Inside, doctors perform cardiopulmonary resuscitation on a woman in a futile attempt to save her life. A hospital source told CNN that she died shortly after being brought inside.
In the four hours that CNN spent outside Hilda Freire Hospital on Tuesday morning, three Covid-19 patients died.
Chaos has become the norm here this month. What is happening in this under-equipped hospital, surrounded by the Amazon rainforest, is a small example of a new massive Covid-19 outbreak involving northwestern Brazil.
Not far from Iranduba is the epicenter of this new outbreak, Manaus. The capital of the state of Amazonas is often referred to as the gateway to the Amazon, its main connections to the rest of the world by plane or boat.
If the city’s name sounds familiar, it may be because it was the scene of one of the worst Covid-19 outbreaks in the world in April and May. The health system collapsed and images of thousands of freshly dug graves became emblematic of the coronavirus crisis in Brazil, the death toll now second only to the United States.
The current situation is worse than ever. January proved by far the deadliest pandemic month in Manaus.
In May, 348 people were buried here, the worst month yet. In the first three weeks of January alone, that number was 1,333.
Although genomic tests are not common in Manaus, scientists tell CNN that the evidence suggests a new variant of the virus mixed with government inaction to create a perfect tragic storm.
A new variant of the coronavirus
Four epidemiologists told CNN that a new variant of the coronavirus, called P.1, is probably causing the new round of devastation that has befallen Manaus.
“I am not normally an alarmist with this kind of thing, but I am concerned with what we are seeing in Brazil now,” said Scott Hensley, a viral immunologist at the University of Pennsylvania.
Scientists say the new version of the virus originated in Brazil and, although there is still much to learn about it, the concerns are manifold.
First, new data suggests that it is more transmissible.
Researchers from Fiocruz, a Brazilian health research institution, study infected people in Manaus. Of the 90 who have participated in the study, 66 had infections with this new variant, according to Fiocruz researcher Felipe Gomes Naveca.
Although not conclusive, experts say it gives credit to the idea that this variant is more easily transmitted.
“If it has the ability to spread more efficiently, it (is) likely to actually become more and more dominant,” Dr. Anthony Fauci told CNN’s Erin Burnett on Tuesday.
Researchers at Fiocruz have also documented at least one case of a person who tested positive for the new variant, although he still had antibodies from a previous Covid-19 infection. This may suggest that people can be reinfected with the new variant, although a case is far from proof.
“The fact that we are seeing infections now indicates that the virus circulating is more transmissible, that it can escape the antibodies, or a combination of both,” said Hensley.
The good news? For now, it appears that current Covid-19 vaccines may still protect against the mutation pattern seen in the new variant – although all epidemiologists interviewed said that much more research is needed.
It’s not just the variant
To blame the last outbreak simply on the variant would be to lose the forest because of the trees. The new emerging variant is simply part of a larger system that has failed people in the state of Amazonas.
Start with the lack of a coordinated federal response, a hallmark of President Jair Bolsonaro’s government during the pandemic.
After the first wave, it was painfully obvious that Manaus’ health system could not cope with another similar crisis.
But as the worst days of April, May and June subsided, the federal government has not doubled its response here to ensure that the city will never again be critically short of fans, medication, oxygen and sleeping space.
Instead, a feeling of complacency took over, while leaders like Jair Bolsonaro called the idea a second wave of lies. In November, he told his people to essentially accept the virus and not fear the virus “like a country of fags”.
Critics are now wondering whether similar complacency may have delayed the Federal Ministry of Health’s response to the warning signs this month of a second crisis in Manaus.
Federal investigators are investigating why Health Minister Eduardo Pazuello was not quicker to send aid to the city after an increase in cases was documented in December, and again after an oxygen supplier signaled problems in January.
“Although an increase in the number of Covid-19 cases has been seen [in Manaus] in the week of Christmas 2020, the Minister of Health chose to send representatives of the ministry to Manaus only until January 3, a week after being informed of the dire situation, “said a report by the country’s attorney general submitted to the Supreme Federal of Brazil. Block.
Pazuello defended his actions, blaming the variant for a disaster that he argues that no one could have predicted.
“This was a situation completely unknown to everyone,” he said on Tuesday. “It was too fast.”
The stage was set
But a basic understanding of how viruses evolve would have suggested that the same situation was coming.
When the blockades were eased at the end of last year, companies reopened and people filled the streets. Despite warnings from several experts that the virus was spreading, a more laissez faire attitude towards the virus spread in Manaus.
Pervasiva was the now proven false notion that the first massive wave of Covid-19 in Manaus reached a population sufficient to create herd immunity.
“People started to live as if we had a normal life, without wearing masks with a lot of crowds,” said Naveca, researcher at Fiocruz. “We saw this a lot at Christmas and at the end of the year.”
As CNN previously reported, even as scientific warnings increased, officials in the state of Manaus and Amazonas faced pressure – both from the public and Bolsonaro’s own statements – to refrain from imposing restrictive blocking measures.
But around the world, wherever existing strains of Covid-19 could continue to circulate, the foundations were being laid for the emergence of new variants.
“The virus is having an opportunity to explore all of these different genetic types and those that are favored are now being selected,” said Hensley.
In other words, the more the virus can spread, the more chances it has to evolve and form new variants.
CNN’s Natalie Gallón and journalists Marcia Reverdosa and Eduardo Duwe contributed to this report.