As coronavirus numbers improve in many countries, in Brazil, things are getting worse – a lot worse.

The country is seeing a surge in cases of a seemingly more contagious variant infecting people who have already been sick. And on Wednesday, Brazil – second only to the U.S. in the number of people who have died – hit their highest death toll number recorded in a single day: more than 1,900.

The health-care system is about to collapse – even in Sao Paulo, Brazil's most populous city with the largest medical infrastructure in the country, Dr. Miguel Nicolelis, a Brazilian-born Duke University neuroscientist, told NPR's Mary Louise Kelly.

He describes a "horrible" situation with hospitals at full capacity, turning people away, with some left to die in ambulances or on the street. "They [hospitals] are refusing to take patients because they cannot find a bed in the ICU. So, let's say you have a heart attack or you have a stroke or you had a car accident ... people are actually dying, waiting for ICU bed."

And for a vaccine rollout, Nicolelis says Brazil, known as one of the best countries for vaccinating citizens for diseases like measles and polio, "didn't do what it had to do" to procure and distribute COVID vaccines.

Nicolelis says Brazilian President Jair Bolsonaro is to blame, calling him "public enemy number one in the world related to the comeback to the fight of the coronavirus."

"He has told Brazilians not to be sissies about that pandemic," says Nicolelis, "despite the fact we should note that he himself has tested positive."

While the president is busy arguing against face masks and sabotaging shutdowns, says Nicolelis, governors from Brazil's 26 states are trying to band together to buy vaccines on the international market.

When asked what it feels like to be in the middle of the crisis, Nicolelis, who has been in Sao Paolo caring for his mother for a year, describes the situation as a war zone.

"It feels like you are in Stalingrad, in World War II. You're surrounded by the enemy. Food is ending. There is no calling for help because nobody can get out to get help. And you just see your comrades dying, your friends, your parents, your relatives, your childhood friends."

The city is about to start a two-week lockdown. But Nicolelis is skeptical that it will make a significant difference: "I have been here for a year now. We have been going in and out of these partial lockdowns, and [they] didn't have any effect."

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