With more than three million confirmed cases of COVID-19, Brazil now has the second-highest number of cases worldwide, trailing only the US. The country’s massive size and lack of transportation across huge swathes of territory have complicated the response to the pandemic, prompting Doctors Without Borders/Médecins Sans Frontières (MSF) to launch an intervention in Brazil’s Amazonas state.
“We had COVID-19 response teams in Rio de Janeiro and São Paulo, and then the bad news started coming from the interior,” said Antonio Flores, medical coordinator for the MSF team that came to Manaus, the capital city of Amazonas state, in April 2020. “When I arrived in Manaus, the grave diggers were working beyond capacity, all the hospital intensive care units (ICUs) were overflowing with dying patients, and there were lists with hundreds of severely sick people waiting in health centers for an intensive care hospital bed to become free. It was worse than we had feared.”
The limited COVID-19 testing deployed by Brazil’s government made tracking the pandemic’s spread across this vast country difficult. It was even harder in the Amazon basin where transportation options are limited and communities often live far apart. In addition, the antibody tests being used showed if patients had recovered from the disease, not if they currently had COVID-19. This epidemiological data gave a rough snapshot of what the situation was like three weeks ago, rather than a current view of the state of the pandemic.