Inside, doctors give CPR to a woman in a futile attempt to save her life. A hospital source told CNN she died shortly after she was introduced inside.
During the four hours CNN spent Tuesday morning at Hilda Freire Hospital, three Covid-19 patients died.
Chaos has become the norm here this month. What is happening in this poorly equipped hospital, surrounded by the Amazon rainforest, is a small example of a new and massive outbreak of Covid-19 that surrounds northwestern Brazil.
Not far from Iranduba is the epicenter of this new outbreak, Manaus. The state capital of the Amazon is often called the gateway to the Amazon, its main connections to the rest of the world by plane or ship.
If the city’s name sounds familiar, it could be because it was the scene of one of the worst Covid-19 outbreaks in the world in April and May. The health care system collapsed and images of thousands of graves recently excavated became emblematic of Brazil’s coronavirus crisis, with the death toll now only second in the United States.
The current situation is worse than ever. January has proven to be the deadliest month of the pandemic in Manaus.
In May, 348 people were buried there, the worst month to date. Just the first three weeks of January, that number was 1,333.
Although genomic testing is not widespread in Manaus, scientists tell CNN that the tests suggest a new virus variant mixed with government inaction to create a tragic perfect storm.
A new variant of coronavirus
Four epidemiologists told CNN that a new variant of coronavirus, called P.1, is likely driving the new round of devastation that fell on Manaus.
“I’m not usually alarmist about this kind of thing, 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, although much remains to be known, there are multiple reasons for concern.
First, the new data suggest that they are more transmissible.
Researchers at Fiocruz, the Brazilian health research institution, have recently studied infected people in Manaus. Of the 90 who have participated so far in the study, 66 had infections caused by this new variant, according to Fiocruz researcher Felipe Gomes Naveca.
While not conclusive, experts say it gives credibility to the idea that this variant is more easily transmissible.
“If it has the ability to spread more efficiently, (it’s) likely to actually be increasingly dominant,” Dr. Anthony Fauci told CNN’s Erin Burnett on Tuesday.
Fiocruz researchers have also documented at least one case of a person who tested positive for the new variant while having antibodies from a previous Covid-19 infection. This could suggest that it can be reinfected with the new variant, although one case is far from a test.
“The fact that we’re seeing infections right now indicates that the circulating virus is more transmissible, which can bypass antibodies or a combination of both,” Hensley said.
The good news? For now, it appears that current vaccines against Covid-19 can still protect against the pattern of mutations seen in the new variant, although all epidemiologists interviewed said much more research was needed.
It’s not just the variant
Blaming the last shoot simply on the variant would be to lose the forest to the trees. The new emerging variant is simply part of a broader system that has failed the people of the state of Amazon.
Start with the lack of a coordinated federal response, a hallmark of the administration of Brazilian President Jair Bolsonaro throughout the pandemic.
After the first wave, it was painfully clear that the Manaus health system could not cope with another such crisis.
But as the worst days of April, May, and June subsided, the federal government did not double its response here to make sure the city would never again be critically charged with fans, drugs, oxygen, and space for beds.
Instead, a sense of complacency was introduced, as 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 fear the virus “like a country of fagots.”
Now critics are wondering if a similar complacency may have slowed the federal Ministry of Health’s response to warning signs this month of a second crisis in Manaus.
Federal investigators are studying why Health Minister Eduardo Pazuello was not quicker to send aid to the city after a rise in cases was documented in December and then after an oxygen supplier caused problems in January.
“Although there has been an increase in the number of Covid-19 cases [in Manaus] in the Christmas week of 2020, the Minister of Health chose to send representatives of the Ministry to Manaus only on January 3, a week after being informed of the calamitous situation, “said a report by the country’s Attorney General was presented to the Federal Supreme Court of Brazil Court.
Pazuello has defended his actions, blaming the variant for a disaster that no one could have foreseen.
“This was a totally unfamiliar situation for everyone,” he said Tuesday. “It was too fast.”
The stage was set
But a basic understanding of how viruses evolve would have suggested that this same situation was approaching.
As closures were reduced late last year, businesses reopened and people filled the streets. Despite warnings from various experts about the spread of the virus, a more laissez faire attitude towards the virus spread in Manaus.
Pervasive was the now demonstrable notion that the first massive wave of Covid-19 Manaus reached enough population to create immunity to the herd.
“People started living like we had a normal life, without wearing masks with a lot of people,” said Naveca, Fiocruz’s researcher. “We saw it a lot during Christmas and the end of the year.”
As previously reported by CNN, even when scientific warnings were issued, state officials in Manaus and Amazonas faced pressure from both the public and Bolsonaro’s statements to refrain from imposing strict closure measures.
But around the world, where existing strains of Covid-19 were allowed to continue circulating, the foundations were being laid for new variants to emerge.
“The virus has a chance to explore all of these different genetic types and now those that are favored are being selected,” Hensley said.
In other words, the more the virus is allowed to spread, the more chances it has of evolving and forming new variants.
CNN’s Natalie Gallón and journalists Marcia Reverdosa and Eduardo Duwe collaborated on this report.