As in many hospitals in this collapsed socialist state, even washing hands is a luxury. The hospital has run out of soap, leaving doctors to bring their own, when possible. None of the six X-ray machines works. Without cleaning products to disinfect surfaces — including those in the waiting room where suspected coronavirus patients are held — hospital infections are common. A shipment of gloves and masks arrived Friday; doctors say they had gone a full month without them. Current supplies, they say, will run out in one week.

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“If we start getting large numbers of patients, we will collapse,” said Maria Eugenia Landaeta, head of the infectious-diseases department at Caracas University Hospital. “Long lines of patients waiting, all beds full and patients we won’t be able to hospitalize. To sum up: total chaos.”

Analysts say Venezuela, already struggling under a dangerous mix of gaps in clean water and soap, underequipped and inadequately supplied public hospitals and authoritarian red tape, is uniquely vulnerable to the pandemic. As the government of President Nicolás Maduro tries to roll out a historic response to a global challenge it is ill-equipped to confront, Venezuela’s neighbors increasingly fear that the country will become a petri dish for the novel coronavirus, hemorrhaging infected migrants and spreading the virus across hard-to-control borders.

“An explosive number of cases would obviously surpass the ability of the Venezuelan health-care system, and will end up with many people demanding care in Colombia,” said Fernando Ruiz Gómez, Colombia’s health minister. “Intensive-care services will be most critical.”

In a few days, South American nations from Brazil to Bolivia to Peru have emerged as some of the world’s most proactive states in seeking to control the virus, imposing curfews, deploying the military, closing borders and barring many, and in some cases all, international flights.

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But few were as early or aggressive as Venezuela. Maduro shut businesses and limited public gatherings last Friday. Soldiers and police have set up roadblocks, limiting movement to people traveling to work, markets, pharmacies and hospitals. The streets of Caracas are now eerily quiet.

The number of confirmed cases of covid-19 announced by the government has grown from two to 46 in less than a week (opposition officials say the real number of people infected is far higher). Maduro has ordered all citizens to wear face masks in public. Members of the SEBIN, his feared intelligence police, are guarding hospitals.

“Either we quarantine, or the pandemic could tragically and painfully take down Venezuela,” Maduro told the nation this week.

The response is complicated by the country’s political stalemate: In Venezuela, even the basic question of who’s in charge remains in doubt. Maduro, who claimed the presidency last year after an election widely viewed as fraudulent, has sought to use the crisis to demonstrate his de facto control of the country. Opposition leader Juan Guaidó is recognized by the United States and more than 50 other nations as its rightful leader.

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On Monday, the rivals issued dueling national messages to a fretting populace. Maduro, known for assailing international lenders as pawns of his enemies in Washington, took the extraordinary step Tuesday of asking the International Monetary Fund for a $5 billion emergency loan to confront the crisis. The IMF dismissed the request, citing the question of his legitimacy.

The World Health Organization has agreed to provide coronavirus tests, medical supplies and technical assistance, Vice President Delcy Rodríguez said in a televised address Wednesday.

“As you well know, this is a special condition, because we are a country illegally sanctioned, criminally blocked,” she said. “In the middle of this global pandemic, whoever maintains a political agenda is really miserable.”

More than 5 million Venezuelans — a sixth of the population — have fled poverty, hunger and spreading disease in recent years. Venezuelan migrants were identified as the source of a wave of measles that spread throughout South America in 2018, and they imported long-dormant diseases such as diphtheria to neighboring Colombia. Now fears that the coronavirus could ravage this underfed nation have led Colombian and Brazilian authorities to close their borders with Venezuela.

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In Colombia, that move came after authorities decided that the installation of heat-detecting cameras to identify migrants with fevers was insufficient to meet the threat. The Venezuelan government, Colombian authorities note, stopped sharing epidemiological information with neighboring nations in 2017.

Critics say shutting the border might only encourage desperate Venezuelans to seek riskier passages to sanctuary: illegal and unmonitored crossings run by armed gangs.

Maduro’s government, meanwhile, is militarizing the nation. Defense Minister Vladimir Padrino López announced this week that all military branches and the national police were being deployed to enforce the quarantine. The black-clad officers of the SEBIN have guarded the entrance of Caracas University Hospital since the first cases were announced.

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Inside, the facility is falling apart. There are holes in the walls, water leaks and a broken elevator that leaves patients to walk up flights of stairs. The hospital has 1,500 beds, but only 350 are in service. The emergency room has one working ventilator; doctors say they need five.

In a nation of about 30 million people, the Venezuelan opposition says, there are 81 fully functioning intensive-care beds. Maduro said last month that the Pan American Health Organization had donated “a significant number of kits to diagnose the coronavirus.” Julio Castro, a physician on a commission designated by the opposition-led National Assembly to respond to the coronavirus, said the government has only about 300 kits.

“Do the math,” he said.

Doctors for Health, a group created in 2014 to gather data from within hospitals, reported recently that 164 people died in 2019 as a result of complications linked to Venezuela’s frequent electricity cuts. The group said 70 percent of hospitals have only intermittent access to running water.

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“In Venezuela, you would need to hammer the virus curve and make it completely flat, because the health-care system is completely collapsed,” said Leopoldo López, Guaidó’s mentor and second-in-command. “This is not just about masks or medicines. It’s the most basic things. Venezuelans can’t even wash their hands.”

The economics of hand-washing panic Vanessa Furtado. The 48-year-old swimming instructor gets running water in the poor Caracas neighborhood of Baruta three days a week. She fills buckets and pans for dry days. She buys soap at a neighborhood store for $1, chops it up and puts it in a bottle with a little bit of water to stretch it out.

Furtado earns $50 a month. Bottled water, at $5 a gallon, is well out of reach.

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“It’s not only the high prices of soap,” she said, “it’s also a problem to find it.” Living with her mother, a cancer patient, she cleans her house only with her homemade soap solution.

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Sometimes it runs so dirty, she uses socks to filter it.

“This is getting ugly, I tell you,” Furtado said. “I am getting very scared. Imagine going to a hospital now. I’d rather stay home, because in a hospital I’m going to die. I’m very scared.”