By Bruno Kelly and Gabriel Araujo

MANAUS (Reuters) – Shirlene Morais Costa died at her home in the northern Brazilian city of Manaus on Monday, likely the latest victim of a devastating new wave of COVID-19 that has returned to this isolated city deep in the Amazon rainforest.

The 53-year-old went to hospital with a cough and a fever, both symptoms of the coronavirus, but was sent home, according to her stepfather, Esteliano Lopes Filho, 74.

“Her death was swift… We called the ambulance, but it only arrived after she was dead,” he said. “We’re seeing death after death… It really is a terrible calamity.”

Brazil is home to the world’s second deadliest coronavirus outbreak after the United States, and Manaus was one of the first Brazilian cities to creak under a spiraling death and caseload from the first wave of the pandemic last year.

So many were infected that some scientists thought the city of 2 million people might have been approaching herd immunity. But that projection has proved well wide of the mark.

The state of Amazonas, where nearly 6,000 people have died from COVID-19, is now suffering a devastating second wave that is pushing emergency services to breaking point. Many people, like Morais Costa, are dying at home.

Beds for COVID-19 patients in the state reached an occupancy rate of over 98% this week, according to data from the Amazonas state health department. Occupancy in temporary facilities that provide assistance to critical patients for later referral to other points of the health network was at 131%.

There are currently 1,391 patients hospitalized with COVID-19 in the state, in addition to a further 603 people hospitalized with suspected cases, the data shows.

Last week, refrigerated containers were placed outside the main hospitals in Manaus for the first time since the pandemic’s April peak. The containers are used to store bodies as the city’s healthcare and burial services again become overwhelmed.

(Editing by Gabriel Stargardter and Rosalba O’Brien)