Accompanied by his wife, Rafael Pereira carries an oxygen tank that bought for his mother in law, who is hospitalized with COVID-19, amid the new coronavirus pandemic at the at the 28 Agosto Hospital, in Manaus, Brazil, Thursday, Jan 14, 2021. Scores of COVID-19 patients in the Amazon rainforest's biggest city will be transferred out of state as the local health system collapses and dwindling stocks of oxygen tanks begin to falter. (AP Photos/Edmar Barros)

SAO PAULO (AP) — Hospital staff and relatives of COVID-19 patients rushed to provide facilities with oxygen tanks just flown into the Amazon rainforest’s biggest city as doctors chose which patients would breathe amid dwindling stocks and an effort to airlift some of them to other states.

As heavy rain poured down Thursday in Manaus, Rafael Pereira carried a small tank containing five cubic meters of oxygen for his mother-in-law at the 28 de Agosto hospital. He didn’t want to be interviewed because of his stress, but he looked relieved when the tank — which he said would aid her breathing for an additional two hours — was taken inside.

Health workers at the Hospital Universitario Getulio Vargas took empty cylinders to its oxygen provider in the hopes there would be some to retrieve. Usually, the provider picks up the cylinders and brings newly refilled ones.

Despairing patients in overloaded hospitals waited as oxygen arrived to save some, but came too late for others. At least one of the cemeteries of Manaus, a city of 2.2 million people, had mourners lining up to enter and bury their dead. Brazilian artists, soccer clubs and politicians used their platforms to cry for help.

Brazil’s air force said in a statement late Thursday that it had dispatched two planes with 18 tons of oxygen cylinders from Sao Paulo, with more planned to follow. The local government’s oxygen provider, multinational White Martins, said in a statement that it was considering diverting some of its supply from neighboring Venezuela. It wasn’t immediately clear whether this would be sufficient to address the spiraling crisis.

“Yes, there is a collapse in the health care system in Manaus. The line for beds is growing by a lot — we have 480 people waiting now,” Brazil’s health minister Eduardo Pazuello said in a Thursday night broadcast on social media. “We are starting to remove patients with less serious (conditions) to reduce the impact.”

Hospitals in Manaus admitted few new COVID-19 patients Thursday, suggesting many will suffer from the disease at home, and some may die.

“My grandmother died today because of lack of oxygen,” Mayline da Mata, 30, told The Associated Press outside one Manaus hospital. “My grandmother, 84 years old, couldn’t survive. She needed 15 liters, and there wasn’t enough.”

The strain prompted Amazonas state’s government to say it would transport 235 patients who depend on oxygen but aren’t in intensive care units to five other states and the federal capital, Brasilia.

“I want to thank those governors who are giving us their hand in a human gesture,” Amazonas Gov. Wilson Lima said at a news conference earlier Thursday.

“All of the world looks at us when there is a problem as the Earth’s lungs,” he said, alluding to a common description of the Amazon. “Now we are asking for help. Our people need this oxygen.”

Governors and mayors throughout the country offered help amid a flood of social media videos in which distraught relatives of COVID-19 patients in Manaus begged for people to buy them oxygen.

Federal prosecutors in the city, however, asked a local judge to pressure President Jair Bolsonaro’s administration to step up its support. The prosecutors said later in the day that the main air force plane in the region for oxygen supply transportation “needs repair, which brought a halt to the emergency influx.”

The air force said in a separate statement Thursday night that it was deploying two planes to transport patients along with medical teams, starting Friday.

The U.S Embassy in Brasilia also confirmed it had received a request from the federal government to support the initiative, without providing details.

Local authorities recently called on the federal government to reinforce Manaus’ stock of oxygen. The city’s 14-day death toll is approaching the peak of last year’s first wave of the coronavirus pandemic, according to official data.

In that first peak, Manaus consumed a maximum 30,000 cubic meters (about 1 million cubic feet) of oxygen per day, and now the need has more than doubled to nearly 70,000 cubic meters, according to White Martins.

“Due to the strong impact of the COVID-19 pandemic, the consumption of oxygen in the city increased exponentially over the last few days in comparison with a volume that was already extremely high,” White Martins said in an emailed statement to AP. “Demand is much higher than anything predictable and … continues to grow significantly.”

The company added that Manaus’ remote location presents challenging logistics, requiring additional stocks to be transported by boat and by plane..

The governor also decreed more health restrictions, including the suspension of public transportation and establishing a curfew between 7 p.m. and 6 a.m.

The new measures challenged protesters who on Thursday carried Brazilian flags through the streets. Lima, once seen as an ally of Bolsonaro, has faced criticism from supporters of the conservative president for imposing new restrictions aimed at stemming the virus’ recent surge.

Bolsonaro has downplayed risks of the disease, saying the economic fallout of the pandemic will kill more than the virus. His son Eduardo, a lawmaker who chairs the international relations committee in Brazil’s lower house, was one of the many conservatives who egged on their supporters in December to challenge social distancing and disobey stay at home orders.

Park of the Tribes, a community of more than 2,500 Indigenous people on the outskirts of Manaus, went more than two months without any resident showing COVID-19 symptoms. In the past week, 29 people have tested positive for the coronavirus, said Vanda Ortega, a volunteer nurse in the community. Two went to urgent care units, but no one yet has required hospitalization.

“We’re really very worried,” said Ortega, who belongs to the Witoto ethnicity. “It’s chaos here in Manaus. There isn’t oxygen for anyone.”

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