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Manaus COVID-19 crisis could strike across Brazil, doctors warn | News on the coronavirus pandemic

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With hospitals overflowing and oxygen supply depleted, Brazilian epidemiologist Jesem Orellana said hospital beds for COVID-19 patients in Manaus, the capital of the country’s Amazonas region, have transformed. in “asphyxiation chambers”.

“Manaus is lost,” said Orellana, who described the city as an open-air laboratory “where all types of neglect and inhumanity are possible” and in which people are dying in their homes without medical assistance.

He warned that the collapse of the local health system, propelled in part by the discovery of a potentially more contagious variant of COVID-19 in the region, could also occur in other parts of Brazil.

“It is not only possible that this is happening, but it is already happening,” Orellana, who works at Fiocruz Amazonia, a public health research center in Manaus, told Al Jazeera.

“There are people in Para State who have died from lack of oxygen. When you start to run out of oxygen you start having problems with increased demand for hospital beds and that could have a domino effect. “

At least 216,000 dead nationwide

Brazil has recorded more than 216,000 COVID-19-related deaths since the start of the pandemic, the second-highest total in the world after the United States, according to data from Johns Hopkins University. It has also reported at least 8.8 million cases.

The lack of a cohesive plan from the federal government to curb the pandemic or the behavior of people has annoyed health professionals.

Right-wing President Jair Bolsonaro downplayed the severity of the virus, refused to receive the vaccine and criticized the lockdown and social distancing orders issued by local government officials.

On January 15, Bolsonaro said the government had done what it could in Manaus. “The problem is terrible there. Now we have done our part, ”he said. But the attorney general’s office said the health ministry would have been warned nearly a week before the oxygen supply reached critical levels in the city, but did not notify federal authorities.

Health worker at Getulio Vargas hospital amid COVID-19 outbreak in Manaus [Bruno Kelly/Reuters]

Orellana said that while the oxygen supply had made international headlines, the real problem was “a failure of government management and logistics”.

He called on international agencies such as the World Health Organization to act as observers in Manaus, “because it is no longer possible to trust the different levels of management leading the pandemic”.

New variant

Despite a sharp increase in cases, many residents of Manaus still flew to Sao Paulo and Rio de Janeiro, said local obstetrician Dr Alexandre Staviack, who added that the virus had reached small towns and could overwhelm their hospital systems.

COVID-19 infections increased by 125% in Manaus between January 7 and January 22, according to the National Council of Secretaries of Health and Brazilian media.

Staviack said doctors have noticed an increase in the number of premature births in Manaus as pregnant women with COVID-19 have had to undergo cesarean sections due to their low oxygen levels. The threat of COVID-19 has also prompted some pregnant women to take drastic measures, he said.

“They are afraid. They avoid going to the hospital unless they have given birth.

Meanwhile, there are growing fears that the new variant of COVID-19 found in the Amazon could easily spread, especially in areas of the country where access to healthcare is limited.

The UK has banned arrivals from Brazil and other South American countries over concerns over the new variant, known as P1, which was first detected in travelers from the state of Amazonas going to Japan.

Dr Fabio Tozzi, visiting professor at the School of Public Health at Federal University of Western Para who has volunteered on a hospital boat for the past 15 years, said the pandemic has revealed just how the brazilian health system is bad in isolated areas.

He said residents of isolated communities in Amazonas typically travel by boat from across the state to Manaus when they are seriously ill due to a lack of intensive care units. “All the logistics around the river are done by boat, but that makes the transmission of the virus that much easier,” he said.

Dr Ricardo Affonso Ferreira is president of Expedicionarios da Saude (EDS), a group of volunteer doctors who regularly travel to the Amazon jungle to provide health care.

Since the start of the pandemic, he has been in charge of logistics in the Amazon region, coordinating difficult tasks such as transporting concentrators and oxygen cylinders to isolated communities.

People participate in a procession to protest against Brazilian President Jair Bolsonaro and his handling of the COVID-19 crisis, in Sao Paulo on January 23 [Amanda Perobelli/Reuters]

Ferreira said doctors working in the area have reported that the variant is spreading and this time more young people between the ages of 30 and 50 are getting sick with more severe symptoms. “The virus will spread to other states such as Rondonia and those in northeastern Brazil – they could suffer from a lack of oxygen because they are so poor,” Ferreira said.

He said the virus is already spreading along the Madeira River that flows through Bolivia.

“We are very, very scared about this,” Ferreira said, adding that Brazilian MP Cassio Espirito Santo recently said that people from Peru and Bolivia are also coming to Tabatinga, in the western Amazonas, to be treated there.

Lock to start

Dr Julio Ponce, an epidemiologist who works in Sao Paulo, said last week that while deaths from the disease are underreported, the latest data showed a seven-day daily average of 54,000 new cases and 983 deaths. in all the countries.

“Manaus serves as a sentinel for the rest of the country,” Ponce said, explaining that in April last year it was the first city in Brazil to experience a spike which led to the collapse of its health system. , followed by Para and other states. in the northeast of the country.

“The same pattern will emerge this time, but with much worse results,” said Ponce, who added that the new variant accounts for 42 percent of new cases in Manaus.

“All states and hospitals are fighting for a limited supply of oxygen. States other than Amazonas could be depleted if we do not have a coordinated effort from the federal government. We’re short, state by state. “

Manaus hospitals pushed to their limits amid spike in COVID-19 cases [File: Bruno Kelly/Reuters]

Over the weekend, the governor of the state of Amazonas announced that new restrictions would come into effect on January 25. Residents will only be allowed out for essential services, such as shopping or health care, for a period of seven days, Wilson Lima said.

The move comes after the state previously imposed a nighttime curfew, from 7:00 p.m. to 6:00 a.m.

In an open letter on Friday, Orellana had urged authorities to institute a 21-day lockdown in Manaus – which he called “the COVID-19 capital of the world” – to avert disaster. He said if the first wave in Manaus was traumatic, the second is worse – and it leaves lasting scars.

A local ambulance driver recently had to transport four people to hospital, but all the patients died along the way, Orellana said.

“He couldn’t sleep for two nights in a row because he kept hearing the whisperings of the dying. He had to take time off and get psychiatric help, ”Orellana said. “The rule seems to be to let the virus run free, horrifying all of humanity.”


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