Coronavirus

Brazil's Overrun ICUs Show How Virus Spreads Across Nation

The South American nation has the second highest number of coronavirus fatalities in the world (after the United States), and with ICU beds in short supply, the death toll will continue to rise.

An intensive care unit in Manaus, Brazil
An intensive care unit in Manaus, Brazil

In raw COVID-19 numbers, Brazil is the second hardest hit country in the world, after the United States, as the case total at two million and death toll reaching 75,000. On ground level, new reports are surfacing of local hospital intensive care units hurtling towards a breaking point that could further accelerate fatalities. For the vast nation of 209 million, the rolling emergencies at ICUs shows how wide the crisis is spreading:

Collapse: In at least five state capitals, ICUs are on the verge of collapse, the daily Correio Braziliense reports.

  • Some 97% of all adult ICU beds were taken in Florianópolis, one of the hardest-hit cities at the moment. State authorities have recently added 570 beds, but demand continues to rise.

  • In Belo Horizonte, Brazil's sixth-largest city, only a handful of beds are available — and some hospitals are simply unable to admit any more patients, according to O Tempo.

  • The situation is even more critical in the central-southern city of Cuiabá, near the border with Bolivia, where municipalities around the capital are unable to cope with the rising patient numbers, the Belo Horizonte-based newspaper Estado de Minas notes. For more than 10 days, no beds have been available, and although neighboring states are stepping in to help, the waiting list for a hospital bed is now 100 patients long — and growing.

A medical worker at a hospital in Sorocaba, Brazil — Photo: Cadu Rolim/Fotoarena/ZUMA

Spread: Unlike in Spain or Italy, where the pandemic was concentrated in certain areas and spared much of the territory, in Brazil (as in the United States) the virus has spread virtually nationwide, with severe clusters flaring up in new and different parts of the country.

  • The country's largest cities, São Paulo and Rio de Janeiro, were hit first. Then, in May, the epidemic began ravaging Manaus, in the northern Amazonas state. In those areas, the peak of the crisis — "the days of patients in corridors, alongside bodies," as BBC Brasil reported — appears to have passed. But other outbreaks have since popped up in the south and the center of the country, perhaps because of falling temperatures in the Southern Hemisphere winter.

  • For patients who are being left out in the cold, hospital saturation has life or death implications. But as BBC Brasil points out, the situation in any given hospital says as much about the number of beds each state provides as it does about the state of the outbreak itself. Some cities are being ravaged by the epidemic but their hospitals are coping.

  • Porto Alegre, Brazil's southernmost state capital, is a case in point. There, as Lúcio Botelho, a public health professor at the Federal University of Santa Caterina, told the network: "The epidemic is spreading, but the occupation of beds is low." For now, at least. The numbers of new cases are indeed spiking there after authorities eased quarantine measures on May 20. "What we expected is happening," said Eduardo Sprinz, head of Infectious Diseases at Porto Alegre's Hospital de Clínicas. "We're reaping what we sowed."

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Geopolitics

Why This Sudan Coup Is Different

The military has seized control in one of Africa's largest countries, which until recently had made significant progress towards transitioning to democracy after years of strongman rule. But the people, and international community, may not be willing to turn back.

Smoke rises Monday over the Sudanese capital of Khartoum

Xinhua via ZUMA
David E. Kiwuwa

This week the head of Sudan's Sovereign Council, General Abdel Fattah El Burhan, declared the dissolution of the transitional council, which has been in place since the overthrow of former president Omar el-Bashir in 2019. He also disbanded all the structures that had been set up as part of the transitional roadmap, and decreed a state of emergency.

In essence, he staged a palace coup against the transitional authority he chaired.


The general's actions, which included the arrest of Prime Minister Abdalla Hamdok, are a culmination of a long period of tension between the civilian and military wings of the council.

A popular uprising may be inevitable

The tensions were punctuated by an alleged attempted coup only weeks earlier. The days leading to the palace coup were marked by street protests for and against the military. Does this mark the end of the transition as envisaged by the protest movement?

Their ability to confront counter revolutionary forces cannot be underestimated.

