Anger swirls around doctors in the huge intensive care unit of the Emilio Ribas Institute for Infectious Diseases in São Paulo when asked about their president’s comments. “Rebellious,” says one. Another explains “irrelevant”.
Dr. Jacques Sztajnbok is more reserved. “It’s not flu. It’s the worst thing we’ve ever had in our professional lives.” His eyes are slow and narrow when I ask if he’s worried about his health. “Yes,” he says twice.
The reasons for this are the overwhelming silence of the intensive care unit. Coronavirus kills behind the veil of a hospital curtain in an oppressive silence that is so distant and alien to the global upheavals and loud political divisions it inspired. But when it takes a life, it is deeply terrible.
The first noticeable break in rest is a flashing red light. The second is a doctor̵
The patient is in her forties and her medical history means for days that the chances of survival are poor. But the change is sudden.
Another nurse runs in. In this intensive care unit, medical personnel pause in an outer chamber to get dressed and wash, but only a few moments before they come in. A doctor fumbles in the corridor outside and clumsily pulls on his dress. These moments have come countless times in the pandemic, but it doesn’t get easier today. This intensive care unit is full and the summit in São Paulo is probably two weeks away.
Employees dressed through the glass huddle together and circle the patient’s head. Replace pipes; Postponing posture; change their position and relieve each other of the strenuous task. Her unforgiving compressions on the patient’s sternum are all that keeps her alive.
A doctor appears drenched in sweat to pause in the cooler air in the corridor. A sliding glass door slams – a rare sound – as another comes in. The quiet frenetic focus continues for 40 minutes. And then it suddenly stops with no audible warning. The lines on the heart monitors are permanently flat.
Coronavirus has damaged our lives so profoundly, but its way of killing is so often hidden in intensive care units, where only brave healthcare workers see the trauma. And for the employees here, it feels closer every day.
Two days before our visit, they lost a 28-year-old nurse colleague, Mercia Alves. Today they stand together at the glass in another isolation room in which a doctor from their team is intubated. Another colleague tested positive that day. The illness that filled her hospital seems to be spreading to her.
Emilio Ribas’ hospital is full of bad news – there is no place in bed before the climax and staff are already dying from the virus – but it is the best equipped hospital in the city of São Paulo. And that is a dark harbinger for the coming weeks in Brazil. The largest city is the richest, in which the local governor has insisted on a lock and face masks. Still, there are nearly 6,000 deaths, and the more than 76,000 confirmed cases are frightening signs of what’s going to happen, even in what is probably the best-prepared place in Brazil.
Wealth instead of health concerns Bolsonaro, who has recently called the fight against the virus “war”. But on May 14, he said, “We have to be brave to face this virus. Do people die? Yes, and I’m sorry. But many more will die if the economy continues to be destroyed by these viruses.” [lockdown] Dimensions.”
Disease common in favelas
There is no debate anywhere in the city in the favelas. Having almost nothing is commonplace and some time ago brought its own form of isolation from the rest of the city. But the priority here has long been clear: survival.
Renata Alves laughs, shakes her head and says “it is irrelevant” when asked about Bolsonaro’s opinion that the virus is just a “cold”. Your business is serious and hourly.
The urgent tasks of keeping alive buzzed around her. Rows of sewing machines are laid out in a room where women learn how to get back on their streets and make masks from whatever they can find. In another case, 10,000 meals in tiny numbers are brought to the streets, prepared, and then brought back to the streets that are unable to put food on their own tables in the castle.
Alves, a volunteer health worker from the G10 Favela Relief Group, goes to one of the worst affected areas in the Paraisopolis suburb. The narrow, dense streets and alleys explain why the disease is so widespread here.
And Alves realizes that she knows only half of the picture among potential 100,000 patients. Only if someone has three symptoms can she offer him a Covid 19 test, and even that is paid for by a private donor. Many cases go undetected.
“Most of the time the test is done when the person is already at an advanced stage of the disease,” she says when she walks into the house of Sabrina, an asthmatic who isolates her three children in three tiny rooms. Doctors use a wooden swab to check her throat with a flashlight and greet her bored, confused children before moving on.
“Cases can be difficult,” says Alves. “An obese woman needed eight people to take her to our ambulance. And a man with Alzheimer’s … we had to ask the family if we could physically remove him from his home. It’s hard.” The woman survived, the man died.
Maria Rosa da Silva is crowded high above the crowded street when everyone seems to be approaching the garbage truck. The 53-year-old says she thinks she got the virus from the market even though she was wearing a mask and gloves. So she is “locked away”, three floors up on her green terrace, without railings. Social distance seems only possible here if you do it vertically.
“People like me die in the risk group,” she emphasizes. “The owner of the pharmacy died yesterday. Many lose their lives due to negligence. If it is for the good of society, we have to do it.”
Social responsibility in these dangerous and poor streets has also led to the isolation of an abandoned school nearby. The government handed the building over to a privately funded project that now houses dozens of patients. It is ready for sparkling, uniform dorms monitored by CCTV for many more.
Other signs of readiness are less reassuring. In the hills above São Paulo, the Vila Formosa cemetery is bursting with sadness and yawning expectantly – lined with endless empty and fresh graves. A funeral appears to be taking place every 10 minutes, and even that does not dent the numerous new holes dug in the red dust.
Brazil had a head start – it watched the coronavirus tragedy sweep the world for at least two months.
But the undeniable evidence of the horror of the disease around the world has instead led to mixed government messages. And the death toll and the number of new cases, as terrible as they may be, are unlikely to reflect the entirety of the tragedy that is already underway.
What has already happened elsewhere – and has sent warning torches around the planet – still happens here and can be worse.