Brazil struggles with lack of ICU doctors as pandemic worsens

Health worker Debora Castro da Silva treats a coronavirus disease (COVID-19) positive patient at the Intensive Care Unit (ICU) of Hospital Sao Paulo in Sao Paulo, Brazil

As Brazil’s coronavirus outbreak spirals out of control, the country is facing a dangerous new shortage, threatening to drive fatalities even higher: a lack of staff in intensive care units.

Some medical professionals are burned out after months of grueling, soul-sapping work. Others are simply unable to keep up with the endless flow of critical COVID-19 patients pushing the country’s healthcare system to the brink.

“Intensive care doctors are a commodity in short supply,” César Eduardo Fernandes, the president of the Brazilian Medical Association (AMB) told Reuters on Wednesday. “There’s no way to meet this brutal, catastrophic demand.”

Driven by an infectious new variant, a lack of containment measures, a chaotic federal response and a patchy vaccine rollout, Latin America’s biggest country has become the epicenter of the global pandemic. More than 284,000 Brazilians have died from COVID-19 since the start of the pandemic – the highest death toll outside the United States.

Brazil is now accounting for one in every six coronavirus infections reported worldwide, according to a Reuters tally.

It has posted record daily deaths and caseloads this week, even as many countries are beating back the coronavirus with immunization drives, creating a political crisis for President Jair Bolsonaro and isolating Brazil internationally.

The country’s health system is buckling, according to the Fiocruz biomedical institute, as intensive care units (ICUs) in 25 of 26 states and the federal district are filled beyond 80% capacity. Nineteen state capitals have passed 90% capacity.

On Thursday, the city of Sao Paulo, Brazil’s affluent business hub, recorded its first death of a patient waiting for a bed in an ICU.

“We are seeing patients arriving at a speed that we can’t handle,” said Flávia Machado, the head of intensive care at the Hospital São Paulo. “This causes us health professionals, who are already tired, an additional stress, as we know that we are not serving everyone who needs us.”

She added that her colleagues were all exhausted and emotional, which threatened their decision-making abilities and raised the chances of them getting things wrong.

In many states, governors and mayors are struggling to open field hospitals due to a lack of qualified professionals. Public health officials are cancelling elective surgeries and converting hospital wings into makeshift ICUs, but still running up against a lack of human resources.

“Now we have ‘field hospitals’ set up within existing hospitals precisely so we can get support from professionals there,” said Jean Gorinchteyn, Sao Paulo state health secretary.

Brazil has over 540,000 doctors and its ratio of physicians per capita is not far off that of the United States. However, only a fraction are qualified for specialized ICU care.

Fernandes, head of the AMB, said Brazil needed to urgently retrain doctors to work in ICUs.

“The government should have an incentive policy so that doctors can be trained quickly,” he said. “It should have been done yesterday.”

Brazil’s Health Ministry did not respond to requests for comment.

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