Brazil's hospitals were running out of drugs needed to sedate COVID-19 patients on Thursday, with the government urgently seeking to import supplies amid reports of the seriously ill being tied down and intubated without effective sedatives.
Health Minister Marcelo Queiroga said Brazil was in talks with Spain and other countries to secure the emergency drugs. Hospitals, he added, were also struggling to get enough oxygen.
The scenes playing out across Brazil, one of the countries hardest hit by the COVID-19 pandemic, are placing growing international pressure on President Jair Bolsonaro.
Aid group Médecins Sans Frontières (MSF) said Brazil's "failed response" had led to thousands of avoidable deaths and created a humanitarian catastrophe that could still get worse.
Brazil has recorded a total of 361,884 coronavirus deaths - only the United States has more - and 13,673,507 confirmed cases.
More Brazilians are currently dying of the virus each day than anywhere else in the world, with South America's largest country reporting another 3,560 deaths on Thursday. Bolsonaro has opposed lockdowns and held large events in which he often does not wear a mask. He has only recently embraced vaccines as a possible solution.
Brazil's hospitals are struggling to cope.
Rio de Janeiro and Sao Paulo have both sounded the alarm over shortages of sedatives, with Sao Paulo's Health Secretary saying the city's ability to care for seriously ill COVID-19 patients is on the verge of collapse.
"I never thought that I would be living through something like this after 20 years working in intensive care," Aureo do Carmo Filho, an ICU doctor in Rio, told Reuters.
"Using mechanical restraints without sedatives is bad practice ... the patient is submitted to a form of torture," he said.
Seriously ill COVID-19 patients struggling for breath are sedated in order to put them on ventilators, an intrusive practice the body can naturally resist.
With ICU beds at or near capacity across the country, hospitals are being forced to create improvised intensive care beds which often lack equipment or professional expertise.
Globo television network on Wednesday reported cases from a Rio hospital in which patients were intubated with a lack of sedatives, tied to beds.
The Albert Schweitzer hospital, through the press office of the city of Rio which runs it, said there was a shortage of intubation drugs but that substitutes were being used to ensure medical assistance was not compromised. It said mechanical restraints were only used when prescribed by a doctor.
The city of Rio added that a batch of intubation drugs was set to arrive on Thursday.
Sao Paulo blamed the shortage on the federal government.
"The irresponsibility and neglect of Brazilian lives is unbelievable," Sao Paulo Governor Joao Doria said on Twitter.
"FAILED RESPONSE"
Médecins Sans Frontières said Bolsonaro's government had not done enough to prevent the tragedy.
"More than one year into the COVID-19 pandemic, the failed response in Brazil has caused a humanitarian catastrophe," said Christos Christou, a medical doctor and president of MSF, called Doctors Without Borders in English.
"Each week there is a grim new record of deaths and infections - the hospitals are overflowing and yet there is still no coordinated centralized response," Christou said in a briefing with reporters, adding that the situation was expected to become even worse in the weeks ahead.
Bolsonaro has openly fought against state and local governments seeking to institute lockdowns, saying Brazilians need to get on with normal life and that job losses are more dangerous than the virus.
MSF Director-General Meinie Nicolai said the surge in cases cannot be blamed only on the contagious Brazilian COVID-19 variant, known as P.1.
"The P.1 variant is certainly a problem, but this doesn't explain the situation in Brazil," she said.
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