The only hospital at Iranduba, an Amazonian town in northwest Brazil, is fast running out of beds and scrambling each day for oxygen as it seeks to accommodate an influx of coronavirus patients who cannot get to the nearest big city. With no dedicated intensive care unit, the Hilda Freire hospital has had to improvise under the onslaught of a second pandemic wave that has battered Brazil’s northern Amazonas state. “It was all very quick. Suddenly everything was full. Our structure cannot handle this,” an administrative employee of the hospital, who asked not to be named, told AFP. Iranduba, a town of 50,000 people some 40 kilometers (25 miles) from the Amazonas capital Manaus, registered 15 coronavirus deaths between Monday and Wednesday this week — more than in the last four months put together. Almost all the hospital’s 30 beds are occupied, and it now has just enough oxygen left for one day. “We have had some losses,” said another hospital worker, clad in top-to-bottom, white protective gear. Health personnel say they do not wish to give their names for fear of professional repercussions. “We were very sad. We had no way to help them,” the worker said, describing how several patients left the world gasping for breath without access to oxygen. The hospital has since received several oxygen cannisters from other Brazilian states as well as neighboring Venezuela. But the relief is short-lived. “As soon as they unload the oxygen, we start worrying where the next day’s supply will come from. It is a constant stress,” said one hospital staffer. One hospital for 100,000 Iranduba is accessible via a road with many muddy stretches that are hard to navigate in periods of heavy rain, which are frequent. It is this road the more seriously-ill patients must travel to Manaus — the only of Amazonas state’s 63 cities with dedicated intensive care beds. But Manaus, too, is under strain, and has itself received emergency oxygen deliveries. Privately, families in Manaus are scrambling to find oxygen as they set up makeshift intensive care units at home, distrustful of the state’s ability to take care of loved ones. Brazil has had more than 210,000 deaths due to the Covid-19 pandemic, second only to the United States. Amazonas state has been particularly hard hit among Brazil’s 27 states, with a death rate of 159 per 100,000 inhabitants in an area where rivers and forest terrain make the logistical challenges of confronting a health crisis even more difficult.