Inside, medics give a woman CPR in an ultimately futile attempt to save her life. A hospital source told CNN she died shortly after being brought in.
In the four hours CNN spent outside Hilda Freire hospital Tuesday morning, three Covid-19 patients died.
Chaos has become the norm here this month. What is happening in this under-equipped hospital, surrounded by the Amazon rainforest, is a small example of a new, massive outbreak of Covid-19 engulfing northwestern Brazil.
Not far from Iranduba is the epicenter of this new outbreak, Manaus. The capital of the state of Amazonas is often referred to as the gateway to the Amazon, the main connections to the rest of the world by air or boat.
If the city’s name sounds familiar, it could be because one of the world’s worst outbreaks of Covid-19 happened in April and May. The health care system collapsed and images of thousands of newly dug graves became symbolic of Brazil’s coronavirus crisis, the death toll of which now ranks second to that of the United States.
The current situation is worse than ever. January has turned out to be by far the deadliest month of the Manaus pandemic.
In May, 348 people were buried here, the worst month to date. In the first three weeks of January alone, that number was 1,333.
While genomic testing is not widespread in Manaus, scientists tell CNN that evidence suggests a new virus variant mingled with the government’s failure to create a tragically perfect storm.
A new variant of the corona virus
Four epidemiologists told CNN that a new variant of coronavirus called P.1 is likely to be driving the new round of devastation that befell Manaus.
“I’m not usually scared of things like this, but I’m concerned about what we’re seeing in Brazil right now,” said Scott Hensley, a viral immunologist at the University of Pennsylvania.
Scientists say the new version of the virus originated in Brazil, and while there is still much to learn about it, there are multiple reasons for concern.
First, new data suggests it is more transferable.
Researchers from Fiocruz, the Brazilian health research institute, have studied newly infected people in Manaus. Of the 90 who have taken part in the study so far, 66 had infections caused by this new variant, according to Fiocruz researcher Felipe Gomes Naveca.
While inconclusive, experts say it holds credence to the idea that this variant is more easily transferable.
“If it has the ability to spread more efficiently, it (is) likely to become even more dominant,” said Dr. Anthony Fauci Tuesday to CNN’s Erin Burnett.
Fiocruz researchers have also documented at least one case of a person who tested positive for the new variant while still having antibodies from a previous Covid-19 infection. That could indicate that people could be re-infected with the new variant, although one case is far from proof.
“The fact that we are now seeing infections indicates that the circulating virus is either more transmissible, that it can evade antibodies, or a combination of both,” said Hensley.
The good news? For now, it appears that current Covid-19 vaccines may still protect against the pattern of mutations seen in the new variant – although all the epidemiologists interviewed said much more research was needed.
It’s not just the variant
Simply blaming the latest outbreak on the variant would be to miss the forest for the trees. The new variant that is emerging is simply part of a wider system that has failed people in Amazonas state.
Start with the lack of a coordinated federal response, a hallmark of Brazilian President Jair Bolsonaro’s government during the pandemic.
After the first wave, it was painfully clear that Manaus’s healthcare system could not handle another crisis like that.
But when the worst days of April, May, and June were over, the federal government didn’t redouble its response here to ensure the city never again faced a critical shortage of fans, medicine, oxygen, and sleeping space.
Instead, a sense of complacency creeps in, as leaders like Jair Bolsonaro called the idea of a second wave a lie. In November, he told his people that they should essentially accept the virus and not fear the virus “as a land of fags.”
Now critics are wondering if a similar complacency could have slowed the federal health department’s response to the warning signs of a second crisis in Manaus this month.
Federal investigators are investigating why Health Minister Eduardo Pazuello was not sending aid to the city more quickly after a spike in cases was documented in December, and then again after an oxygen supplier spotted problems in January.
Although an increase in the number of Covid-19 cases has been verified [in Manaus] in the week of Christmas 2020, the health minister chose not to send ministry representatives to Manaus until January 3, a week after being made aware of the disastrous situation, ” said a report by the attorney general of the country that was submitted to Brazil’s federal highest. Court.
Pazuello has defended his actions, blaming the variant for a disaster he said no one could have foreseen.
“This was a situation completely unknown to anyone,” he said Tuesday. “It was too soon.”
The stage was set
But a basic understanding of how viruses evolve would have suggested that this situation was coming.
When lockdowns eased towards the end of last year, businesses reopened and people filled the streets. Despite warnings from multiple experts that the virus was spreading, a more laissez-faire attitude to the virus was spreading in Manaus.
Now ubiquitous, the now arguably erroneous idea was that Manaus’s massive first wave of Covid-19 reached enough people to create herd immunity.
“People started living as if we had a normal life, without using masks with a lot of crowds,” said Naveca, the Fiocruz researcher. “We’ve seen this a lot over Christmas and the end of the year.”
As CNN has previously reported, despite mounting scientific warnings, officials in the state of Manaus and Amazonas were pressured – both from the public and from Bolsonaro’s own statements – to refrain from imposing strict lockdown measures.
But all over the world, where existing types of Covid-19 were allowed to continue to circulate, the foundation was laid for the emergence of new variants.
“The virus will have the opportunity to investigate all of these different genetic types and beneficiaries are now being selected,” said Hensley.
In other words, the more the virus is allowed to spread, the more chances it has to evolve and form new variants.
CNN’s Natalie Gallón and journalists Marcia Reverdosa and Eduardo Duwe contributed to this report.