The Amazon rainforest's worst start to a fire season in a decade is threatening to overwhelm Brazil's already strained health care system, environmentalists and health leaders have warned.
Almost a year since raging fires provoked an international outcry, this year's fire season is already in full swing, with early evidence indicating that the destruction will be worse than it was last summer, according to official data and interviews with researchers.
With Brazil still struggling to contain a coronavirus pandemic that has already killed more than 108,000 people, many Brazilians will now have to contend with smoke from the fires, as well.
More than 10,000 fires were recorded in the first 10 days of August, according to government data compiled by the National Institute for Space Research. That was a 17 percent increase from the same period last year and the worst total since 2010.
"When you have a pandemic situation, all the hospitals are already full of people suffering from respiratory illness, so these extra people that are going to need hospitalization will put even more pressure on the health system," said Ane Alencar, scientific director at the Amazon Environmental Research Unit, a nonprofit organization that advocates for conservation of the rainforest.
"And for people who have coronavirus, if they can't breathe in good quality, imagine in bad quality with lots of smoke," she added.
Those fears are already recognized on a medical front line struggling for staff and supplies following a traumatic period.
Dr. Renan Granato, speaking after a busy shift at Transamazônica Regional Public Hospital in Altamira, a sprawling city in the northern state of Para that is already experiencing major fires, said the combination of the fires and the coronavirus has hammered hospital resources.
"I think we have reached full capacity. We do not have enough hospital beds. Many are reserved for patients with COVID-19," he said. "We have just one pulmonologist for a population estimated of 400,000. This is very alarming.
"COVID and a surge of respiratory disease caused by fires is a deadly combination for our region," he added.
The warnings are in stark contrast to the attitude of President Jair Bolsonaro, who last week denied the existence of fires and deforestation in the Amazon, calling it "a lie" and claiming that anyone who flew over the rainforest "won't find any spot of fire, nor a quarter of a hectare deforested."
Bolsonaro's office did not respond to a request for comment.
The situation is likely to deteriorate further, Alencar said, because of a "perfect recipe" of factors: rampant deforestation leaving more debris on the ground, people willing to set fires without the fear of consequences from the Bolsonaro administration and a drier-than-usual climate.
Fires of this scale are rarely a natural phenomenon, experts say, instead resulting from deliberate burning by farmers and land grabbers to use deforested land.
The worrying early intensity comes despite a ban issued last month by the Bolsonaro administration on setting fires in the Amazon for 120 days, as well as a highly publicized decision in May to deploy the army amid concerns that environmental crimes were being carried out under the cover of the coronavirus.
Brazil's ministers have hailed the success of the operation, branded Operation Green Brazil 2 and involving nearly 4,000 troops, saying that more than 28,000 cubic meters of illegally deforested wood have been seized and that fines totaling $3.1 million have been issued.
But as NBC News reported last month, deforestation has continued to rise. Forest loss from August 2019 to July was around 9,205 square kilometers, according to the National Institute for Space Research — a 34.5 percent increase compared to a year earlier.
Critics argue that the money invested in the operation — estimated to be $10.8 million a month, nearly the entire annual inspection budget for Ibama, Brazil's specialist environmental protection agency — would be better spent on the agencies with the expertise to combat illegal deforestation and forest fires.
Brazil's Defense Ministry did not respond to a request for comment.
Environmentalists fear that without more effective action to protect the rainforest, the Amazon will soon reach a "tipping point" at which it starts releasing more carbon dioxide than it stores — a critical blow in the planet's fight against climate change.
The fires over the coming weeks, however, represent an immediate threat to public health in the coronavirus age.
"Air pollution from the fires can affect how our immune system responds to the virus," said Dr. Aaron Bernstein, a specialist in the health impacts of the climate crisis at Harvard University.
Expressing specific concern for those with heart disease, asthma and diabetes, as well as pregnant women, Bernstein added: "For people with chronic medical conditions, the air particles can make those diseases worse, which may make them more susceptible to the virus."
As he prepared for another shift in the intensive care unit and with the threat of the flames growing each day, Granato, the doctor in Altamira, concluded: "The worst type of blind man is the one who refuses himself to see what is crystal clear right in front of his very eyes. This is what I would say for President Bolsonaro."