Marisol Bejarano, a doctor in the intensive care unit at El Tunal Hospital in the Colombian capital, Bogotá, has seen people die – slowly and far from their families – since the start of the pandemic.

She has been on the front lines as the disease ravaged the South American country, killing more than 100,000, and breaking the news to loved ones so many times that it is no longer counting. But little could have prepared the 28-year-old specialist for what she is seeing now.

“We’ve been training for this since we started our medical training, but the psychological toll of seeing so many deaths is heavy,” Bejarano said, raising his voice above the cacophony of beeps from the 14 survival machines in the world. ‘unit. “It’s bad.”

Like much of South America, Colombia is hit by a third surge of Covid-19. About 40,000 lives have been lost to the disease since mid-March, or around 40% of the total death toll.

Marisol Béjarano. Photograph: Joe Parkin Daniels / The Guardian

More than 25,000 cases are reported every day, with a daily average of 590 deaths in the past week. Hospital networks across the country have collapsed, with intensive care occupancy rates in the three largest cities – Bogotá, Medellín and Cali – surpassing 97%.

But unlike its neighbors, Colombia has reached the most difficult point in the pandemic as the country is rocked by unprecedented social upheaval and protests against economic inequalities – which only increased during the pandemic. And now doctors are seeing worrying new pathologies in the spread of the virus, even as new variants spread.

“The difference now is that more young people are dying,” Bejarano said, adding that most of the elderly in Colombia have now been vaccinated and the protests are more often followed by young people. Leaders of the protests last week announced a temporary break in mass marches in response to the public health calamity, heeding appeals from authorities.

About half of the patients treated by Bejarano, intubated and unconscious, are under 65 years of age. Many of them suffer from kidney failure and will likely die connected to dialysis machines and mechanical ventilators.

As the fresh-faced doctor and a team of technicians checked in on patients, sometimes making jokes to lighten the mood, a good order transported oxygen tanks – of which supplies are scarce – into the intensive care unit. . A nurse, wiping the sweat from her forehead, came out to visit a vending machine. Another turned a comatose patient on his side and bathed him. “We are exhausted, we have fallen ill and we are poorly paid,” Bejarano said.

When Covid-19 hit Colombia in March 2020, El Tunal hospital had 32 intensive care beds. Now he has 106 and each one is used. Patients who require a bed must wait until a current occupant recovers or dies.

“We could have 1,000 beds here – we could be the biggest hospital in the world – but the situation would not improve as long as the contagion rates are so high,” said Jhon Parra, the doctor in charge of intensive care at the hospital. ‘hospital. “We are scared and we are psychologically and emotionally exhausted.”

The factors that are contributing to the current epidemic are innumerable.

A nurse brings an oxygen tank to El Tunal hospital, Bogotá
A nurse brings an oxygen cylinder to El Tunal Hospital in Bogotá. Photograph: Joe Parkin Daniels / The Guardian

The launch of the vaccination was slow to start and only 20% of the population received a dose yet. The marches and rallies during the unrest contributed to this. Many Colombians, who experienced one of the longest lockdowns in the world last year, are increasingly relaxed about the use of masks and social distancing.

Meanwhile, President Iván Duque’s government continued to open up the country in an effort to avoid further damage to the economy. Since the end of last year, gyms, restaurants and nightclubs have been opened in some towns, with various caveats. And despite the influx of cases, the country lifted most of the remaining restrictions on June 8.

“I understand the need to restart the economy – but you won’t have many if everyone is dead,” Parra said, during a rare break in his office. “And the reopening of the economy gave people a false sense of security, so they stopped protecting themselves in the marches and elsewhere.”

Public health experts have been less diplomatic.

“The response to the pandemic has been a model of disaster. It’s a scandal, ”said Román Vega, professor of public health at the Javeriana University in Bogota. “First, we have a surge of cases. Second, we have low vaccination rates. Third, we have an ongoing social uprising. Fourth, the government decided to further open up the economy despite all of this. Fifth, we have a health care system that cannot respond. It’s a disaster.”

Ronny Suárez, a journalist who has been covering the pandemic in Colombia daily for the newspaper El Tiempo since March 2020, went further. “We have to say it very clearly: as a society we have failed ourselves and the victims. “

Violinist Antonio Hernández performs for the relatives of a Covid-19 victim at Serafin cemetery in Bogota last week.
Violinist Antonio Hernández performs for the relatives of a Covid-19 victim at Serafin cemetery in Bogota last week. Photography: Ivan Valencia / AP

Earlier this month, Bogotá Mayor Claudia López advised people to avoid showing up to hospitals except in the most serious cases, and pleaded with people to avoid marches and protests in person.

In the parking lot outside El Tunal Hospital, large tents with stretchers and basic supplies have been set up so that doctors can treat urgent patients quickly, without admitting them inside the main buildings. Ambulances, some with screaming sirens, line up for a block to drop off patients.

“So far we haven’t had any deaths waiting to be seen, like in Europe at the start of the pandemic, but it’s going to happen here unless people start to protect themselves,” said Daniel Huertas, 34, who heads the accident and emergency service. “It’s frustrating to say the least quitting your job and seeing people not doing that.

“But that’s what we’re dealing with,” the exasperated doctor said. “Everything is collapsing around us.