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The virus has killed more than 300,000 people in Brazil, its spread favored by a highly contagious variant, internal political struggles and distrust in science.
PORTO ALEGRE, Brazil – Patients began arriving at Porto Alegre hospitals much sicker and younger than before. Funeral homes were seeing a steady increase in business, while exhausted doctors and nurses pleaded in February for it to be closed to save lives.
But Sebastião Melo, mayor of Porto Alegre, argued that there was a greater imperative.
“Risk your life so we can save the economy,” Melo appealed to his constituents at the end of February.
Now Porto Alegre, a thriving city in southern Brazil, is at the heart of a staggering collapse of the country’s healthcare system, a predicted crisis.
More than a year after the pandemic, deaths in Brazil are at their peak and highly contagious variants of the coronavirus are sweeping the nation, fueled by political dysfunction, widespread complacency and conspiracy theories. The country, whose leader, President Jair Bolsonaro, has downplayed the threat of the virus, now reports more new cases and deaths per day than any other country in the world.
“We have never seen a health system failure of this magnitude,” said Ana de Lemos, executive director of Doctors Without Borders in Brazil. “And we don’t see a light at the end of the tunnel.”
On Wednesday, the country surpassed 300,000 deaths from Covid-19, and approximately 125 Brazilians succumb to the disease every hour. Health officials in public and private hospitals struggled to expand intensive care units, stock up on increasingly scarce supplies of oxygen, and purchase the scarce intubation sedatives that are sold at an exponential price.
Intensive care units in Brasilia, the capital, and 16 of Brazil’s 26 states report a severe shortage of available beds, with capacity below 10 percent, and many are experiencing increasing contagion (when 90 percent of those beds are full, the situation is considered dire).
In Rio Grande do Sul, the state that includes Porto Alegre, the waiting list for intensive care unit beds doubled in the last two weeks, to 240 critically ill patients.
At Hospital Restinga e Extremo Sul, one of Porto Alegre’s main medical facilities, the emergency room has become a crowded Covid room where many patients receive care in chairs, for lack of a free bed. Last week, the military built a field hospital in tents outside the main entrance, but hospital officials said the extra bed space is of little use to medical personnel stretching beyond its limit.
“The whole system is on the brink of collapse,” said Paulo Fernando Scolari, director of the hospital. “People come in with more severe symptoms, lower oxygen levels, and in desperate need of treatment.”
The collapse is a resounding failure for a country that, in recent decades, was a model for other developing nations, with a reputation for promoting agile and creative solutions to medical crises, including an increase in HIV infections and the outbreak. of Zika.
Melo, who campaigned last year promising to lift all pandemic restrictions in the city, said a shutdown would cause people to starve.
“Forty percent of our economy, our workforce, is informal,” he said in an interview. “They are people who need to go out to work to be able to eat something at night.”
President Bolsonaro, who continues to promote ineffective and potentially dangerous drugs to treat the disease, has also said that the lockdowns are unsustainable in a country where so many people live in poverty. While several Brazilian states have ordered trade closures in recent weeks, there have been no strict closures.
Some of the president’s supporters in Porto Alegre have protested against the business closure in recent days, organizing caravans that stop outside hospitals and honk their horns as Covid rooms overflow.
Epidemiologists say Brazil could have avoided further lockdowns if the government had promoted the use of masks and social distancing and aggressively negotiated access to vaccines that were being developed last year.
Instead, Bolsonaro, a close ally of former President Donald J. Trump, called Covid-19 a “miserable flu,” often rooting for large crowds and creating a false sense of security among supporters by endorsing anti-malaria drugs. and parasites. – contradicting top health officials who warned they were ineffective.
Last year, the Bolsonaro government accepted Pfizer’s offer of tens of millions of doses of its Covid-19 vaccine. The president later celebrated setbacks in the clinical trials of CoronaVac, the Chinese-made vaccine that Brazil came to rely heavily on, and joked that pharmaceutical companies would not be held liable if people who obtained newly developed vaccines fell back. turned into alligators.
