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More Brazilian states facing collapse under Covid-19 pressure

. Apr 19, 2020
After Amazonas, more and more Brazilian states facing collapse under Covid-19 pressure Amazonas' healthcare system experiences a collapse. Photo: Amazônia Real

On Saturday, news website UOL published a series of shocking videos sent in by residents of the city of Manaus, the northern urban expanse with a population of 2 million, slap bang in the middle of the Amazon rainforest. The footage showed desperation at public hospitals around the city, with a lack of beds and, most notably, medical professionals. The Covid-19 pandemic has already driven the city’s healthcare system to complete collapse.

On Saturday evening, the head director of the São Raimundo accident and emergency facility — featured in more than one of the videos sent to UOL — died from Covid-19. It is estimated that 1,000 health professionals in the northern state of Amazonas, of which Manaus is the capital, are on leave from work due to contracting the virus.

</p> <p>Manaus was the <a href="https://brazilian.report/coronavirus-brazil-live-blog/2020/04/06/manaus-mayor-amazonas-health-system-collapse/">first Brazilian city to experience</a> the scenes we had seen around Europe and the U.S., of overflowing hospitals, doctors having to deny people care, and mounting piles of cadavers. However, it will not be the last.</p> <div class="flourish-embed flourish-chart" data-src="visualisation/1957916" data-url="https://flo.uri.sh/visualisation/1957916/embed"><script src="https://public.flourish.studio/resources/embed.js"></script></div> <h2>Reason for concern in North and Northeast</h2> <p>In the northeastern state of Ceará, there are <a href="https://t.co/AcMiAxcgHu?amp=1">no longer any available intensive care beds</a> on the public health network, and the state health secretary Carlos Roberto Martins has already declared that their system has entered collapse. Fifteen thousand graves have been bought by the state government in order to bury the wave of dead patients. Dr. Martins predicted that Ceará&#8217;s capital Fortaleza will see 250 deaths per day in the month of May.</p> <p>While the 4,931 cases confirmed in Ceará and Amazonas combined pale in comparison to the almost 14,000 recorded in São Paulo, the infection rate per capita is higher in these northern and northeastern states, and has risen more sharply.</p> <iframe src="//datawrapper.dwcdn.net/TLtoF/1/" width="100%" height="400" scrolling="no" frameborder="0" allowtransparency="true"></iframe> <iframe src="//datawrapper.dwcdn.net/ET4w3/1/" width="100%" height="400" scrolling="no" frameborder="0" allowtransparency="true"></iframe> <hr class="wp-block-separator"/> <p>Looking at the chart above, we see that Ceará has surpassed the infection rate of São Paulo, despite having registered its first Covid-19 case some 18 days later than the southeastern state. In Amazonas and fellow northern state Amapá, the situation is even more critical. The infection rate per 1 million is around double that of São Paulo, and has seen vertiginous increases over the last week.</p> <p>Amapá and Roraima are the least populated states in Brazil, with a number of inhabitants comparable to that of Fiji and Luxembourg, respectively. Per capita figures in these areas are perhaps skewed by the population concentration in capital cities Macapá and Boa Vista.</p> <h2>Covid-19 reaches São Paulo&#8217;s urban poor</h2> <p>However, though cases per million people in São Paulo is not yet <em>as</em> dramatic as in Amazonas or Ceará, the country&#8217;s most populous state has certainly established itself as <a href="https://brazilian.report/newsletters/brazil-daily/2020/04/16/brazil-health-minister-sacking-bolsonaro-coronavirus/">Brazil&#8217;s Covid-19 epicenter</a> and is set for a dramatic month ahead.</p> <p>With the virus initially reaching São Paulo by air, often from the well-traveled jet set, the initial demand on the health system in the state capital fell largely on private hospitals. Now, however, Covid-19 has spread from the elite reference centers in the city center and São Paulo&#8217;s public health system is beginning to collapse.</p> <iframe src="//datawrapper.dwcdn.net/KmQX5/6/" width="100%" height="400" scrolling="no" frameborder="0" allowtransparency="true"></iframe> <hr class="wp-block-separator"/> <p>The renowned <a href="https://oglobo.globo.com/sociedade/uti-do-hospital-emilio-ribas-tem-100-de-ocupacao-por-pacientes-com-coronavirus-24373417">Emilio Ribas Institute</a>, a public reference center for infectious disease, has already filled up all of its available intensive care beds. Other public hospitals in São Paulo&#8217;s poor and densely populated suburbs are heading in the same direction.</p> <p>The majority of Covid-19 deaths in the city are now found in peripheral low-income neighborhoods. In the eastern district of Sapopemba, deaths are piling up and the local population is struggling to reconcile social isolation measures with the need to work and put food on the table. Bars, hair salons and other non-essential businesses largely remain open.</p> <p>At the end of March, the municipal government shut down a local nightclub in Sapopemba which had promoted a &#8220;Party at the End of the World,&#8221; promising a club night with free distribution of protective face masks and hand sanitizer, as well as an open bar of Corona beer.</p> <iframe src="//datawrapper.dwcdn.net/RCAj1/1/" width="100%" height="400" scrolling="no" frameborder="0" allowtransparency="true"></iframe> <hr class="wp-block-separator"/> <p>A study by newspaper <a href="https://oglobo.globo.com/sociedade/coronavirus/em-sao-paulo-15-dos-internados-por-coronavirus-nao-sobrevivem-doenca-1-24372141"><em>O Globo</em></a> found that of the patients hospitalized due to Covid-19 in São Paulo, 15 percent die — a high rate in comparison with global levels. In the state of Amazonas, it is even worse: 17 percent of those who have to go to the hospital due to Covid-19 symptoms do not survive.</p> <p>The country is braced for a challenging month ahead, with projections that the nationwide public health system may collapse as early as next week, and the peak of Covid-19 infections is expected for the month of May.

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Euan Marshall

Originally from Scotland, Euan Marshall is a journalist who ditched his kilt and bagpipes for a caipirinha and a football in 2011, when he traded Glasgow for São Paulo. Specializing in Brazilian soccer, politics and the connection between the two, he authored a comprehensive history of Brazilian soccer entitled “A to Zico: An Alphabet of Brazilian Football.”

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