Brazil surpassed 10 million confirmed coronavirus cases on Thursday, as a new variant discovered in the Amazon threatens to further ravage a country where inoculations have been halted in many cities due to a lack of vaccines.
Epidemiologists warned the recent carnival holiday could see a further uptick in infections, coming on the heels of Christmas and New Year's Eve celebrations that sent cases soaring.
A drop in infection rates from September to October led some to think the worst was over, but the country has set fresh weekly records for new cases and deaths this year.
As of Thursday, the Health Ministry had tallied 10,030,626 total infections, including 51,879 cases in the past 24 hours.
The pandemic has killed 243,457 people in Brazil, the worst death toll outside the United States. Ministry data showed 1,367 additional deaths since the last update on Wednesday.
"Despite the size of this number, it is still probably well below the real figure due to a lack of testing," said Alexandre Naime Barbosa, head of epidemiology at the State University of Sao Paulo.
President Jair Bolsonaro has consistently played down the gravity of the pandemic, urging Brazilians back to work and saying he would not be vaccinated.
With the new Brazilian strain - which originated in the jungle city of Manaus - experts worry things could get worse.
The new strain, thought to be more contagious, has already been reported in six Brazilian states including Rio de Janeiro, where its spread may put more pressure on creaky health services.
In Manaus, a wave of infections has overloaded hospitals. At one point in January, intensive care wards there were so full that scores of patients were being airlifted to other states health authorities said. Doctors reported sharing oxygen between patients, alternating every 10 minutes.
"We believe it (the variant) is one of the factors responsible for the explosion in cases," said Felipe Naveca, a virologist at the Fiocruz Amazonia institute.
The surging case numbers is particularly worrying due to Brazil's sluggish vaccination program.
Several major cities, including Rio de Janeiro and Salvador, have halted immunizations after running out of doses.
Despite vowing to vaccinate the entire population of around 210 million by the end of the year, the Health Ministry has provided states with just 11.8 million doses so far.
That is far short of the 104.2 million doses needed to immunize just the highest risk groups in Brazil, using vaccines that require two shots per person.
On Wednesday, Health Minister Eduardo Pazuello promised to make another 11.3 million doses available by the end of the month, including 2 million doses of the AstraZeneca vaccine whose delivery is yet to be confirmed by India, where they are being produced.
"It's hard to see this tragic situation improving by the end of the year," Naime said.