Sao Paulo: Frederic Lima arrived at the already overwhelmed Emilio Ribas hospital in Sao Paulo with coronavirus symptoms. Less than 12 hours later a doctor told the 32-year-old's aunt: "We did everything possible."
It's become an all too familiar sight for Dr Fernanda Gulinelli, who treated Lima.
She signs as many death certificates as release forms in the intensive care unit (ICU) at Emilio Ribas, the state's first public hospital to be pushed to breaking point by the coronavirus.
In Brazil there have been more than 3,300 deaths from COVID-19, with hardest-hit Sao Paulo state home to one-third of the country's cases.
"Usually we have more discharges than deaths outside of the pandemic, but with the seriousness of these patients we have days with more deaths than discharges," said Gulinelli.
Brazil still hasn't reached the apex of its outbreak, which the health ministry predicts will not occur until May.
Apart from a 22-year-old suffering from tuberculosis, all the patients at the Emilio Ribas ICU, aged from 37 to 66, are either confirmed or suspected cases of COVID-19, said Jaques Sztajnbok, a medical supervisor at the unit.
The 54-year-old says that this disease is different from any other he's come across in his 28 years at Emilio Ribas.
Now "we always have 100 percent occupancy because when one person leaves there are 100 requests" to come in, said Sztajnbok.
Beds only become available when an existing patient either recovers, or dies.
For Sztajnbok, what's different about COVID-19 is "the huge number of cases" and that it's "a very serious disease that affects various organs and requires weeks of intensive care."
The problem is that "you need to maintain the capacity to treat the five percent (of cases) that according to statistics need intensive care. No country has that many intensive care beds and Brazil is no exception," he said.
