Every day between 15,000 and 30,000 people in Brazil are diagnosed with COVID-19 and hundreds of people die. The country has the second highest number of cases and deaths in the world—with more than 900,000 cases and 45,000 deaths recorded by the World Health Organization. Nurses are dying of COVID-19 at a higher rate than any other country: almost 100 nurses in Brazil die from the disease per month.
The outbreak has spread across the country from large cities, such as Rio and São Paulo, to remote areas, such as Amazonas state, threatening the most vulnerable and neglected communities, including those living in slums and favelas, homeless people, and indigenous and riverside communities.
MSF has launched six COVID-19 emergency responses in Amazonas and Roraima states—both in the greater Amazonia region—in Rio de Janeiro, and in São Paulo, but we are reaching our capacity. A more focused COVID-19 response is required from the central government, which must provide greater support to community leaders, local organizations, and staff on the front line of the epidemic. Local groups and health workers need direct assistance and essential tools—whether that support comes from inside Brazil or from other countries.
“It is not a coincidence that Brazil is suffering so acutely,” said Ana de Lemos, executive director of MSF Brazil. “We have long known that Brazil is a country with enormous inequalities, but COVID-19 is exposing a health system plagued with structural inequalities and exclusion from care for huge numbers of poor or homeless people, and for regions such as Amazonia that have been starved of proper health investment for decades. We have seen amazing efforts deployed at the state or local level to deal with the pandemic, but we also see a huge misalignment in guidelines, policies, and the general approach between the central government and the regions.”
Brazil’s capacity to respond to the COVID-19 outbreak is being stretched beyond its limit. Testing is not being rolled out fast enough. Brazil has reported 7,500 tests per million people—almost ten times less than the United States (which reported 74,927 per million). A stronger COVID-19 response from the central government is needed to prevent this outbreak from getting even worse.
Helping communities in Amazonia
Amazonas state has the highest mortality rate from COVID-19 in Brazil. Brazil’s Amazon region is vast and sparsely populated by indigenous communities. The area has suffered from mining, deforestation, and farming for years. There is chronic underinvestment in health care. When COVID-19 spread to the region from the larger cities, the health care system simply could not cope.
In Manaus, the state capital, the situation in the hospitals has been devastating. “COVID-19 moves fast, and sometimes unpredictably,” said Brice de le Vingne, MSF coordinator of COVID-19 response programs. “We shifted our attention from the coastal cities to the big Amazon city of Manaus when reports of high case numbers and mass graves started emerging. By then, the situation was already at disaster levels, and with a small team we had to rapidly identify where we could best assist.”