Doctor Says More Than 200 Reported Dead in Tehran as Regime Opens Fire on Protests

As protests against Iran’s government swelled significantly in size on Thursday night, the regime responded in many places by opening fire. A Tehran doctor told TIME on condition of anonymity that just six hospitals in the capital had recorded at least 217 protester deaths, “most by live ammunition.”

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The death count, if confirmed, would signal a feared crackdown presaged by the regime’s near-total shutdown of the nation’s Internet and phone connections since Thursday night. It would also constitute a direct challenge to U.S. President Donald Trump, who earlier in the day warned that the regime would “pay hell” if it killed protesters who have taken to the streets in growing numbers since Dec. 28.

The demonstrations, which now span all 31 provinces, began as a protest against an economy in freefall. But they soon broadened to demand the overthrow of the authoritarian Islamic regime that has ruled the nation of around 92 million since 1979. Though the rallies have been largely peaceful, with chants of “Freedom” and “Death to the Dictator,” some government buildings have been vandalized.

The doctor said authorities removed corpses from the hospital on Friday. Most of the dead were young people, he said, including several killed outside a northern Tehran police station when security forces sprayed machine gun fire at protesters, who died “on the spot.” Activists reported at least 30 people were shot in the incident.

Human rights groups on Friday reported much lower death tolls than the physician, though the discrepancy might be explained by differing reporting standards. The D.C.-based Human Rights Activist News Agency, which tallies only victims who have been identified, reported at least 63 deaths since the start of the protests, including 49 civilians.

TIME has been unable to independently verify these figures.

The death tolls arrived as the regime broadcast a series of ominous messages. “The Islamic Republic will not back down in the face of vandals” seeking to “please” Trump, Supreme Leader Ayatollah Ali Khamenei said in a speech broadcast on Friday. Meanwhile, Tehran’s prosecutor declared that protesters could face the death penalty. And on state television, an Islamic Revolutionary Guard official warned parents to keep their children away from protests, saying, “If… a bullet hits you, don’t complain.”

For the first 11 days of protests, uncertainty had surrounded the regime’s response. “There is a lot of disagreement now among security forces” over whether a massive crackdown will restore order or further inflame public anger, a black-clad riot-police officer in a Kurdish city in northwest Iran told TIME on Wednesday. “There is 100% confusion” within the riot police, he said, speaking anonymously.

Key decisions were being made in meetings that were not being communicated to officers like him, he said. “I’m a senior rank here, and I don’t know what’s happening. They’re doing things in secret, and we’re afraid of what’s coming.”

“There is chaos everywhere, in the city, in homes, in the streets and within the police forces, too,” he added. “I know all the officers in my station, and they believe the regime is collapsing.”

But bloody social media posts emerging on Friday, coupled with the blunt warnings from the regime, appeared to signal clear orders had been issued.

“I think that under current circumstances, since the protests have extended to middle-class areas, the regime will not hesitate in using brute force,” as it has to quell previous unrest, said Hossein Hafezian, a New Jersey-based Iran expert and political scientist. “At this time, it is considered an existential threat.”

“From now on, the casualties will increase rapidly,” he predicted, but added, “if Trump attacks a few anti-riot police barracks, it might be a game changer!”

Trump’s threats, along with the U.S. capture of Nicolás Maduro, the sitting President of Venezuela, were offered as one explanation for the uneven response of Iranian authorities during the earlier days of the protests. In Malekshahi, in western Ilam province, at least five protesters were killed by gunfire outside a building operated by Iran’s Basij paramilitary forces, according to Paris-based Kurdistan Human Rights Network. But at the original source of the protests, Tehran’s Grand Bazaar, a traditional base of regime support, security forces had largely dispersed crowds using tear gas and arrests rather than live fire.

Others noted the sheer number of challenges facing the Islamic Republic. “It’s still a very solid regime,” said Afshon Ostovar, a professor of international security at the Naval Postgraduate School in California and the author of two books on Iran, “but if you… look around, it’s weaker than it’s ever been on just about every front” since just after the 1979 Islamic Revolution.

