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COVID: Second wave overwhelms medical system in Manaus, Brazil | News on the coronavirus pandemic

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Rio de Janeiro, Brazil – Consuelo Cesar, 84, was in stable condition in an IT unit at the SPA do Alvorada hospital when the hospital warned that its oxygen supply would run out within minutes.

On Thursday, January 14, as Manaus reported 2,516 new infections and 254 hospitalizations, the highest figure since the start of the pandemic, Consuelo’s family launched a desperate search for oxygen.

Her niece managed to buy an oxygen cylinder, but that would only last three hours. After the bottle ran out, Consuela survived on a combination of donated oxygen at the hospital and manual ventilation, until the wee hours of Saturday morning.

“It was 48 hours of racing, terror and suffering,” Consuelo’s grandson Rafael Cesar told Al Jazeera by phone from his family home in Manaus.

When donations ran out and with no ventilators available, her granddaughter Thais was called in to perform manual ventilation, due to limited medical staff. After 20 exhausting minutes, when she could no longer pump, news arrived that 10 oxygen cylinders had arrived at the hospital.

“Oxygen was distributed to all patients but it would only have lasted eight hours,” Rafael explains. “Unfortunately, for my grandmother, it was too late”.

Conseula died at 1:10 a.m. on Saturday, a few minutes after the 10 cylinders arrived at the hospital.

Health workers transport patient to Getulio Vargas hospital [Bruno Kelly/Reuters]

Calls for help

The surge in COVID-19 infections, oxygen shortages and an explosion in hospital demand have so far defined the second wave in the Brazilian jungle city of Manaus, which is experiencing a health disaster.

The government has yet to reveal the number of deaths since state emergency care units ran out of oxygen last Thursday. A resident doctor at Getulio Vargas Hospital, who spoke on condition of anonymity because they were not authorized to speak to the media, told Al Jazeera that around 100 patients have died of asphyxiation since the 14th. January.

On Saturday, after Rafael Cesar’s mother, uncle and grandfather also began to experience severe symptoms of COVID-19, he joined Brazilian celebrities and politicians to ask for help on the platforms of social media.

“Due to a collapse of the medical system in Manaus, my family is transferred to Sao Paulo. Any donation will go towards the treatment and recovery of my family, ”he wrote in a Facebook post.

Critics blame the government of Brazilian President Jair Bolsonaro for mismanaging the crisis. According to the attorney general’s office (AGU), the health ministry was reportedly warned nearly a week before the oxygen supply reached critical levels in the city, but has not notified federal authorities.

A truck is loaded with oxygen to supply local hospitals, after arriving on a Brazilian Air Force plane at Manaus airport on January 15. [Bruno Kelly/Reuters]

Brazilian Health Minister Eduardo Pazuello, who visited Manaus days before the city ran out of oxygen, said on Monday outside the Planalto Palace that “they had done all they needed” .

Although the Brazilian Air Force has since responded to the crisis by providing an emergency supply of liquid and gaseous oxygen, the crisis in Manaus is far from stable.

‘A war every day’

“The government says the situation is under control, but it is not… Hospitals survive on donated oxygen and medical supplies. It’s a war every day. Patients of all ages are in critical condition and there is nothing we can do about it, ”the primary care doctor at Getulio Vargas hospital said over the phone.

The doctor informed Al Jazeera that due to the saturation of medical systems, patients who do not have extremely severe symptoms are being treated at home.

Even before the oxygen crisis, infectious disease specialists had urged authorities to impose a version of a lockdown since August 2020, in order to avoid a repeat of the first wave that led Manaus to dig mass graves.

State governors did not begin imposing restrictive measures until December 26, calling for business establishments to be closed for 15 days. But the decision was quickly overturned after protests from Bolsonaro-backed workers erupted across the Amazon state.

“ The Manaus crisis should be an alarm for the foreigner ”

“Letting the virus circulate freely is a monstrosity,” said Jesem Orellana, a local epidemiologist at the Fiocruz Public Health Research Center in Al Jazeera.

“It’s chaos. Seven people died of suffocation in the Amazon on Tuesday alone. During the past week, an average of 27 people die at home every day due to the unavailability of UTI beds, ”Orrellana added.

Osmar Magalhaes, 68, who suffers from COVID-19, is undergoing physical therapy at his home, where he has set up his own emergency department with air tanks due to the lack of oxygen in the system. Manaus public health [Bruno Kelly/Reuters]

The epidemiologist attributes year-end events and the possibility of a new, much more infectious variant of the coronavirus as likely causes for the sudden outbreak, although he says it is too early to confirm.

“What is happening in Manaus with this possible new variant could happen abroad,” he warned.

Brazil is the second hardest-hit country in the world in terms of COVID-related deaths, with more than 214,000 dead. In the past 24 hours, 1,335 new coronavirus deaths have been recorded.

In response to the crisis in the Amazon, the state governor last Thursday introduced emergency measures, including a nighttime curfew and a ban on public transport.

Health officials say this is not enough.

Orrellena says the government’s rhetoric that Manaus “is oxygen-free” obscures the seriousness of the problem.

“The world thinks the crisis is due to a lack of oxygen but it is a lack of everything. A lack of medical equipment, basic sanitary conditions and especially containment measures. We need an impending lockdown to reduce the transmission of the virus, ”he insists.

For Jesem, the work to contain the pandemic and the tally of deaths must be done outside the hospital.

“Inside the hospital, we will always lose the war. Oxygen only prolongs the situation. With or without oxygen, people will die, ”he adds.

‘Loss of humanity’

The residents are lost, shocked and frightened.

“I have already lost family members who have died at home due to the virus. I feel like I lost my humanity, ”Manaus resident Alanna Smith, who is recovering from COVID, told Al Jazeera.

Vania Tanara, dienerist at the Dr Plantao Araujo morgue, a small hospital in the eastern area of ​​Manaus, is concerned.

“We are not prepared. The number of deaths has increased to 80 percent in the last 15 days, we are now receiving around 25 deaths per day, whereas before we were receiving around two, ”she said.

Tanara believes oxygen shortages and a much more serious virus are the cause of this sudden surge.

“A lot of people are not taken care of, they die in the car on the way. When they arrive, they are already dead.



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