Medical personnel transport a patient on a stretcher at a field hospital on March 11, 2021 in Santo Andre, Brazil.
(CNN) -
The temperature reached 35 degrees Celsius on Tuesday, but the humidity made it feel worse.
Amid the sweltering end-of-summer heat in Rio de Janeiro, Brazil, Silvia Silva Santos held her 77-year-old mother as they walked to the clinic door.
"We have already come here twice but have not been able to get vaccinated," Silva Santos said.
"She just stands in line and then there are no more shots and we have to go."
At the door, Silva Santos asked the guard if he could give his mother a vaccine.
Well aware of the CNN cameras watching her, she quickly ushered her in.
MORE: Pfizer and J&J agree to deliver 138 million doses of their vaccines to Brazil
About five minutes later, the couple walked out again, bad news on their faces.
"I think this is very wrong," said Silva Santos, clearly angry and frustrated.
"Now we will have to find out again when they will have the vaccines, you never know when that will be."
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That frustration spread through the elderly crowd when one person after another was denied the first dose of a vaccine, after the state of Rio de Janeiro suspended its vaccination campaign because it had run out of vaccine supplies.
"This is a disaster, a total disaster," one woman told CNN after she was denied the vaccine.
Who is to blame for all this?
I think our leaders, our politicians suck.
Medical personnel transport a patient on a stretcher at a field hospital on March 11, 2021 in Santo Andre, Brazil.
The growing perfect storm
The covid-19 crisis in Brazil is at its worst.
Nearly every state in the country has an ICU occupancy of 80% or more, according to a CNN analysis of state data.
As of Friday, 16 of the 26 states were at 90% or higher, meaning those healthcare systems have collapsed or are in imminent risk of happening.
The seven-day averages of new cases and additional deaths are higher than ever.
In the past 10 days, about a quarter of all coronavirus deaths worldwide have been in Brazil, according to an analysis by CNN.
"They are clear signs that we are in a very critical acceleration phase of the epidemic and it is unprecedented," said Jesem Orellana, a Brazilian epidemiologist.
If vaccines are the best way out of this global pandemic, Brazil has a long way to go to achieve it.
As of Friday, fewer than 10 million people in a country of about 220 million had received at least one dose, according to federal health data.
Only 1.57% of the population was fully vaccinated.
That is the result of a slow implementation program that has been plagued with delays.
During the announcement of its distribution plan in early February, the government promised that some 46 million doses of vaccines would be available in March.
But he has repeatedly been forced to cut that number, now forecasting just 26 million by the end of the month.
Local production of what governments say will eventually be hundreds of millions of doses of the Oxford-AstraZeneca vaccine has only just begun.
The first 500,000 doses were delivered and celebrated by top officials of the Ministry of Health in Rio de Janeiro this week, despite being months late.
MORE: Bolsonaro appoints his fourth Minister of Health since the start of the pandemic
"[There are] no vaccines in sufficient quantity to really have an impact right now," said Natalia Pasternak, a Brazilian microbiologist, who said it won't be until well into the second half of the year before there are enough vaccines available to have a substantial impact on the epidemic.
If vaccines will remain in short supply for the foreseeable future, the only remaining ways to control the exponential growth of the epidemic in Brazil are the methods the world has listened to ad nauseam: physical distancing, no large crowds, restricted movement, and good hygiene.
But in many places in Brazil, that just doesn't happen.
In bustling Rio de Janeiro, it's easy to find crowds without masks walking the streets, chatting in tight spaces.
Although the city's famous beaches are closed this weekend, restaurants and bars may be open until 9pm and many will likely be full.
Several states have imposed much tougher restrictions, including nightly curfews, but local leaders fight federal leadership, or lack thereof, determined to keep things open.
President Jair Bolsonaro, a Covid-19 skeptic who has mocked the efficacy of vaccines and has not obtained one publicly, announced Thursday that he would take legal action against certain states in the country's Supreme Court, claiming that it is the only one. person who can order curfews, something he has promised never to do.
MIRA: While deaths from covid-19 skyrocket in Brazil, Bolsonaro says there is a "war" against him
Despite thousands of people dying from the virus every day, the president says the real threat comes from the economic damage driven by restrictions to control the virus.
Millions of Bolsonaro supporters follow his example, openly questioning local regulations on physical distancing and wearing of masks.
All of this would be troubling enough on its own, but is compounded by a deeply troubling reality: the spread of covid-19 variants.
'People don't realize how much worse P.1 is'
The P.1 variant was first discovered in Japan.
Health authorities detected the viral mutation in several travelers returning from the state of Amazonas, an isolated region in northern Brazil full of tropical rainforest.
CNN reported from the region in late January, where a brutal second wave of covid-19 decimated the city of Manaus.
Almost two months later, more and more research points to the P.1 variant as a crucial factor not only in the Manaus outbreak, but also in the national crisis Brazil currently faces.
A study by Brazil's main medical research foundation, Fiocruz, from early March found that of the eight Brazilian states studied, covid-19 variants, including P.1, were prevalent in at least 50% of cases. new.
The variant is known to spread easier, up to 2.2 times, according to a recent study.
That's more transmissible than the B.1.1.7 variant widely identified for the first time in the UK, which is up to 1.7 times more transmissible, according to a December study.
That same study also found that people are 25% to 65% more likely to evade existing protective immunity from previous non-P.1 infections.
Finally, there remain concerns that different vaccines might not be as effective against the P.1 variant.
Although a recent UK study found that "existing vaccines can protect against the Brazilian variant of the coronavirus," CNN spoke to several epidemiologists who remain concerned.
"The world has not understood the dire potential reality that the P1 variant could represent," said Epidemiologist Dr. Eric Feigl-Ding.
"People don't realize how much worse P1 is."
LOOK: A more contagious variant of coronavirus spreads through the US Can vaccines stop it?
Brazil becomes a global danger
Amid Brazil's viral spread are two separate additional threats.
One, the easy spread of the existing P.1 variant abroad.
It's already in at least two dozen countries and international counting and travel to and from Brazil is still open for most countries.
Two, if the P.1 variant was created here, others can too.
"The out-of-control pandemic in Brazil caused the variant," said Pasternak, the Brazilian microbiologist.
And it will cause more variations.
It's going to cause more mutations because this is what happens when you let the virus replicate freely.
Under the laws of viral evolution, new variants are created to try to make the virus spread more easily.
Along the way, more dangerous iterations can be created.
"More variants means that there is a greater chance that one of these variants can actually escape all vaccines, for example," Pasternak explained.
It's weird, but it could happen.
That, he says, makes Brazil a global danger, not just to its neighboring countries but to others around the world.
"All this together should sound the alarms in all countries of the world to help Brazil contain P1, lest we all suffer the same fate of the collapse of the Brazilian hospital system," said Dr. Feigl-Ding.
With a lack of vaccines and a government unwilling to take the necessary steps to prevent that from happening, it is unclear how things will improve in Brazil in the short term.
Eduardo Duwe contributed to this report.
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