Via Deutsche Welle Brazil: Amid collapse, the interior of the Amazon struggles over lockdown and chloroquine. Excerpt from the Google translation:
The meeting of the murky waters of the Amazon River with the clarity of Tapajós produces one of the postcards of Santarém, in western Pará. The natural beauty of the city surrounded by water as far as the eye can see attracts tourists from all over the world, especially to the village of Alter from the ground. For those who live in the region, the reality is quite different. Only half of the population has access to clean water in Santarém, one of the 100 largest municipalities in Brazil. Basic sanitation, in turn, is a privilege of 4.2%.
"The Amazon receives the pandemic in the worst possible conditions," says Caetano Scannavino, coordinator of the Saúde & Alegria Project, an NGO that has been operating in the region for more than three decades. "The main cause of infant mortality here is diarrhea from contaminated river water. Imagine working on the importance of hygiene with the population that does not have a tap at home."
The advancement of the new coronavirus in the region caused the health system in Santarém to collapse, as had already occurred in Belém and Manaus, the main capitals of the region. The 31 available ICU beds are full, and the city is a service reference for a population of more than 1 million people, distributed in 22 municipalities in the interior of the Amazon.
Some of these municipalities are larger than European countries. Itaituba, with just over one hundred thousand inhabitants, is twice the size of Belgium. The displacement of patients who need assistance in Santarém depends on transport by helicopter that the state government has made available.
Of the 7.8 million Brazilians who are more than four hours from a breathing apparatus, more than half live in the Amazon. The state of Pará alone accounts for almost a third of this population.
While at the beginning of the pandemic, the city of São Paulo had one respirator per 2,400 inhabitants, the rate was one per 20,000 in Santarém. This Tuesday (May 26), the city of Pará reached 1,016 confirmed cases and 65 deaths due to covid-19, the disease caused by the new coronavirus.
The data, however, have a large lag. As there is no structure for conducting clinical examinations in Santarém, the samples are sent by plane to Belém, the state capital, and take up to two weeks to be processed. There is also a limitation of rapid tests, mainly used to monitor already detected cases.
"Given the number of hospitalizations, I estimate that there are between 20,000 and 40,000 infected in western Pará," says João Guilherme Assy, an infectious disease physician in the municipality, who monitors local health units. The growth of the queue for an ICU bed forces doctors to improvise.
Often, patients have to take respirators to ensure more people have access to oxygen. There is also a shortage of medical professionals, as those on the front line become ill from contact with the virus.
Lockdown raises tension
The situation is aggravated by the population's low adherence to social isolation. To respond to this situation, the city government decreed a lockdown, that is, drastic measures of confinement, for six days, until last Sunday. The social isolation rate rose from 39% to an average of 49.9% on the days the measure was in force. Despite the improvement, the indicator was below the 70% recommended by the World Health Organization (WHO).
Covidly.com on Wednesday night reports 414,661 Brazilian cases—19,995 in the past 24 hours. Deaths total 25,697; 1,092 have died in the past 24 hours.
