The Washington PostDemocracy Dies in Darkness

As vaccinations accelerate and the coronavirus retreats, Brazil finally allows itself to hope for better days

A weather-damaged grave lies in a public cemetery in Manaus, Brazil, dedicated exclusively to victims of covid-19. More than 9,200 people have died of the disease in the Amazonian city. (Raphael Alves for The Washington Post)

MANAUS, Brazil — Aldei Silva stepped out of the hospital, took off his mask and surveyed the courtyard. The scene was peaceful: No families were screaming for help, no ambulances were lining up, no patients being turned away and left to die. There was none of the chaos the intensive care nurse had come to associate with this city’s protracted struggle against the coronavirus.

Vendors were back selling water. People were back laughing at their phones. Silva felt a sense of relief.

“Thank God,” he said. “It was total desperation here. By comparison, this is paradise.”

Better days seem finally to have arrived to Manaus, the isolated Amazonian city of 2 million that introduced the world to the destructive potential of the coronavirus in the developing world. After two devastating waves — one last year, and one this year — the hospitals are now largely empty of covid-19 patients. This month, for the first time since the pandemic arrived here, Amazonas state had a day when it did not register a single covid death.

“We have weeks where there is practically no one showing up with symptoms of covid,” said Uildéia Galvão, lead physician in the coronavirus ward at the 28th of August Hospital. “The vaccine has been fundamental.”

The Amazonian city that hatched the Brazil variant has been crushed by it

Throughout the pandemic, Brazil has looked to Manaus for clues for what was coming next. The city, which eschewed containment measures successful elsewhere, was the country’s first to experience a widespread medical failure. After a period of recovery, it then gave rise to the variant known as gamma or P.1, which devastated the country and punctured hopes that Manaus had reached herd immunity. Researchers have described the city as a “sentinel,” allowing the scientific community to study an urban setting where the virus was allowed to spread largely unmitigated.

Now Brazil, which has buried more coronavirus victims than any country but the United States, is again glancing northward at Manaus. While the national vaccine campaign rolled out sluggishly in much of the country, Manaus raced ahead. The city, one of the first places in the country to begin coronavirus vaccinations, has immunized 75 percent of adults with at least one dose — far more than the national rate of 55 percent. Even healthy adults in their early 20s are getting the shot now.

As hospitalizations and deaths here plunge, Brazilians in other parts of the country are beginning to express hope that relief could soon arrive. The vaccine campaign has picked up considerable speed in recent weeks. A record 94 percent of Brazilians say they want the shot. On Monday, the nation registered its fewest cases since January. Plans are underway to hold the country’s famously raucous New Year’s Eve celebrations in December and Carnaval next year.

For the first time in more than a year, scientists — who have issued dire warning after warning — are beginning to sound hopeful.

“Unpredictability is a mark of covid-19,” said Renato Kfouri, head of the immunizations department at the Brazilian Society of Pediatrics. “But in this moment, the retreat of the pandemic nationally has gone through Manaus first. It could be something of a mirror for what you can expect to see in other parts of the country.”

In the Brazilian Amazon, a sharp drop in coronavirus sparks questions over collective immunity

Many in Manaus now carry themselves with the air of shipwreck survivors — delirious to have survived, but changed forever by the experience. For more than a year, the city suffered a kind of claustrophobia — isolated by geography, overwhelmed by disease, 2 million people marooned in the middle of the Amazon. There was no escaping the disease, and few options for those who got it.

More than 9,200 people died in the city. Many survivors lost loved ones. A collective pain is now just beneath the surface. Talk to most anyone for a few minutes, and it rises to the surface.

“It’s this tattoo on me,” said Marcia Freitas, 44. “There’s no way to forget.”

As the hospital system failed last year, her grandmother, father-in-law and aunt fell ill. “There were so many people dying at the same time,” she said. Hospital beds were running out. She put her grandmother in the car and took off to find one. But by the time they arrived at a hospital, her grandmother was dead. Her father-in-law also died that day. Her aunt also succumbed.

Freitas, a government worker, sees some in the city trying to move on. But some days she still feels stuck, thinking about that day. Having lost so much to the coronavirus, she doesn’t know where to put all of that heartache.

She sees the same struggle etched into the faces of those around her.

In Brazil, a desperate search for an open bed

Her friend Carla Lima’s family made it through the first coronavirus wave in the city, but then came the P.1 variant. Within days it sickened her mother, father and brother. Patients overwhelmed the city’s medical system and depleted oxygen supplies.

There was nowhere to take Lima’s loved ones and no oxygen to give them. She searched the city for oxygen but came up with nothing. It took three days of waiting through lines to find a single tube.

But it was no use: The virus soon took all three of her loved ones.

All that remains of the family is Lima and her sister.

“I wake up screaming all of the time,” she said. “I can’t sleep. I’m on anti-depressants. There’s no way to forget something like this. It was chaos.”

In a cemetery on the outskirts of Manaus, a gravedigger walked among the graves. Ulisses Xavier was still wearing the full protective suit he had worn since the beginning of the pandemic. These days he barely buries anyone by the coronavirus, but he’s not ready yet to loosen his regimen.

Xavier rested a gloved hand on one of the thousands of crosses adorning the graves of coronavirus victims. They went on and on — it was like looking out into the sea.

The ground where he stood was once a soccer field where cemetery workers played ball. But when the second wave came and every available large patch of dirt in the cemetery was consumed, they sacrificed their pitch to make another graveyard.

Xavier looked at the clearing and thought of days he hopes will never return.

“It was like a war zone — a war against the virus, and we were losing,” he said. “But now, with the vaccine, we’re finally making our comeback.”

Read more:

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Remote learning is deepening the divide between rich and poor

One disease. Two Brazils.

Coronavirus: What you need to know

Where do things stand? See the latest covid numbers in the U.S. and across the world. In the U.S., pandemic trends have shifted and now White people are more likely to die from covid than Black people.

The state of public health: Conservative and libertarian forces have defanged much of the nation’s public health system through legislation and litigation as the world staggers into the fourth year of covid.

Grief and the pandemic: A Washington Post reporter covered the coronavirus — and then endured the death of her mother from covid-19. She offers a window into grief and resilience.

Would we shut down again? What will the United States do the next time a deadly virus comes knocking on the door?

Vaccines: The CDC recommends that everyone age 5 and older get an updated covid booster shot. New federal data shows adults who received the updated shots cut their risk of being hospitalized with covid-19 by 50 percent. Here’s guidance on when you should get the omicron booster and how vaccine efficacy could be affected by your prior infections.

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