Oxygen-starved city in Brazil's Amazon starts immunization

RIO DE JANEIRO (AP) - The Amazonian city of Manaus began administering vaccines against the coronavirus, providing a ray of hope for the rainforest's biggest city whose health system is collapsing amid an increase in infections and dwindling oxygen supplies.

Amazonas state Gov. Wilson Lima led a ceremony that kicked off the vaccination campaign Monday night in Manaus, an isolated riverside city of 2.2 million people.

Vanda Ortega, 33, a member of the Witoto ethnicity and a nurse technician, received the first dose of CoronaVac, a vaccine developed by Beijing-based biopharmaceutical company Sinovac.

'œI want to thank God and our ancestors,'ť said Ortega, who is also a volunteer nurse in her Indigenous community.

Brazil on Monday began rolling out its national immunization program with 6 million doses of CoronaVac in almost a dozen states, and hopes to receive 46 million doses up to April to distribute among states. Amazonas received 256,000 doses.

The state government on Tuesday started distributing the doses to municipalities. The priority in the first vaccination phase will be health workers, elderly people above 80 years old, and Indigenous people in about 265 villages.

Amazonas has recorded at least 232,000 cases of the virus since the start of the pandemic, according to official figures. The state is in the midst of a devastating resurgence of infections and a lack of oxygen supplies.

Hospitals in Manaus have admitted few new COVID-19 patients, causing many to suffer from the disease at home and some to die. And many doctors in Manaus have had to choose which COVID-19 patients can breathe while desperate family members searched for oxygen tanks for their loved ones.

The city is receiving an average of four Brazilian air force flights per day to bolster oxygen stocks, along with one shipment per day from the city of Belem near the mouth of the Amazon river, according to officials.

The government of Venezuela's President Nicolás Maduro, which Bolsonaro regularly criticizes, authorized the dispatch of a caravan of trucks loaded with 107,000 cubic meters (3,78 million cubic feet) of oxygen that is scheduled to arrive in Amazonas on Tuesday, according to the state government.

Even as Amazonas welcomed the support, Bolsonaro lobbed critiques at Maduro.

'œIf you want to offer us oxygen, we will receive it without a problem,'ť Bolsonaro said Monday. 'œBut he (Maduro) could give emergency aid to his people too, right? The minimum wage there doesn't buy half a kilo of rice.'ť

The Brazilian health ministry sent seven oxygen generating plants Sunday, which once installed will supply oxygen to 100 ICUs.

Amazonas' government transferred 18 patients by plane to Goiás state Monday. The state had already transferred 112 patients to be treated in the Federal District, Brasilia, and other states, according to the state's health secretariat.

The health system collapse in Manaus, which had already gone through a critical situation last April, generated criticism of the government for allegedly not having anticipated the problems. Thousands of people protested in cities across Brazil on Friday, the same day that images emerged showing desperate relatives searching for oxygen for loved ones.

Health Minister Eduardo Pazuello admitted Monday that the federal government knew on Jan. 8 that oxygen supply could run out in the Amazon capital, a week before people died in intensive care beds. The speed of hospitalizations increased significantly in the last days and made the supplier company unable to meet demand, Pazuello said.

A new strain of the coronavirus has been circulating in Manaus. There have been concerns about greater transmissibility or potential for reinfection, although such possibilities remain unproven.

A positive coronavirus test doesn't reveal which variant of the virus the patient has, but some epidemiologists have speculated the new strain has been at least partially responsible for driving Manaus' second wave.

Jesem Orellana, an epidemiologist at public research institute Fiocruz Amazonia, said the rise of deaths in Manaus is not necessarily due to the coronavirus' new mutation.

'œSince October, there has been a problem of overcrowding in hospitals. People don't get to arrive early and end up being admitted late to the hospital, in a more deteriorated state,'ť Orellana told The Associated Press.

'œEverywhere there is a chaotic situation, lethality is higher, but not necessarily due to the severity of the infectious agent, but rather due to other factors: there are fewer doctors, health professionals are tired, medications are lacking and ICUs are overwhelmed,'ť Orellana added. 'œAll this creates a climate that favors premature death.'ť

___

Associated Press videojournalist Fernando Crispim in Manaus contributed to this report.