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Lungs of the World Desperate for Oxygen: The Epicentre of Brazil’s COVID-19 Pandemic

Monica Piccinini speaks to those on the ground in the Brazilian state where health workers are battling against a horrendous surge in Coronavirus cases

Cemetery workers in protective suits carry the coffin of a person who died of COVID-19 at Nossa Senhora Aparecida Cemetery, in the state of Amazonas, Brazil. Photo: Lucas Silva/dpa

Lungs of the World Desperate for OxygenThe Epicentre of Brazil’s COVID-19 Pandemic

Monica Piccinini speaks to those on the ground in the Brazilian state where health workers are battling against a horrendous surge in Coronavirus cases

Manaus, the capital of Amazonas state in Brazil, is once again suffering the devastating effects of COVID-19’s march through the country. While it was badly hit throughout last year, it has now entered a new phase of the Coronavirus crisis, which can only be described as catastrophic.

A surge in COVID-19 cases was reported in Manaus last week, putting huge pressure on already stretched resources. Oxygen supplies were exhausted leaving many patients dying from asphyxiation. The scenes are of total despair and fear for the immediate future of COVID-19 patients, their families and health care professionals.

The health system in Manaus was the first to collapse during the initial nationwide peak of COVID-19 infections. Less than a year later, the situation is even more desperate and chaotic. During the first 14 days of January, 1,654 deaths were reported in the state of Amazonas alone. This is considerably more than in any 14-day period last year.

A doctor working at Hospital Universitário Getúlio Vargas, who wishes to remain anonymous, told Byline Times: “The current situation is chaotic throughout the city and the entire health service. My colleagues have said that in some emergency rooms the situation is simply surreal. They have to choose who lives and who dies and deal with a terrible physical and emotional overload.

“There is a lack of basic medicines to keep patients on mechanical ventilation, infusion pumps and human resources. In short… all very sad and regrettable. Patients arrive very seriously ill in the emergency rooms, many of them are already dead.”

Health care professionals in Manaus have spoken of the desperate attempts by doctors to keep their patients alive. Some patients don’t even get to go to hospital and end up dying at home.

But the doctor said he also saw some hope in the way that the pandemic was bringing out the best in people: “We see groups of sympathetic and anonymous people delivering meals to health professional colleagues waiting outside hospitals. They take food and snacks to the exhausted healthcare staff. We also see groups of colleagues coming together to buy medications and equipment that is missing.

“It seems the difficulties imposed by the pandemic are arousing these feelings of solidarity in people but it would be good if it didn’t need a pandemic to make this happen.”

Lack Of Oxygen

A 10-day curfew has been imposed between 7pm and 6am by the Governor of Manaus, Wilson Lima. Unfortunately, it may not be enough to contain the new strain of the virus in the state of Amazonas.

The new variant was identified by Japanese researchers and is still being studied, but research suggests that it is much more transmissible than the original strain and, as a result, is much harder to contain.

“Today, the state of Amazonas, which is a reference for the world, and where everyone turns their eyes when there is a problem related to preserving the environment, is crying out, asking for help,” said Lima. “Considered by many to be the lung of the world, a forest that produces a significant amount of oxygen, today our people are in need of that oxygen.”

George Lucas, a nurse at Hospital e Pronto Socorro, told Byline Times that a “lack of oxygen” is the biggest challenge currently facing health workers amidst the chaos. “Considering that we care for people infected with the new Coronavirus strain and the only way to keep them stay alive is with oxygen, without it, they suffer and die,” he said.

The federal Government of the authoritarian populist Jair Bolsonaro has attempted to supply the region with oxygen but it is too little, too late. It has sent 386 oxygen cylinders, 18 tons in weight, to Manaus. According to the State Government, daily oxygen consumption was around 30,000 cubic meters between April and May 2020, but this has now reached 70,000 cubic meters. This demand is bound to rise and a much better supply of oxygen will be necessary.

Furthermore, 235 patients in a fairly stable condition have been transferred to other Brazilian states – Goiás, Maranhão, Paraíba, Piauí and Rio Grande do Norte – and to the federal district to receive medical care. The danger is that this could make the spread of the new COVID-19 variant to other parts of the country much harder to contain.

President’s Blame

Brazil has recorded more than 208,000 COVID-19 deaths – the second highest in the world, just behind the US.

Many Brazilians blame COVID deniers and the calamitous situation in Manaus, as well as those who did not support stricter measures such as lockdowns and social distancing. They also blame President Bolsonaro for dismissing the seriousness of the pandemic and encouraging the use of drugs such as hydroxychloroquine, which has no beneficial effect.

Just before Christmas, he told his supporters in São Francisco do Sul, Santa Catarina, that the best vaccine against COVID-19 is the virus itself: “I cannot speak as a citizen one thing and as a President another. But, as always, I never ran away from the truth, I tell you; I’m not going to get a vaccine. If someone thinks my life is at risk, it’s my problem. And final point, imbecile, I already had the virus, so I’m already immune.”

The Minister of Health, Eduardo Pazuello, was in Manaus on 11 January to announce a pandemic contingency plan for Amazonas. During his visit, he recommended the use of chloroquine, hydroxychloroquine, a few vitamins, chlorine dioxide, rectal ozone, amongst other drugs in order to treat early COVID-19 symptoms. The Mayor of Manaus, David Almeida, has said he intends to speed up the distribution of these drugs.

But hospital nurse George Lucas is convinced that the Government is responsible for this crisis.

“Unfortunately, we have Government officials and even health officials who have guided the population the wrong way,” he told Byline Times. “They have ignored Brazilian and international researchers and the indisputable evidence they have presented to them. 

“Almost all of my incubated patients self-medicated with drugs that were of no or dubious use like hydroxychlorine, resemsevir and they are in the condition they are in – very serious. The people are not to blame for the lack of management of public resources, much less for having made a mistake in not following the health recommendations, especially as the President himself does not follow the public health advice.”

According to the Brazilian federal Government, India will initially provide Brazil with the Oxford and AstraZeneca vaccine so it can start its immunisation campaign. But, only last week, India denied Brazil an immediate export of the vaccine, leaving the Government empty-handed. A Brazilian plane was then chartered to collect the vaccines directly from India but the flight had to be rescheduled. India has now just confirmed it will allow the export of vaccines to Brazil but the date of the first shipment is not scheduled. It is still unclear when and how Brazil will be able to start its vaccination programme.

“The tragedy that occurs in Manaus is a warning to Brazil and the rest of the world that one should not let one’s guard down in the fight against COVID-19 pandemic,” the assistant director-general of the World Health Organisation, Mariangela Simões, has said.

Manaus is living through a very dark, lonely and painful moment. Health workers are trying desperately to deal with the high number of deaths, the chaos, the distress and the lack of support and planning. But, with the timeframe for the delivery of vaccines still uncertain, there is little to raise their spirits.

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