The Horror Of A Collapsed Health System: Inside Amazon’s Covid-19 Catastrophe

Last year in April it was the first Brazilian city to dig mass graves. By June, the number of deaths has returned to pre-pandemic levels and it took no longer than autumn for the leaders of Brazil to celebrate the so-called herd immunity acquired by 76 per cent of the people of Manaus – a city of two million people in the Amazon’s state. A paper entitled “Covid-19 herd immunity in the Brazilian Amazon,” initially published online and later, in December, under a more cautious name in Science, estimated that 76 per cent of Manaus’s residents have been infected and that meant that the city reached herd immunity. “We didn’t think there would be a second wave,” Ester Sabino, one of the authors said. Indeed, there were no signs of it.

Corruption, a collapsed health system, and the mishandling in containing the virus and preparing for the future made Brazil the second hardest-hit country in the world. Nicolás Maduro, the President of Venezuela described it as “Jair Bolsonaro’s public health disaster.” Ten months and more than 220,000 Brazilian deaths – later, Manaus is in a more precarious situation than ever before. A devastating second wave caused by a new and more contagious variant left many without the most basic supplies, while hospitals ran out of oxygen. A catastrophic government failure which many hope, it will act as a warning on what could happen in other parts of Brazil unless more drastic measures are being taken.

“Manaus is lost,” said epidemiologist Jesem Orellana from Fiocruz Amazonia public health research centre. Mr Orellana compared the hospital beds in the Amazonian capital with “asphyxiation chambers” and described the city as “an open-air laboratory where all types of negligence and inhumanity are possible. On January 15th, anti-lockdown President Jair Bolsonaro said the government had done everything it could in Manaus. “The problem is terrible here. Now, we have done our part.” It was the same day when hospitals ran out of oxygen and doctors were praying for divine intervention.

But Orellana said: “We gave 13 alerts, and a very alarming one in mid-December, saying that the situation was getting very serious. Everyone was making fun of the studies and warnings, especially the President Jair Bolsonaro.” He called on the World Health Organisation to act as observers in Manaus, “because it is no longer possible to trust the different levels of management leading the pandemic”.

Stories about the heart-breaking settings of the people of Manaus are being reported in every corner of the world. Venezuela, South America’s most unstable country, began sending oxygen supplies across the border. Celebrities and social media influencers chartered private jets full of tanks. The families and friends of those in need are queuing for hours on end to find enough oxygen to keep their loved ones alive, and doctors are struggling to control the rising number of cases. According to the National Council of Health Secretaries, the Covid-19 infections in Manaus surged by 125 per cent between January 7 and January 22.

Helmo Quieroz, a 40-year-old resident from Manaus waited in line 18 hours to refill his sister’s oxygen tank, which would last her five hours. He said the price of one tank had increased six times within a week and that he feared his sister would die in the hospital’s precarious conditions. “I’ll be back in the morning,” he said. One staff member at the Alvorada health clinic described the atmosphere as one of “disgust, abandonment, despair and impunity. What we’re watching is a complete massacre, a desperate situation, a horror film.” 

In December as cases spiked, the governor of Manaus ordered a lockdown but revoked it as protests began. Officials in Amazonas faced pressure, both from the public, as well as from Bolsonaro’s statements, who in November told his people to not fear the virus “like a country of fags.” 

The rollout of the vaccine is predicted to be extremely difficult. Brazil, which has 212 million citizens, has so far secured six million doses of China’s CoronaVac shot and two million of the AstraZeneca/Oxford shot. On January 21st, the federal health ministry said the vaccine is going to be distributed to state and municipal governments “in a proportional and egalitarian way,” and within hours after the first vaccines were administered on live TV to government officials, the children of a few wealthy Manaus families posted on social media that they had received shots as well. Amazonas will get only 70,000 of the six million secured.

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