Inside, medics give a woman CPR in an eventual futile attempt to save her life. A source in the hospital told CNN she died shortly after being brought inside.
In the four hours that CNN spent Tuesday morning outside the hospital Hilda Freire, three Covid-19 patients died.
Chaos has become the norm this month. What is happening in this subordinate hospital, surrounded by the Amazon rainforest, is a small example of a new, massive Covid-19 outbreak that is engulfing northern Brazil.
Not far from Iranduba is the center of this new outbreak, Manaus. The capital of the state of Amazonas is often called the gateway to the Amazon, the main connections to the rest of the world by plane or boat.
If the city’s name sounds familiar, it could be because it was the scene of one of the world’s worst Covid-19 outbreaks in April and May. The health care system collapsed and images of thousands of newly dug graves became the sign of the coronavirus crisis in Brazil. His death toll is now second in the United States.
The current situation is worse than ever. January is by far the deadliest month of the pandemic in Manaus.
In May, 348 people were buried here, the worst month so far. During the first three weeks of January, that number stood at 1,333.
While genomic testing is not widespread in Manaus, scientists tell CNN that evidence points to a new virus variant mixed with the government’s inaction to create a tragic perfect storm.
A new coronavirus variant
Four epidemiologists told CNN that a new coronavirus variant, called P.1, is likely to drive the new round of devastation Manaus has encountered.
“I’m not usually an alarmist about this kind of thing, but I’m worried about what we’re currently seeing in Brazil,” said Scott Hensley, a viral immunologist at the University of Pennsylvania.
According to scientists, the new version of the virus originated in Brazil, and although much remains to be learned about it, there are several causes for concern.
First, new data suggests that it is more transferable.
Researchers at Fiocruz, the Brazilian research institute for heaths, have just studied infected people in Manaus. Of the 90 who have participated in the study so far, 66 have had infections caused by this new variant, according to Fiocruz researcher Felipe Gomes Naveca.
While not conclusive, experts say the idea that this variant is easier to transmit is reliable.
“If it has the ability to spread more efficiently, it can probably become more and more dominant,” said Dr. Anthony Fauci told CNN’s Erin Burnett on Tuesday.
Researchers at Fiocruz 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. This may indicate that people with the new variant can be re-infected, although one case has not been proven for a long time.
“The fact that we are currently seeing infections suggests that the virus that is spreading is more transmissible, that it can avoid antibodies, or a combination of both,” Hensley said.
The good news? For now, it appears that current Covid-19 vaccines could still protect against the pattern of mutations seen in the new variant – although all epidemiologists surveyed said more research was needed.
This is not just the variant
To simply blame the latest outbreak on the variant is to miss the forest for the trees. The new variant that is emerging is merely part of a broader system that has failed people in the state of Amazonas.
Start with the lack of a coordinated federal response, a feature of the government of Brazilian President Jair Bolsonaro throughout the pandemic.
After the first wave, it was painfully obvious that Manaus’ healthcare system had not yet been able to handle such a crisis.
But as the worst days of April, May and June disappeared, the federal government did not respond to this to ensure that the city would never again have a shortage of fans, medicine, oxygen and space.
Instead, a sense of complacency crept in, while leaders like Jair Bolsonaro called the idea of a second wave a lie. In November, he told his people to essentially accept the virus and not be afraid of the virus ‘like a country with flags’.
Now critics are wondering if a similar complacency has slowed the federal health ministry’s response to warning signs of a second crisis in Manaus this month.
Federal investigators are investigating why Health Minister Eduardo Pazuello did not send aid to the city more quickly after an increase in cases was documented in December, and then again after an oxygen supplier made a problem in January.
‘Although an increase in the number of Covid-19 cases has been confirmed [in Manaus] in the week of Christmas 2020, the Minister of Health chose to send representatives of the Ministry to Manaus only by 3 January, one week after being notified of the disastrous situation, “reads a report by the country’s lawyer- General submitted to the Federal Supreme Court of Brazil.
Pazuello defended his actions and blamed the variant for a disaster that he said no one could foresee.
“It was a situation that was completely unknown to everyone,” he said on Tuesday. “It was too fast.”
The stage is covered
But a basic understanding of the development of viruses would indicate that this situation would arise.
As the closure eased towards the end of last year, businesses reopened and people filled the streets. Despite warnings from several experts that the virus is spreading, a more lazy attitude towards the virus has spread in Manaus.
Pervasive was the now demonstrable false idea that Manaus’ massive first wave of Covid-19 reached enough of the population to create herd immunity.
“People started living as if we were living a normal life, not using masks with many crowds,” said Naveca, the Fiocruz researcher. “We saw it a lot during Christmas and the end of the year.”
As CNN reported earlier, officials in the state of Manaus and Amazonas, even when scientific warnings came in, came under pressure – from both the public and Bolsonaro’s own statements – to refrain from strict lock-in measures.
But wherever the existing strains of Covid-19 were allowed to continue circulating, the foundation was laid for new variants.
“The virus has the opportunity to examine all of these different genetic species, and those that are preferred are now being selected,” Hensley said.
In other words, the more the virus is allowed to spread, the more likely it is to develop and form new variants.
CNN’s Natalie Gallón and journalists Marcia Reverdosa and Eduardo Duwe contributed to this report.