Iran was the immediate epicenter of the COVID-19 pandemic in the Middle East and among the most severely hit countries globally. Despite having the highest number of cases and deaths in the region, Iran was late to enforce lockdown measures and early to resume economic activity. Tehran’s reluctance to impose a comprehensive lockdown was driven by its lack of capacity to provide economic support to its population. Iran could not afford severe lockdown measures due to US sanctions, a significant decrease in oil prices, and the leadership’s fears of stirring domestic protest. The lack of effective lockdown, compounded by the regime’s concealment of credible information, led to severe outbreaks of the virus and significantly impacted the population’s trust in government.