Health officials are worried that coronavirus will swamp Brazil's low-income communities
By Gram Slattery and Rodrigo Viga Gaier
MIGUEL PEREIRA, Brazil, March 24 (Reuters) - Last Monday, housekeeper Cleonice Gonçalves suddenly fell ill while working at an apartment in Leblon, an exclusive neighborhood in Rio de Janeiro tucked between the mountains and the city's famous beachfront.
Her family called a taxi for the 63-year-old when they learned of her condition. It took Gonçalves two hours of traveling through twisting switchbacks to reach her home in the small town of Miguel Pereira, deep in the mountains. At around 6 p.m., she checked into the town's local hospital, complaining of difficulty urinating.
By the following afternoon, she was dead. Her death was the first fatality attributed to coronavirus in greater Rio de Janeiro, and the fifth in Brazil.
The source of the infection was her employer in Leblon, a woman who had recently returned from holiday in Italy, according to four state and local officials who recounted Gonçalves' case to Reuters. They said the boss had been feeling ill and sought testing for coronavirus, but alleged she did not inform Gonçalves, who had worked for the family for decades.
"When (Gonçalves' employer) came back, she already suspected" she had COVID-19, the respiratory disease caused by coronavirus, said Camila Ramos de Miranda, the municipal health secretary in Miguel Pereira.
Ramos would not disclose the name of the employer, and Reuters was not able independently to verify her identity. The news agency was not able to confirm the state and local officials' account of how Gonçalves became infected, including the allegation that the employer didn't share her suspicions about her possible infection.
The episode has provoked panic among the 25,000 residents of Miguel Pereira, where officials say there are now 19 suspected cases of coronavirus.
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It has also sparked a public conversation about class and privilege. People affluent enough to travel abroad helped coronavirus get a foothold in Brazil, according to health officials, who worry it will now swamp low-income communities in Latin America's largest nation.
Brazilian social media lit up following news reports of Gonçalves' death.
In a March 19 column in the nation's largest newspaper, Folha de S.Paulo, Djamila Ribeiro, a well-known public intellectual, said the case exemplifies the precarious state of Brazil's poor, many of whom don't have the luxury of staying at home.
"We don't even need to say that the most vulnerable will be the most affected," said Ribeiro, who teaches political philosophy at the University of São Paulo. "It's a structural issue."
Brazil's Health Ministry last week said nearly 60% of suspected cases of coronavirus it was tracking as of last Tuesday were people who had recently traveled to places such as Italy, Spain and the United States, where the pandemic is raging.
Some 22 Brazilian officials and business leaders who joined President Jair Bolsonaro on a trip to Florida earlier this month have confirmed testing positive for the virus. At least four of them accompanied Bolsonaro to Mar-a-Lago, U.S. President Donald Trump's Palm Beach resort, where the two leaders had dinner.
A major cluster has been traced to an opulent wedding at a beach resort in the northeastern Brazilian state of Bahia. At least 10 attendees had presented symptoms as of March 11, according to media reports. The virus was introduced by a guest who had recently traveled to Aspen, Colorado, the resort said in a statement. Preta Gil, a popular Rio singer and actress who attended the event, disclosed on social media on March 14 that she had tested positive.
Coronavirus cases are expanding quickly in Brazil. As of Monday, the country had recorded 1,891 confirmed cases, an eight-fold increase in a week, with 34 deaths tied to the virus, according to the latest Health Ministry figures.
More than 12% of those confirmed cases were in Rio de Janeiro, where around one-fifth of the population lives in densely populated, unplanned communities known as favelas.
Wilson Witzel, the governor of Rio de Janeiro state, warned on Friday that the state's public health system was in danger of "collapse" within 15 days, amid an influx of patients and strained public finances. Rio's government is heavily dependent on taxes on oil production, a source that is drying up quickly thanks to a recent crash in crude prices.
Many low-income workers in Brazil, as in much of the rest of the world, toil in the informal economy without benefits or paid sick days. Mirian María de Lira, a domestic worker in Rio, is relatively lucky. She said her regular clients are paying her to stay home during the outbreak. But she said many friends and relatives are still required to show up or risk losing their jobs, including her husband, a doorman at an upscale apartment building.
"He keeps working because it's the only option," she said.
WORLDS APART
The town of Miguel Pereira is only 40 miles northwest of Leblon, but the differences are stark. Leblon's beachfront and bars are gathering spots for wealthy Rio youth; its real estate is some of the most expensive in Latin America.
In contrast, the narrow street where Gonçalves lived is partially dirt, lined with wildflowers and boxed in by mountainsides. Modest homes are built from cinder block. Many in the area commute to Rio daily, cobbling together buses and trains for a journey that takes nearly three hours via public transport.
Gonçalves' family, now in quarantine, declined to talk with Reuters.
Her death happened quickly, according to Ramos, the municipal health secretary; André Português, the town's mayor; and two other people with knowledge of the case who declined to be identified.
When Gonçalves checked into the municipal hospital, which has no intensive care unit, doctors determined she had a urinary tract infection, high blood pressure and diabetes, which had not been diagnosed previously. People with underlying conditions are most at risk from COVID-19.
Between 9 a.m. and noon the following day, Gonçalves' condition deteriorated rapidly. She was having trouble breathing. Ramos said she received a call that morning from Gonçalves' employer; the Leblon resident said she had tested positive for coronavirus.
Doctors intubated Gonçalves to help her struggling lungs, but she died that afternoon. On Thursday, Rio state officials said lab testing confirmed Gonçalves had died of the virus.
She was interred in the municipal cemetery about a block from her house in a simple white structure, where bodies are stacked one on top of the other. Local workers call the structure "the vertical." Most graves are unmarked.
With coronavirus cases mounting, officials here say they are imploring residents to stay inside to slow the spread.
Ramos, the health secretary, said the local hospital has been training in coronavirus treatment protocols since December and has for weeks been building an intensive care facility within the hospital to handle an expected surge in cases.
Still, she said, the fear here is palpable.
"We're in panic," Ramos said, choking back tears.
(Reporting by Gram Slattery and Rodrigo Viga Gaier; Additional reporting by Lucas Landau; Editing by Marla Dickerson)
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