There is no ideal time for a pandemic, but fewer countries are less equipped to deal with the Covid-19 outbreak than crisis-ridden Venezuela, warn doctors and public health experts.

Bed shortages, a lack of isolation areas and short supplies of soap are already a daily reality at one hospital in Ciudad Guayana, a city in the country’s east. There is a nearby centre set up for the pandemic response but workers there say there are not enough ambulances to ferry patients.

“We are experts in crisis,” one health worker said. “But the coronavirus is a whole other challenge and we’ll need much more support.”

Cases of Covid-19, the disease caused by the novel coronavirus, reached 33 in Venezuela on Monday evening, following the first two confirmed cases three days earlier. The government responded with a quarantine in the capital, Caracas, and six other states, alongside travel bans. On Monday the regulation was extended to the whole country.

Venezuela crisis takes deadly toll on buckling health system Read more

But the outbreak could hardly come at a worse time for Venezuela, which despite boasting the planet’s largest proven oil reserves remains mired in years-long economic and social turmoil. Hyperinflation is rampant – Venezuela’s central bank said inflation reached nearly 10,000% last year – while shortages in basic foodstuffs and medical supplies are routine.

Hospitals regularly face power outages, while basic supplies – from latex gloves to basic antibiotics – are often hard to come by. Four and a half million people have fled Venezuela, with healthcare workers and disease specialists among them. Treatable diseases such as diphtheria, measles and malaria continue to spread in fertile conditions.

“The health system is completely weakened and without the capability or resources to respond to people’s basic needs – let alone an epidemiological situation like Covid-19,” said José Félix Oletta, who served as Venezuela’s health minister from 1997 to 1999.

A survey of doctors across the country carried out by the local NGO Médicos Unidos found that only 25% of respondents had reliable running water in their hospitals and clinics. Two-thirds said they did not have gloves, masks, soap, goggles or scrubs.

At the University Hospital of Caracas 80% of health workers are without protective equipment to treat patients who could be contagious. “The stretcher bearer should wear a face mask, a disposable gown and gloves; the orderly who collects the waste must wear glasses and gloves – but none of that exists at the moment,” said Mauro Zambrano, a representative of the Union of Hospital and Clinic Workers.

On Monday workers in at least two hospitals in Caracas were resorting to making their own masks from items that had been donated. “We are looking for solutions,” Zambrano said. Hospitals across the country have started online campaigns to bring in supplies.

Few know for certain how broken the health system is, owing to the opacity of the administration of the embattled president, Nicolás Maduro. The most recent epidemiological survey carried out by his health ministry was published in 2016.

“When forces close to Maduro censor information, it is difficult to tell people what they need to know – it’s difficult to respond,” said José Manuel Olivares, an opposition politician and doctor. “Actions taken by Maduro to hurt the health system have made it a sad fact that the coronavirus pandemic will cause more deaths in Venezuela and the region.”

Maduro, the leftwing successor to Hugo Chávez, is resisting a challenge to his legitimacy from Juan Guaidó, an opposition leader backed by the US and 50 other countries. The incumbent retains the key support of the military and remains allied with Russia, China and Cuba. It is unclear how the international community will respond to the outbreak in Venezuela, or which leader it would be prepared to work with.

Maduro, announcing flight bans in response to the pandemic, said US sanctions were hurting his administration’s ability to buy medicines and foodstuffs.

Feliciano Reyna, who runs an NGO in Caracas that distributes medications to those who cannot get them otherwise, predicts that the isolation measures announced by the Maduro government will also be hampered by the crisis. “When trash isn’t collected, or there is no water to wash your hands, isolation at home can become unsanitary,” Reyna said. “We are not at all well prepared.”