Brazil closed out its deadliest month of the coronavirus pandemic by far on Wednesday as a surge of COVID-19 patients overwhelmed hospitals, forcing doctors to make agonising decisions over whom to give life-saving care.
With 66,573 COVID-19 deaths in March, the health ministry recorded more than twice as many fatalities as the second-deadliest month of the pandemic in Brazil, July 2020, when there were 32,881 deaths.
"Never in Brazilian history have we seen a single event kill so many people" in a single month, said doctor Miguel Nicolelis, former coordinator of the pandemic response team for Brazil's impoverished northeast.
With the southern hemisphere winter now approaching and the virus spreading fast, Brazil is facing "a perfect storm," he told AFP. "That's a threat not just for Brazil but for the entire world."
Brazil's average daily death toll has more than quadrupled since the start of the year, to 2,976 this week, the highest by far worldwide.
Health experts say the recent explosion of cases in the sprawling South American country of 212 million people is partly driven by a local variant of the virus known as P1.
Workers place a coffin inside a grave in the Vila Formosa cemetery in Sao Paulo, Brazil Source: EFE
Believed to be more contagious, P1 can re-infect people who have had the original strain of the virus, and has spread to more than two dozen countries, including the United States, Britain and Japan.
And as long as the pandemic continues to rage unchecked in Brazil, there is a risk that more variants could emerge in the country, researchers say.
Bolsonaro renews anti-lockdown stance
President Jair Bolsonaro faces mounting criticism for his handling of the pandemic.
The far-right leader's resistance to lockdowns, face masks and vaccines has caused a firestorm of controversy as COVID-19 has claimed more than 321,000 lives in Brazil, second only to the United States.
Under pressure from allies in Congress and the business world, Mr Bolsonaro installed his fourth health minister of the pandemic last week, replacing Eduardo Pazuello - an army general with no medical experience - with cardiologist Marcelo Queiroga.
The president also sought to show he was taking the pandemic seriously, launching a crisis committee.
However, he reverted to his anti-lockdown message at the committee's first meeting Wednesday.
"We're not going to solve the problem by staying at home," he said - contradicting his new health minister, who had just urged Brazilians to "respect social distancing."
Mr Bolsonaro argues the economic damage of lockdowns is worse than the virus itself, a stance that has left state and local governments to implement a messy patchwork of pandemic policies.
Brazil is meanwhile struggling to secure enough vaccine doses, and is far off the pace to meet the health ministry's target of immunising the entire adult population by the end of the year.
"We're at the worst moment of the pandemic, and indications are that April will be very bad, too," said epidemiologist Ethel Maciel of Espirito Santo Federal University. And "the worst is yet to come," she told AFP.
COVID-19 beds in intensive care units are more than 90 per cent full in 18 of Brazil's 27 states, and another seven states are approaching that level.
At least 230 patients with suspected or confirmed cases of COVID-19 died waiting for a bed in intensive care in Sao Paulo this month, according to TV Globo.
"We're in a very tragic situation," said Ms Maciel.
Meanwhile, Mr Bolsonaro will replace all three commanders of Brazil's armed forces.
The exit of the army, navy and air force chiefs came a day after Mr Bolsonaro overhauled his cabinet, replacing the foreign, defense and justice ministers as well as his chief of staff, attorney general and government secretary.
Mr Bolsonaro, who comes up for re-election in October 2022, faces sliding popularity and growing pressure over his handling of the pandemic, including from key allies in Congress and the business world.
The defense ministry did not give a reason for the departure of Army General Edson Pujol, Navy Admiral Ilques Barbosa and Air Force Lieutenant-Brigadier Antonio Carlos Bermudes.
Some Brazilian media reported the trio had resigned in protest at Bolsonaro's surprise decision to replace defense minister Fernando Azevedo.
"For the first time in history, the commanders of all three branches of the armed forces presented their joint resignation in disagreement with the president," said newspaper Folha de Sao Paulo.
