The virus swept the region like past epidemics that traveled the river with colonizers and companies.
It spread with the dugout canoes that carried families from city to city, the dinghies with clattering engines, the ferries that carried goods hundreds of kilometers and filled with passengers who slept in hammocks side by side for days.
The Amazon is South America's most important source of life, a glittering freeway that cuts across the continent. It is the central artery in a vast network of tributaries that supplies approximately 30 million people in eight countries and transports supplies, people and industry deep into forest areas that are often left untouched by the road.
But once again, in a painful echo of history, it also brings disease.
As the pandemic strikes Brazil, overwhelming it with more than two million infections and more than 84,000 deaths – second only to the United States – the virus takes an extraordinarily high toll on the Amazon region and the people who have depended on its abundance for generations .
In Brazil, the six cities with the highest exposure to coronavirus are all located on the Amazon. This emerges from a comprehensive new study by Brazilian researchers in which antibodies were measured in the population.
The epidemic has spread so rapidly and thoroughly along the river that in remote fishing and farming communities like Tefé, people are just as likely to contract the virus as in New York City, home to one of the worst outbreaks in the world.
"It was all very quick," said Isabel Delgado, 34, whose father Felicindo died of the virus shortly after his illness in the small town of Coari. He was born on the river, raising his family and spending his life making wooden furniture on its banks.
In the past four months, when the epidemic traveled from the largest city in the Brazilian Amazon, Manaus, with its skyscrapers and factories, to tiny, seemingly isolated villages deep inland, the fragile health care system has contracted under the rush.
Cities and towns along the river have some of the highest deaths per capita in the country – often several times the national average. In Manaus, there were times when every community in Covid was full and 100 people died each day, forcing the city to cut new graves from thick forests. Grave diggers lay rows of coffins in long trenches in the freshly turned earth.
Down the river, hammocks have become stretchers that bring sick people from communities without doctors to ambulances rushing through the water. In remote areas of the river basin, Medevac planes land on tiny runways cut into the lush countryside and find that their patients have died while waiting for help.
The virus takes a particularly high toll on indigenous peoples, a parallel to the past. Waves of explorers have traveled the river since the 16th century, looking for gold, land and converts – and later for rubber, a resource that fueled the industrial revolution and changed the world. But with them, these outsiders brought violence and diseases such as smallpox and measles, killed millions, and wiped out entire communities.
"This is a place that has created so much wealth for others," said Charles C. Mann, a journalist who wrote extensively about America's history, "and see what happens to it."
According to the Brazilian study, indigenous people are around six times more likely to be infected with the corona virus than whites and die in distant river villages that are unaffected by electricity.
Even in the best of times The Amazon was one of the most neglected parts of the country, a place where the government's helping hand can feel distant, even if it doesn't exist.
However, the region's ability to counter the virus was further weakened under President Jair Bolsonaro, whose public release from the epidemic was sometimes mocking, even though he tested positive himself.
The virus has appeared on his government's disorganized and lackluster watch and has pierced the nation. From his early days in office, Mr. Bolsonaro has made it clear that protecting the welfare of indigenous communities was not his priority. He cut funding, removed protection, and promoted illegal interference in their territory.
To the outsider, the densely forested region along the Amazon appears impenetrable and separate from the rest of the world.
However, this isolation is deceptive, said Tatiana Schor, a Brazilian geography professor who lives on one of the tributaries of the river.
"There are no isolated communities in the Amazon," she said, "and the virus has shown that."
The boats that almost everyone relies on and that are sometimes crowded with more than 100 passengers for days are behind the spread of the virus, researchers say. And even if local governments officially restricted travel, people continued to go to the water because almost everything – food, medicine, even the trip to the capital to get emergency relief – depends on the river.
Scientists have long described life in the Amazon as "an amphibious way of being".
The crisis in the Brazilian Amazon began in Manaus, a city of 2.2 million people that has risen from the forest in a massive eruption of concrete and glass and tapers on its edges to groups of wooden houses that stand on stilts high above the water enthroned.
Manaus, the capital of the state of Amazonas, is now an industrial power plant, a major motorcycle manufacturer with many foreign companies. It is closely connected to the rest of the world – its international airport receives around 250,000 passengers a month – and across the river to much of the Amazon region.