The popular uprising against Bashir's government was led by the Sudan Professional Association. It ushered in the political transitional union of civilians and the military establishment. The interim arrangement was to lead to a return to civilian rule.

But this cohabitation was tenuous from the start, given the oversized role of the military in the transition. Moreover, the military appeared to be reluctant to see the civilian leadership as an equal partner in shepherding through the transition.

Nevertheless, until recently there had been progress towards creating the institutional architecture for the transition. Despite the challenges and notable tension between the signatories to the accord, it was never evident that the dysfunction was so great as to herald the collapse of the transitional authority.

For now, the transition might be disrupted and in fact temporarily upended. But the lesson from Sudan is never to count the masses out of the equation. Their ability to mobilize and confront counter revolutionary forces cannot be underestimated.

Power sharing

The transitional pact itself had been anchored by eight arduously negotiated protocols. These included regional autonomy, integration of the national army, revenue sharing and repatriation of internal refugees. There was also an agreement to share out positions in national political institutions, such as the legislative and executive branch.

Progress towards these goals was at different stages of implementation. More substantive progress was expected to follow after the end of the transition. This was due in 2022 when the chair of the sovereignty council handed over to a civilian leader. This military intervention is clearly self-serving and an opportunistic power grab.

A promised to civilian rule in July 2023 through national elections.

In November, the rotational chairmanship of the transitional council was to be passed from the military to the civilian wing of the council. That meant the military would cede strong leverage to the civilians. Instead, with the coup afoot, Burhan has announced both a dissolution of the council as well as the dismissal of provincial governors. He has unilaterally promised return to civilian rule in July 2023 through national elections.

Prior to this, the military had been systematically challenging the pre-eminence of the civilian authority. It undermined them and publicly berated them for governmental failures and weaknesses. For the last few months there has been a deliberate attempt to sharply criticize the civilian council as riddled with divisions, incompetent and undermining state stability.

File photo shows Sudan's Prime Minister Abdalla Hamdok in August 2020

Mohamed Khidir/Xinhua via ZUMA

Generals in suits

Since the revolution against Bashir's government, the military have fancied themselves as generals in suits. They have continued to wield enough power to almost run a parallel government in tension with the prime minister. This was evident when the military continued to have the say on security and foreign affairs.

For their part, civilian officials concentrated on rejuvenating the economy and mobilizing international support for the transitional council.

This didn't stop the military from accusing the civilian leadership of failing to resuscitate the country's ailing economy. True, the economy has continued to struggle from high inflation, low industrial output and dwindling foreign direct investment. As in all economies, conditions have been exacerbated by the effects of COVID-19.

Sudan's weakened economy is, however, not sufficient reason for the military intervention. Clearly this is merely an excuse.

Demands of the revolution

The success or failure of this coup will rest on a number of factors.

First is the ability of the military to use force. This includes potential violent confrontation with the counter-coup forces. This will dictate the capacity of the military to change the terms of the transition.

Second is whether the military can harness popular public support in the same way that the Guinean or Egyptian militaries did. This appears to be a tall order, given that popular support appears to be far less forthcoming.

The international community's appetite for military coups is wearing thin.

Third, the ability of the Sudanese masses to mobilize against military authorities cannot be overlooked. Massive nationwide street protests and defiance campaigns underpinned by underground organizational capabilities brought down governments in 1964, 1985 and 2019. They could once again present a stern test to the military.

Finally, the international community's appetite for military coups is wearing thin. The ability of the military to overcome pressure from regional and international actors to return to the status quo could be decisive, given the international support needed to prop up the crippled economy.

The Sudanese population may have been growing frustrated with its civilian authority's ability to deliver on the demands of the revolution. But it is also true that another coup to reinstate military rule is not something the protesters believe would address the challenges they were facing.

Sudan has needed and will require compromise and principled political goodwill to realise a difficult transition. This will entail setbacks but undoubtedly military intervention in whatever guise is monumentally counterproductive to the aspirations of the protest movement.

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David E. Kiwuwa is Associate Professor of International Studies at University of Nottingham

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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