Brazilian officials were warned six days before an approaching oxygen crisis in Manaus

In a country already severely affected by coronavirus, the lack of oxygen and the increase in the number of Covid-19 cases have pushed Manaus, the capital of the state of Amazonas, into a medical crisis. Nurses in the city were quoted in local news as saying that patients had died of asphyxiation in the city’s hospitals because there was no oxygen to provide them.

The Brazilian government has been heavily criticized for managing the crisis. Last week, Supreme Court Judge Ricardo Lewandowski ordered the government to present a response plan to address the oxygen shortage, citing the Jair Bolsonaro administration’s “omission behavior” in addressing the emergency.

On Sunday, Bolsonaro’s attorney general, José Levi do Amaral, sent a 16-page report defending the government’s response to the court. The report reveals that the federal health ministry knew about the crisis six days before the situation became critical on January 14.

He also points out that the local government in the Amazon has not informed the federal authorities about the approaching lack of oxygen. “The Ministry of Health … got acquainted (January 8) with an e-mail sent by the product manufacturer”, the report states. The supplier, named in the report as the White Martins, first notified the Amazon government and then the federal authorities, the report said.

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It is unclear why the federal government’s notification of oxygen shortages was left to a private contractor. According to the Prosecutor General’s report, the Manaus health department was aware that the city’s health system was on the verge of collapse from the beginning of January.

Manaus officials did not respond to a request for comment from CNN.

A spokesman for an Amazon state told CNN that they would provide “clarifications” to the attorney general’s office and added that the state continues to work to alleviate the crisis, including “transporting oxygen from other states to Manaus, installing mini oxygen in hospitals , transferring patients for care to other states and requesting all production from local oxygen suppliers. “

Brazil’s attorney general, Augusto Aras, has ordered the health ministry to open an investigation into the collapse of Manaus’ health system, in addition to a separate investigation examining the potential negligence of state and city officials.

But the Attorney General’s report raises questions about why the Federal Ministry of Health could not help prevent the collapse of Manaus’ health care system after receiving prior notification. Ministry officials traveled to Manaus in early January, and Pazuello personally visited the city from January 11 to January 13.

The disaster hit the city’s hospitals the next day. On January 14, officials in the state of Amazonas announced that hospitals and emergency rooms in Manaus were facing oxygen deficiencies in the context of increasing Covid-19 cases. “We are facing a lot of difficulties in getting medical supplies. And as everyone is following her, our main difficulty now has been getting oxygen,” Governor Wilson Lima told reporters.

Cemetery workers in protective suits carry the coffin of a person who died of Covid-19 at the Nossa Senhora Aparecida cemetery in Brazil on January 15.

Although the Brazilian Air Force has responded by urgently delivering liquid and gaseous oxygen, the shortages continue. Logistics problems have exacerbated the crisis, as Manaus’ supplies enter the city mainly through the Amazon River. There is only one motorway outside the city, which connects it to the neighboring state of Amapá.

The Minister of Health, Eduardo Pazuello, defended the response of his agency. “We took action immediately,” he told a news briefing in Brasilia on Monday. “There were no indications of a lack of oxygen at our meetings in early January. The increase in cases has been very rapid,” he said.

“When we [visited Manaus] on [January] 4, the problem was not oxygen. The problem was the structure of the bed, the number of patients with Covid-19, the queues “, Pazuello added.

The appointment of Bolsonaro as Pazuello, a former military commander, to lead the Ministry of Health, has been strongly criticized by the opponent, as the death toll in Brazil, Covid-19, remains second in the world, behind only the United States.

Bolsonaro himself denied any responsibility for the city’s lethal crisis. “There is a problem in Manaus … We mourn the deaths caused by suffocation, due to lack of oxygen and people blame the government. We have allocated billions to the states, but those responsible for the lack of drugs are the health of the state and municipal secretaries,” he said. he told supporters Monday.

His statement followed Vice President Hamilton Mourão’s statement last week that no one could have predicted the collapse of the city’s health system.

“You can’t predict what would happen to this (virus) strain that is taking place in Manaus. It’s completely different from what happened in the first half,” Mourão said.

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