Rio de Janeiro, Brazil – Rafael da Silva, 56, a hospital security guard, had been battling with COVID-19 symptoms for just more than a week when they began to intensify. But when his family rushed him to hospital, he was sent home.
“All the doctor did was offer him treatment as if it were a cold,” his son, Rafael da Silva Jr told Al Jazeera.
After deteriorating for four days, he was again taken to a COVID-19 hospital with shortness of breath and put on oxygen. The doctors said da Silva Sr should be on a ventilator.
“But there are no intensive care beds left,” his son said. “They are trying to find a bed in the only field hospital in the city but they’re all full.”
Da Silva is one of the hundreds of patients in Rio de Janeiro in desperate need of an intensive care bed as health officials warn the medical system is on the verge of collapse.
Long queues for intensive care beds are forming outside public healthcare systems across Rio de Janeiro with wait times of more than 15 days for some COVID-19 patients.
Even in the private healthcare centres, 98 percent of the COVID-19 intensive care beds had been occupied for two consecutive weeks, said the Association of Private Hospitals of Rio state. The number jumped from 81 percent to 98 percent during the first week of December.
Brazilian President Jair Bolsonaro has been at odds with health officials over how to respond to the pandemic.
Bolsonaro has consistently downplayed the novel coronavirus as a “little flu” and said on Thursday Brazil was at the “tail end of the pandemic”.
The number of COVID-19 cases in Brazil peaked in late July, in the middle of winter, followed by three months of gradual falling numbers. But government data shows an upward trend in infections and deaths in the past month. More than 181,000 Brazilians have died of the new coronavirus, the second-highest number in the world, and with more than 6.9 million coronavirus cases, Brazil ranks third behind the United States and India.
Hospital admissions are growing in the population centres of Sao Paulo and Rio De Janeiro. In Rio,1,460 patients with COVID-19 were admitted to hospital last weekend. Of the 273 patients in critical condition, there were not COVID-19 beds for 222 of them according to government data.
National health authorities say the increase in illness is likely due to a relaxation of social distancing and lockdown measures, as well as super-spreader events such as last month’s municipal elections and the return of crowded live events.
“The most natural explanation for the rise in infections is in making activities more flexible, with many people circulating again on public transport and other environments,” explained Daniel Villela, a researcher at the COVID-19 Observatory and coordinator of the Fiocruz Scientific Computing Program.
Villela also told Al Jazeera as Brazil enters what many call a second wave, the country never fully emerged from its first.
“The number of cases slowed down after reaching its peak in the middle of the year but even with a reduction, it never reached low levels,” he says.
For now, 21 of 26 Brazilian states are experiencing a growth in coronavirus cases. Out of this total, seven have COVID-19 intensive care bed occupancy rates exceeding 80 percent, according to Fiocruz.
Last week, the southern state Rio Grande do Sul registered a 47 percent increase in deaths. The state’s governor, Eduardo Leite, said it is more severe than the winter outbreak.
Tedos Adhanom Ghebreyesus, the director-general of the World Health Organization (WHO), has urged Brazil to be “very, very serious” about its rising coronavirus infection numbers.
Some health experts have blamed the Brazilian president for spreading disinformation and for not giving the public clear guidelines.
“To combat the outbreak, social distancing, facemasks and reducing mass-crowding are needed. But the government has not recommended any preventive measures, instead touting scientifically unverified treatments like Hydroxychloroquine,” said Julio Croda, infections researcher at Fiocruz.
Gulnar Azevedo, president of the Brazilian Association of Public Health (ABRASCO), says the government’s failure to present a strategic plan to combat COVID-19, has left states and municipalities to formulate their own.
“Many have died because of the disorganization of the government,” she told Al Jazeera.
‘Much more deaths this time’
In Rio de Janeiro, a lockdown was implemented at the beginning of the pandemic. While many did not strictly adhere to the rules, numerous businesses were closed and several field hospitals were set up to deal with mounting COVID-19 patients.
But as the country endures a second wave, the public appears to have lost interest in pandemic restrictions.
Despite the spike in cases, Brazilians are not following health guidelines. Rio de Janeiro’s beaches, bars and nightclubs, many without masks and social isolation measures in place, are full.
“In many states and within the favelas, many people who could be carrying COVID-19 are not wearing masks or social distancing. I think that there will be much more deaths this time,” said a government official working with COVID-19 data, who requested to remain anonymous because he was not authorised to speak to journalists.
Throughout the pandemic, Bolsonaro has derided state governors for imposing lockdowns or restrictions, calling the economic consequences too severe.
Even the prospect of a vaccine has become political with an opposition party suing to hear Bolsonaro’s vaccination plan – which has no start date and with vaccine allocated for about a quarter of the population initially. The country’s health regulator has not approved a vaccine yet. Fiocruz researcher Margareth Dalcolmo said Brazil was “six months behind in its vaccination plan”.
The executive secretary of the Ministry of Health, Elcio Franco said last month there will not be enough vaccines for the entire population. “Our goal is to vaccinate 80 million Brazilians a year,” he said. Brazil has a population of 212 million.
With no national game plan, local officials have begun making independent plans.
Sao Paolo’s governor, Joao Doria released his own immunisation strategy, promising to begin distributing the vaccine in January. Last week, Sao Paulo recorded 309 deaths, the highest in 10 weeks.
Rio de Janeiro’s newly re-elected mayor, Eduardo Paes dismissed a new lockdown as “extreme and unnecessary”. Paes said he plans to open more COVID-19 intensive care beds and distribute quick tests to the capital at the beginning of his term in January.
Last week, Rio city hall also announced that it would “evaluate” whether New Year’s celebrations across the city will go ahead.
Niteroi, a city in the municipality of Rio de Janeiro, has already announced the suspension of all New Year’s events, including house parties.
As COVID-19 cases continue to grow, the Sao Paulo state government announced on Friday it would reduce business opening hours and that bars would close early.
New Year’s eve parties in Sao Paulo bars, restaurants and hotels are also banned, with the state government urging families to celebrate at home.
In Brazil’s southernmost state, which borders Argentina and Uruguay, Rio Grande do Sul governor Eduardo Leite has also suspended all public and private New Year’s events.
Many health officials fear that without enough vaccines, with unprepared medical services and the upcoming holiday celebrations, health systems already stretched to the limit could completely collapse.
“January is a tragedy just waiting to happen,” said researcher Julio Croda.