The Guardian
‘A complete massacre, a horror film’: the Covid disaster in Brazil
Hospitals in the state of Amazonas overloaded after increased infections linked to the new variant, leaving many without even the most basic supplies A relative of a patient infected with Covid-19 waits to refill an oxygen tank in Manaus, state of Amazonas, on Tuesday -market. Photography: Marcio James / AFP / Getty Images It took just 60 minutes at dawn for the seven patients to die, suffocated when the coronavirus returned to the Brazilian Amazon with a nightmare force. “Today was one of the most difficult days in all my years of public service. You feel so helpless, ”sobbed Francisnalva Mendes, head of health in the riverside city of Coari, as he remembered the moment on Tuesday when the hospital’s oxygen supply ran out. “We need to get back to the fight – keep saving lives,” insisted Mendes while digesting the loss of a third of the 22 patients at Covid-19 in his city at once – four of them in their 50s. “But we all feel broken. It was such a difficult day. ”Coari was at the center of the most recent coronavirus catastrophe in Latin America last week, after an outbreak of infections linked to a seemingly more contagious new strain overwhelmed hospitals in the state of Amazonas, leaving many without the most basic supplies. The circumstances were so bleak that the oxygen tanks were rushed across the border with Venezuela, the economically collapsing neighboring country, with its leader, Nicolás Maduro, condemning what he called “Jair Bolsonaro’s public health disaster”. Health agents bring a patient to the Emergency Room of the public hospital in Manacapuru, Amazonas, on January 20. Photo: Marcio James / AFP / Getty Images “It is a very chaotic situation. We cannot keep up with the number of patients who come to us, ”said Marcus Lacerda, an infectious disease specialist in the capital of Amazonas, Manaus. “Private hospitals do not want to receive anyone because they are afraid to admit a patient and then run out of oxygen again.” Manaus made international headlines in April after a torrent of deaths from Covid forced authorities to dig mass graves in the city’s reddish earth. Nine months – and more than 210,000 deaths of Brazilians – later, the situation is even worse. In a few days, about 200 bodies are being buried in Manaus, compared to the usual 40. Last week, many hospitals were left without the oxygen that supported Covid’s patients, apparently because of a catastrophic failure by the government to predict the magnitude of the impending disaster. “Nothing like this happened – not even last year. I never imagined that there would be a wave of reinfections as big as the one we are seeing now in Manaus ”, said Lacerda, one of the main infectologists in the region, blaming a variant“ that seems to be more contagious ”. The drop in people’s immunity and changes in the virus mean that this second wave is uncontrollable Marcus Lacerda Lacerda said he hoped the scale of last year’s epidemic could have provided the riverside city with some immune protection against such a devastating second wave. “But the truth is, there is no way. The drop in people’s immunity and the changes in the virus mean that this second wave is uncontrollable. ”Anguishing stories of suffocating patients and evacuation of premature babies sparked a public revolt against the leaders of Amazonas, which critics accuse of not having planned, let alone avoided, their second cataclysm in a year. “There is an atmosphere of disgust, abandonment, despair and impunity,” said an official at the Alvorada health post, in Manaus, where doctors were filmed begging for divine intervention. “What we are seeing is a complete massacre, a desperate situation, a horror film,” added the worker, who asked not to be identified. Much of the anger is directed at the government of Brazil’s far-right president, Jair Bolsonaro, who has trivialized Covid-19 even as the death toll in his country has risen to the second highest on earth. Bolsonaro’s obedient health minister, Eduardo Pazuello – an army general with no medical experience – visited Manaus on the eve of the health collapse last week, but pushed the false “early treatments” Covid-19 promoted by his leader instead of solving the impending oxygen crisis. “The president’s boot lick had warning days that Manaus hospitals would run out of oxygen. He only prescribed useless chloroquine, ”wrote journalist Luiz Fernando Vianna in Época magazine, blaming Bolsonaro and Pazuello for the“ killing ”. Lacerda accused the government of trying to distract citizens from their deadly inaction with the “false hope” of ineffective remedies. “This is not happening anywhere else on the planet,” he said. Relatives of a man who died at home are routinely questioned by a professional from the Manaus municipal health department on January 15. Photo: Raphael Alves / EPA In Manaus, a city flanked by the jungle and accessible only by plane or boat, the public’s anger was combined with the action. Dozens of groups of volunteers, many formed by young manauaras, came to raise funds and supply oxygen, equipment and food to the city’s health system. “It is a Dantesque situation … we feel that we live in a place without government,” said Vinícius Lima, 16, who uses Twitter and Instagram to crowdsource cylinders, oximeters and PPE. “I’m doing what I think is my duty. I wouldn’t be able to sleep at night if I wasn’t doing anything to help the city I love, ”said the student. “I am very proud to be from the city in the heart of the Amazon, you know?” Others use social media to mourn, flooding Facebook with photos of loved ones lost in the punishment of the second wave. “It is as if the city is in constant mourning,” said the clinic worker, who lost an aunt. Some consider Manaus’ latest calamity an aberration, the result of its fragile health service and geographical isolation. Lacerda said that it actually offered a glimpse of the future for other parts of Brazil, as the rainy season in the Amazon meant that the flu season would arrive earlier. “If we don’t immediately put in place a more aggressive vaccine ‘blockade’, what happened in Manaus will happen in the rest of the country,” he warned. “We need to vaccinate people.” This may not be easy. The inoculation finally started last Sunday, weeks after other Latin American countries, such as Chile and Mexico. But Brazil, which has 212 million citizens, has so far secured only 6 million shots of China’s CoronaVac shot and 2 million of the AstraZeneca / Oxford shot. “This is absolutely insufficient to halt the spread of the disease,” said Lacerda, who believed that Brazil’s “complete international isolation” under Bolsonaro’s government helped explain his failure to get enough vaccines. Vítor Cabral comforts his wife, Raissa Floriano, in Manaus on January 14th. Photo: Bruno Kelly / Reuters Last week, Brazil’s efforts to import essential pharmaceutical active ingredients (IFAs) for vaccine production from China were found to have stopped, with some blaming Bolsonaro’s criticism of China and his supporters. Raissa Floriano, whose 73-year-old father is fighting Covid at the hospital, said at least six of his companions died after the oxygen ran out. “With better decisions, this whole tragedy could have been avoided. But every sensible decision that could have been made has been rejected or ridiculed, ”said the 27-year-old teacher. “I feel discouraged, disappointed and angry – just absolute discouragement and fear for the future.”