“The government initially ruled out the threat of the pandemic, then the need for preventive measures, and then goes against science by promoting miracle cures,” said Natália Pasternak, a microbiologist from São Paulo. “That confuses the population, which means that people feel safe going out into the streets.”
Terezinha Backes, a 63-year-old retired shoemaker living in a municipality on the outskirts of Porto Alegre, had been extremely careful for the past year, venturing out only when necessary, said her nephew, Henrique Machado.
But her 44-year-old son, a security guard tasked with taking the temperatures of people entering a medical facility, appears to have brought the virus home earlier this month.
Ms. Backes, in good health, was taken to a hospital on March 13 after she started having trouble breathing. With no beds to spare, she was treated with oxygen and an IV in the hallway of an overflowing wing. She died three days later.
“My aunt was not given the right to fight for her life,” said Mr. Machado, 29, a pharmacist. “They left her in a hallway.”
His body was one of the scores that made March the busiest month at a funeral home owned by a family friend, Guaraci Machado. Sitting in his office one recent afternoon, Machado said he has been impressed by the number of young Covid-19 patients who have been brought to his facility in coffins in recent weeks.
However, Machado, 64, who removed his mask midway through an interview, said he opposes business closings or business closures. From the beginning, he said, he was convinced that the virus was created by China so that it could sell medical supplies around the world and ultimately develop a vaccine for profit.
When he had Covid-19 in June of last year, Machado said he took the antimalarial drug advocated by the president, hydroxychloroquine, to which he attributed “keeping me alive.”
Machado will be eligible in the coming weeks for a Covid-19 vaccine in Brazil. But you won’t get one even if you are “hit with a stick,” Machado said, noting that he recently read online that vaccines are more deadly than the virus.
Such conspiracy theories about Covid-19 vaccines have spread widely on social media, including on WhatsApp and Facebook. A recent public opinion poll by IPEC found that 46 percent of respondents believed at least one widely publicized falsehood about vaccines.
Mistrust of vaccines and science is new to Brazil and a dangerous feature of the Bolsonaro era, said Dr. Miguel Nicolelis, a Brazilian neurologist at Duke University who led a task force on the coronavirus in the northeast of the country on last year.
“In Brazil, when the president of the republic speaks, people listen,” said Dr. Nicolelis. “Brazil has never had a movement against vaccines, never.”
But many staunch supporters of Bolsonaro, who retains the support of about 30 percent of the electorate, argue that the president’s instincts about the pandemic have been strong.
Geraldo Testa Monteiro, a retired firefighter in Porto Alegre, praised the president as he and his family prepared to bury his sister, María de Lourdes Korpalski, 70, who died of Covid-19 last week.
In recent months, Monteiro said he began taking the deworming drug ivermectin as a preventive measure. The drug is part of the so-called Covid drug kit, which also includes the antibiotic azithromycin and the antimalarial drug hydroxychloroquine. Bolsonaro’s Health Ministry has endorsed its use.
Leading medical experts from Brazil, the United States and Europe have said that these drugs are not effective in treating Covid-19 and some can have serious side effects, including kidney failure.
“Lies,” said Monteiro, 63, about the scientific consensus on the Covid kit. “There are so many lies and myths.”
He said medical professionals have sabotaged Bolsonaro’s plan to curb the pandemic by refusing to prescribe those drugs more decisively in the early stages of the disease.
“There was a solution: listen to the president,” he said. “When people choose a leader it is because they trust him.”
Distrust and denials, and the caravans of Bolsonaro supporters blowing their horns in front of hospitals to protest pandemic restrictions, are crushing medical professionals who have lost colleagues to the virus and suicide in recent months, said Claudia Franco, president of the nurses union in Rio Grande do Sul.
“People are in such denial,” said Ms Franco, who has been caring for Covid-19 patients. “The reality we are in today is that we don’t have enough respirators for everyone, we don’t have oxygen for everyone.”
Ernesto Londoño reported from Porto Alegre. Letícia Casado reported from Brasilia.
