Manaus COVID-19 disaster might strike throughout Brazil, medical doctors warn | Coronavirus pandemic Information

Brazilian epidemiologist Jesem Orellana said the hospital beds of COVID-19 patients in Manaus, the capital of the country’s Amazon region, have become “chambers of suffocation.”

“Manaus is lost,” said Orellana, who described the city as an open-air laboratory, “where all kinds of negligence and inhumanity are possible” and where people die at home without medical assistance.

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

“Not only is it possible that it will happen, 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 of lack of oxygen. When oxygen supplies become scarce, you have problems with the increased demand for hospital beds, which could have a knock-on effect. “

Nationwide at least 216,000 dead

According to the Johns Hopkins University, Brazil has recorded more than 216,000 deaths related to COVID-19 since the pandemic began. This is the second highest number in the world after the US, according to Johns Hopkins University. At least 8.8 million cases have also been reported.

The lack of a coherent federal government plan to contain the pandemic or human behavior has angered medical professionals.

Right-wing President Jair Bolsonaro has minimized the severity of the virus, refused to receive the vaccine, and criticized 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’ve done our part, ”he said. However, the attorney general said the health ministry was reportedly warned almost a week before the city was reaching critical levels, but it failed to inform federal authorities.

A health worker at Getulio Vargas hospital during the COVID-19 outbreak in Manaus [Bruno Kelly/Reuters]Orellana said that while oxygen supplies made international headlines, the real problem was “a failure of government management and logistics”.

He called on international organizations like the World Health Organization to act as observers in Manaus “because it is no longer possible to trust the various levels of leadership that are leading the pandemic”.

New variant

Despite a steep rise in cases, many in 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.

According to the National Council of Health Secretaries and the Brazilian media, COVID-19 infections in Manaus rose 125 percent between January 7 and January 22.

According to Staviack, doctors in Manaus have seen an increase in premature births as pregnant women with COVID-19 have had to have cesarean sections due to their low oxygen levels. The threat of COVID-19 also caused some pregnant women to take drastic steps, he said.

“You are scared. They avoid going to the hospital unless they are in labor. “

Meanwhile, concerns are growing that the new variant of COVID-19 could easily spread in the Amazon, especially in parts of the country where access to health care is restricted.

The UK has banned arrivals from Brazil and other South American countries over concerns about the new P1 variant, which was first seen among travelers from the Amazon state to Japan.

Dr. Fabio Tozzi, a visiting professor at the Federal University of Western Para’s School of Public Health who has volunteered on a hospital boat for 15 years, said the pandemic had shown how bad Brazil’s health system is in remote areas.

He said residents of isolated Amazon communities typically travel to Manaus by boat from across the state when they are very ill due to the lack of intensive care units. “All of the logistics around the river are done by boat, but that makes it a lot easier to transmit the virus,” 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 care for the indigenous people.

Since the beginning of the pandemic, he has been responsible for logistics in the Amazon region and coordinates challenging tasks such as transporting oxygen concentrators and bottles to isolated communities.

People join a motorcade to protest against Brazilian President Jair Bolsonaro and his handling of the COVID-19 crisis in Sao Paulo on January 23 [Amanda Perobelli/Reuters]According to Ferreira, doctors working in the region are reporting 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 like Rondonia and northeastern Brazil – they could be oxygen deprived because they are so poor,” Ferreira said.

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

“We are very scared of it,” said Ferreira, adding that Brazilian MP Cassio Espirito Santo recently said that people from Peru and Bolivia would also come to Tabatinga in the western Amazon for treatment.

Lock to begin

Dr. Julio Ponce, an epidemiologist working in Sao Paulo, said last week that although deaths from the disease were not adequately reported, the latest data showed a daily average of 54,000 new cases and 983 deaths across the country.

“Manaus serves as a guard post for the rest of the country,” Ponce said that in April last year it was the first city in Brazil to see a climax that led to the collapse of its health care system, followed by Para and other states in the northeast of the country .

“This time around the same pattern will occur, but with far worse results,” said Ponce, who added that the new variant accounts for 42 percent of new cases in Manaus.

“All states and hospitals are struggling for limited oxygen supplies. States other than the Amazon could go out if we don’t have a coordinated federal government effort. We run from state to state. “

Manaus hospitals have reached their limits due to an increase in COVID-19 cases [File: Bruno Kelly/Reuters]Over the weekend, the Amazon state governor announced that new restrictions would come into effect on January 25th. Residents are only allowed to use essential services like food or health care for seven days, Wilson Lima said.

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

In an open letter on Friday, Orellana had asked the authorities to initiate a 21-day lockdown in Manaus, which he described as the “world capital of COVID-19”, in order to avert a disaster. He said while the first wave in Manaus was traumatizing, the second is worse – and leaves permanent scars.

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

“He couldn’t sleep for two nights because he kept hearing the whispers of the dying. He had to say goodbye and get psychiatric help, ”Orellana said. “The rule seems to be to let the virus run free, which horrifies all of humanity.”