Patients with mild symptoms are instructed to remain isolated at home and to seek medical care at any sign of their symptoms worsening. But for the more than 24,000 homeless people in São Paulo, these recommendations are difficult, if not impossible, to follow. To make matters worse, these people regularly suffer neglect and prejudice by the health system when they seek treatment.
For Dr Simakawa, the COVID-19 pandemic has brought to light injustices that cannot be ignored.
“It is not the virus along that has caused all this suffering,” Dr Simakawa says. “The man I am looking at is living proof that there are other villains here, including social and economic inequalities.
“How is it possible that an elderly black man, sick and homeless, feels that he is causing ‘trouble’ to health professionals who are only doing their jobs? This care is his right.”
The escalating emergency
Brazil now has more than one million confirmed cases of COVID-19, with an additional 15,000-30,000 more people being infected every day—the country is second only to the United States in terms of total case numbers and deaths. The death count has risen to more than 52,000 deaths, with many more inevitable due to the lack of access to effective healthcare. The state of Amazonas has the highest mortality rate, and the situation in the capital, Manuas, is dire.
“The four main hospitals in Manaus were all full,” says Dr Bart Janssens, MSF Emergency Coordinator. “The hard-working medical teams there are dealing with extremely sick patients, often arriving too late and too far gone to be saved. A high percentage of the patients going into intensive care units are dying, and large numbers of medical staff are falling sick.”