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Rio de Janeiro (AFP)

Dr. Valdilea Veloso is racing against time: she needs ventilators, face masks and medical staff before the coronavirus outbreak peaks in Brazil, where social distancing is proving problematic, not least because of President Jair Bolsonaro.

With Brazilians increasingly ignoring health officials' warnings to stay home -- encouraged by their far-right president, who has condemned the "hysteria" over the virus -- predictions for how the pandemic will play out in the hardest-hit country in Latin America are getting dire.

Brazil, an country of 210 million people, has registered 1,532 deaths from the new coronavirus so far.

But the state of Sao Paulo alone is expecting 111,000 deaths over six months, nearly equal to the entire worldwide toll to date.

A number of states face the possibility that their healthcare systems will collapse.

They include Sao Paulo; Rio de Janeiro, the second-hardest hit; and Amazonas, a huge territory with a large number of indigenous communities that have a tragic history of being decimated by new diseases.

Veloso, the head of the main hospital fighting COVID-19 in Rio de Janeiro, says her staff are already tired, sick and running out of protective equipment.

Her hospital, the National Infectious Diseases Institute, is rushing to build a new facility with 200 intensive care beds, train new staff, and buy scarce ventilators and face masks.

What happens if they are not ready for the crush of patients expected to start later this month?

"I try not to think about that," she told AFP.

"It's too much stress. When I do think about it, I think about all the deaths we'll have here, and how they will hit us unequally. The wealthiest people will not be hurt as much as the poorest, the people who live in the favelas" -- the crowded slums of tin-roof shacks that coexist, sometimes side by side, with Brazil's posh neighborhoods.

- Anti-isolationist-in-chief -

Known for its wild carnivals, sultry climate, pulsing mega-cities and sprawling size, Brazil has not been very good at social distancing.

Surfers in Rio de Janeiro, anti-isolation protesters in Sao Paulo and people who simply need to work are increasingly flouting state and local authorities' measures to "flatten the curve."

In Sao Paulo, the proportion of the population staying home has dipped as low as 47 percent, according to monitoring based on cell phone location data -- far below the goal of 80 percent.

The offender-in-chief is Bolsonaro, who has compared the virus to a "little flu," condemned the economic impact of stay-at-home measures and proudly broken them himself, insisting on his "constitutional right to come and go as I please."

Dr Veloso said she was worried by a visible decline in social distancing.

"It's the only chance we have to avoid the collapse of the healthcare system," she said.

- Alarm bells -

There are worrying signs in various places.

Sao Paulo has at least five hospitals with more than 70 percent of intensive care beds occupied by coronavirus patients -- a percentage that is rising rapidly.

A study found the municipal health system faced collapse by April 19 if social distancing measures were not intensified.

Rio Health Secretary Edmar Santos said his state can handle around 16,000 hospitalizations, but fears the number will reach 40,000 to 50,000.

Rio Governor Wilson Witzel, himself fighting off the virus, said the state could run out of ventilators by April 28.

In Amazonas, the health system is already on the brink of collapse.

Its capital, Manaus, is the only city with an intensive care unit.

Its 50 beds serve a state more than four times the area of Germany. Brazilian media report that new patients have to wait for someone to die to be admitted.

The government has started building field hospitals to boost capacity in such cases. It is urgently sourcing ventilators and medical supplies, and deploying more than 1,000 nurses and 80 doctors as reinforcements.

"The curve (of infections) in Manaus is very close to the line of health system capacity... So we are trying to move that line, to increase capacity," health ministry official Joao Gabbardo said Saturday.

But there are limits to how far and how fast it can move.

Public health officials report that vital supplies and equipment such as face masks and ventilators are increasingly difficult to source, with international suppliers sometimes charging quadruple the usual price or more.

© 2020 AFP