like a dead animal,” the man added.

Despite reports that Iran has implemented a tight lockdown on public life, the same person said the authorities have failed to quarantine cities and enforce social distancing.

Instead many citizens are gearing up for the Nowruz, the Iranian new year, on Friday.

“Unfortunately many don’t understand and still travel around and are preparing to go on vacations,” the Tehran resident said.

“The regime simply doesn’t want to confess its incompetence,” the person added.

The nurse in Karaj also reported there was very little police presence and little enforcement of curfews.

The authorities have released statements telling people to stay home and avoid travelling during the new year holidays to help contain coronavirus contagion.

They just threw him in a grave, without any ceremony like a dead animal Resident of Tehran

But on Thursday photos were shared online purportedly showing traffic jams on the Tehran-Qom motorway.

Iran’s outbreak began in Qom, a city 120km southwest of the capital and a stronghold of Iran’s shiite clergy.

There the authorities have battled to close down shrines to curb the spread of the disease: videos also shared online apparently show hardline faithful storming the courtyards of Fatima Masumeh and Mashhad shrines demanding they open.

“From our sources on the ground – witnessing in person or getting this from reports they receive from key places – the numbers of Covid-19 cases are at least four times higher than being reported,” said Mzahem Alsaloum, a researcher working for western defence contractors.

“The authorities cannot do proper tests, they have been testing only those who have extreme symptoms. They have been unable to impose quarantine or social distancing measures, there are concerns about the New Year.

“There has been radical mismanagement by the regime.”

In his special message for Nowruz, Iranian foreign minister Javad Zarif, also pointed to the United States saying it is responsible for the “destructive ramifications” of continuing to impose crippling sanctions on the country as it struggles to contain the disease.

The US administration of Donald Trump has resisted pressure to ease sanctions on Iran to allow for easier access to medical supplies, ignoring a precedent set by George W Bush when he removed trade restrictions and dispatched aid after a 2003 earthquake.

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Instead on Tuesday, Washington imposed fresh sanctions, blacklisting three Iranian individuals, for engaging in "significant transactions" to trade in Iranian petrochemicals.

Mike Pompeo, secratery of state, insisted Washington will maintain its maximum-pressure campaign to choke off Tehran's ability to export its oil.

Iran has strong commercial and political ties with China, where coronavirus emerged last year. It denied for weeks that the virus had been encountered in Iran finally acknowledging its presence on 19 February.

Still, Iranian president Hassan Rouhani insisted on Wednesday that Iran had been honest with people, calling accusations that Iran first tried to downplay the outbreak of coronavirus “propaganda” in a speech broadcast live on state television.

Responding to mounting public criticism, including an actor on television who publicly blasted the authorities for lying and failing to shut down the city of Qom, Tehran has offered a major olive branch to its many opponents, releasing 85,000 prisoners on furlough.

On Wednesday Iran announced it would pardon prisoners serving sentences of less than five years for “security crimes” ahead of Nowruz.