The leadership is still reeling from its June conflict with Israel, when airstrikes destroyed its air defenses and set back Iran’s nuclear program—with an assist from U.S. B-2 bombers dispatched by Trump. At the same time, a currency collapsing under international sanctions, water shortages and recurring power outages have sharpened a sense of crisis across the country.

“They can’t provide even basic economic welfare for their own population,” Hafezian said. “They are in survival mode now.”

Deepening the regime’s dilemma is that, unlike the Women, Life, Freedom protests that swept across Iran in 2022, the current demonstrations were launched by bazaar merchants and spread to working-class communities—groups the authorities are wary of alienating, according to a Tehran-based political analyst who spoke on condition of anonymity. “The establishment finds it more difficult to suppress working-class people,” he said, adding, however, that “some harsh treatment has been seen in some places … and the degree of the regime’s restraint will be tested” as the protests expand.

Also complicating matters is the structure of Iran’s ruling regime. At its apex is Khamenei, who controls the security apparatus, including the Islamic Revolutionary Guard Corps. The elected President, Masoud Pezeshkian, has taken a conciliatory line in public, but his cabinet favors a crackdown, two cabinet members said on condition of anonymity.

“The majority have argued the protests should be met with force under the current circumstances because they believe there are signs of Israeli and U.S. involvement,” one member said.

Pezeshkian’s personal influence remains limited both by his office and lack of access to the Supreme Leader. Regular meetings between the two men have stopped since Khamenei went into hiding during the Israel-Iran war, according to the second member of cabinet. “He now communicates with Khamenei through multiple intermediaries,” he said.

Government public relations advisor Mashallah Shamsolvaezin said the Trump Administration wants to “encourage Iranians to take to the streets, and then, under the pretext of saving the people, attack Iran and implement the Venezuelan model here.” He noted that the government had taken a “trial and error” approach, holding talks with protest representatives, changing the Central Bank governor and handing out money—1 million tomans, or about 7 dollars, per month to each Iranian for the next four months, “trying to buy time.”

Shamsolvaezin said the regime also has resumed indirect nuclear negotiations with the West over suspending Iran’s uranium enrichment. “The regime is hoping that negotiations over Iran’s nuclear and missile programs will deliver some relief,” he said.

Interviewed before Thursday night’s bloodletting, analysts named several wild cards in how the protests—and the regime’s response—might evolve. One is whether even larger numbers of middle- and upper- class Iranians and minority ethnic groups continue to join the demonstrations despite the growing threat of a violent response. Many chanted support for Reza Pahlavi, the eldest son of the Shah, or King, deposed in the 1979 Islamic Revolution that brought the clerics to power. Pahlavi, who lives in the United States, had called for a massive showing on both Thursday and Friday nights. He has promised to return to Iran and usher in a secular democracy.

Kurdish opposition groups had already issued a call of their own. Rebin Rahmani, a board member of the Kurdistan Human Rights Network, said many Iranian Kurds have been taking to the streets because they feel they have nothing left to lose and they realize the regime is vulnerable. “This awareness has reduced fear and increased the boldness of the protesters,” he said.

Still, one Kurdish demonstrator argued, little will change unless even more residents in major cities—as well as President Trump—get involved. “Our hope is with Trump,” he said on condition of anonymity. “He should do to Iran what he did to Venezuela.”

Perhaps the biggest wild card is the security apparatus itself. While observers saw few significant signs of defection at the leadership level, they said every round of protests sees more rank-and-file police and members of the Basij (a volunteer militia of regime loyalists) refusing to take part in a crackdown.

“My own family is urging me to take off my uniform and leave this job,” the riot-police officer said, adding that he fears the moment his commanders order live fire. “If I disobey, they’ll kill me.”

“I’m in the police force for the income,” he added, “not to kill people.”