Rio de Janeiro, Brazil – When Rosa Dos Anjos was admitted to a COVID-19 intensive care unit in the Amazonian capital of Manaus for 15 days in January, she thought her fortunes could not get worse.
The 50-year-old had already lost his father to the virus during a deadly first wave of pandemic last year, and Dos Anjos was fighting for his life as oxygen supplies and the system ran out. plumbing collapsed around him.
Although he narrowly survived, his family’s struggle is far from over, as his 41-year-old brother also contracted the disease and saw his oxygen saturation levels sink to the ground. 80% in April, the deadliest month in Brazil since the pandemic began.
“I used to worry about myself. Now he’s my brother, ”Two Angels told Al Jazeera.
The Dos Anjos family has experienced two brutal waves of coronavirus pandemics, which they have suffered it claimed more than 400,000 lives nationwide: the second highest mortality rate in the world after the United States.
Although public health data show that last week 11 of the 27 Brazilian states recorded stable figures for infection and mortality, in the state of Amazonas COVID-19 cases have begun to accelerate. InfoGripe data from Fiocruz Health Research Institute and Amazon Health Secretary showed infection rates rose 42.3 percent in the last week of April after cases went up. go up for two consecutive weeks.
Health experts now warn that self-indulgence and the slow deployment of the vaccine could mean disaster, and that another rise could be imminent. This would be especially devastating in the state of Amazonas, which is in the midst of a period of respiratory disease and where highly contagious countries P.1 coronavirus variant it was first detected before becoming the dominant strain in the country.
“We’re preparing for the worst-case scenario possible,” Amazon State Governor Wilson Lima said last month. “[Previously] Amazonas was the first state affected, followed by the rest of the country. “
Lucas Ferrante, a biologist and researcher at the National Research Institute in the Amazon, told Al Jazeera that the Amazon could be affected by a third wave in a month and a half.
“A third wave is a big concern. It may not be as explosive as the second, but it could last longer. It depends on whether it generates new variants “, said Ferrante, who warned of an imminent second wave months before the region was hit.
Amazon state intensive care units had a 63 percent capacity on May 7, according to Fiocruz, and health experts have said that if coronavirus infections increase, the health care system could collapse. lapsar.
The Amazon health secretary, who is in charge of the state’s health network, told Al Jazeera that the department was working with the Pan American Health Organization (PAHO) to prepare a third wave.
“We plan to increase the number of COVID beds and ensure that drug stocks are sufficient,” the office said in an email, among other measures to strengthen the regional health network.
But while these steps are positive, some front-line health workers fear it won’t be enough.
“We are very concerned,” Dr. Tamires Imed, who works at the SPA Hospital in Manaus, told Al Jazeera. “We are very exhausted and have little personality. We lost many colleagues due to illness and others resigned after the health system collapsed again this year.
“We have lost governance”
The government of far-right President Jair Bolsonaro is increasingly accused of Brazil’s health crisis, as a Senate committee on April 27 opened an investigation in his treatment of the pandemic.
The former army captain has rejected the closures, encouraged mass rallies, dismissed the virus as “low flu” and has not urgently addressed the purchase of COVID-19 vaccines.
“A crucial pillar in public health security is governance. But in Brazil, we have lost governance,” said Eliseu Alves Waldman, an epidemiologist and professor at the Public University of Sao Paulo (USP). not only internally but also externally to ensure sufficient medical imports “.
Brazil’s health ministry has ordered 281 million COVID-19 vaccines by 2021, but just over seven percent of the Brazilian population has been completely vaccinated and less than 15 percent of Brazilians have received the first dose so far. according to Our World in Data, search website data.
Despite growing criticism and continuation of the parliamentary poll, Bolsonaro has remained challenging and defending his policies. Last week hinted that China could have created the coronavirus as part of a “chemical war.”
The Butantan Institute, which produces the CoronaVac jab, made in China, Brazil, warned on May 6 that it could run out of vaccines this week due to China’s shortage of key ingredients.
Back in the state of Amazon, health experts say vaccines offer maximum hope, but delays in shipments of punctures and ready-made ingredients have led to the suspension of first-dose applications.
More than 38% of Amazonas residents have been fully inoculated, according to the Amazonas Health Surveillance Foundation (FVS-AM). But expanding state health workers, where more than two million people live in 1,571 million square kilometers (607,000 square miles) enclosed almost entirely by the rainforest, face a serious challenge of vaccinating people. residents of remote riverside communities.
“If it’s a rainy day, it can take up to three days to go down the river. Other shorter trips take about 12 hours, ”said Bruno Correa, a nurse coordinator for the National Immunization Program (PNI) who works for the president of Figueiredo, a small tourist town in the Amazon.
Correa, who coordinates vaccination campaigns in more than 11 rural communities in Manaus, said health workers have to walk several kilometers through the forests to reach 70% of the communities they serve, while the rest of trips are made by boat. He said about 1,500 people live in these hard-to-reach areas.
Long journeys make administering a second dose of COVID-19 vaccines a challenge. To date, 28.4 percent of rural community residents have received the first dose and 0.2 percent are fully inoculated, according to FVS-AM data.
“We could come and they are not there. They could have moved, made a trip to Manaus or turned down the shot. That means our team has to come back several times to make sure all the second doses have been applied, ”Correa told Al Jazeera.
While vaccination efforts continue in hopes of softening the blow of a third wave, Correa said more public health measures are needed to curb the potential spread of the virus.
“We need a blockade. But the governors have allowed it schools and commerce will reopen“If transmission rates increase, we can generate more lethal variants. Brazil does not have adequate control systems to identify new strains.”
Waldman, the epidemiologist, also said reopening is a risk. “Manaus continues to be the center of international tourism; if the virus spreads in large numbers, that could be dangerous, ”he said.
Meanwhile, Inloco, a technology startup that uses GPS data to track social distancing, found that less than 40 percent of the Amazon population respected social distancing, one of the lowest rates in northern Brazil, a reality that Dos Anjos , a resident of Manaus, knows too well.
“COVID feels like a ghost here. I’m sorry to see people on the street acting like the virus doesn’t exist. COVID survivors live with what we have suffered and take precautions, ”he said, adding that he is preparing for the worst.
“I prepare to stay and survive. We all are. Our goal now is to avoid losing more lives. ”