Manaus & # 39; first documented case, which was confirmed on March 13, came from England. The patient had mild symptoms and was quarantined at home in a more affluent part of the city, the city's health officials said.
However, the virus soon appeared to be everywhere.
"We ran out of beds – or no armchairs at all," said Dr. Álvaro Queiroz, 26, about the days when his public hospital in Manaus was full. "People never stopped coming."
Gertrude Ferreira Dos Santos lived on the eastern outskirts of the city in a quarter pressed against the water. She used to say that her favorite pastime in the world was to travel the river by boat. With the breeze on her face, she said, she felt free.
Then, in May, Ms. dos Santos, 54, fell ill. Days later, she called her children to her bed and made them promise to stick together. She seemed to know that she was going to die.
Eduany, 22, her youngest daughter, stayed with her that night. In the early morning, when Eduany got up to take a break, her sister Elen, 28, asked her to come back.
Her mother had stopped breathing. The sisters tried desperately to reanimate from mouth to mouth. At 6 a.m. when the sun rose over the city, Ms. dos Santos died in her arms.
When men in white protective suits later arrived to carry their bodies away, the sisters began to cry.
Ms. dos Santos was a single mother. Life had not always been easy. But she had kept a feeling of wonder, something her daughters admired. "In everything she did," said Elen, "she was happy."
According to the women, her mother's death certificate lists many underlying diseases, including long-term breathing problems. Breathing failure has also been listed, a key indicator that a person has died from the coronavirus.
But her daughters didn't think she was a victim of the pandemic. Surely she died for other reasons, they said. God would not have given her such an ugly illness.
Along the river, people kept saying similar things and were reluctant to admit contagion, although the health of their siblings and parents deteriorated. Many seemed to believe that their families would be avoided, that diagnosis would somehow tarnish an otherwise dignified life.
But when this stigma made people downplay the symptoms of the virus out of fear, the pandemic quickly spread, the doctors said.
The virus traveled east and west to Manaus and sped away from the region's health center.
In Manacapuru, More than an hour from the capital, the 40-year-old Messiah Nascimento Farias carried his sick wife to her car and raced down one of the few country roads in the region to hit the ambulance that could take her to a hospital.
His wife Sandra Machado Dutra  gasped in his truck.
"The Lord is my shepherd, I will not want to," he prayed again and again until he gave it to the health care workers. You were lucky. It survived.
For most people on the river, hundreds of miles from Manaus, the fastest way to a large hospital is by plane.
Even before the virus hit, people in distant communities with a life-threatening emergency could desperately call for an aircraft ambulance that would take them to a hospital in the capital.
But the small planes turned out to be dangerous for people with Covid-19, which sometimes caused blood oxygen levels to drop as the plane went up. Very few of the Airlift patients seemed to survive, the doctors said.
Instead, doctors and nurses flew their patients to painful deaths, far from anything and everyone they loved.
One morning in May, a white plane landed at Coari Airport, about 230 miles from Manaus.
On the asphalt on a stretcher, Mr. Delgado, 68, the furniture maker, was barefoot and barely breathing.
Dr. Daniel Sérgio Siqueira and a nurse, Walci Frank, who were exhausted after weeks of constant work, invited him to the small cabin. When the plane got on, its oxygen content began to drop.
Mr. Delgado's daughter Isabel panicked at the doctor. "My father is very strong," she told him. "He will make it."
When the Delgados finally reached the hospital in Manaus, Isabel was stunned by the scenes around them. Desperate relatives held up relatives who had collapsed under the burden of the disease and rushed to treatment.
At the same time, patients who survived Covid-19 stumbled into the cheering arms of family and friends.
"I was just there," she said, "and prayed that God would save my father."
Mr. Delgado died a few days later. When Isabel found out, the doctor started crying with her.
She had no doubt that the river her father loved had brought him the virus too. Soon she and five other family members also fell ill.
When the corona virus arrived in America, There were widespread fears that this would wreak havoc on indigenous communities across the region.
In many places along the Amazon, these fears appear to be true.
According to an association representing the country's indigenous peoples, at least 570 indigenous people in Brazil have died of the disease since March. The vast majority of these deaths occurred in places connected to the river.
More than 18,000 indigenous people were infected. Community leaders have reported that entire villages have been confined to their hammocks and have had difficulty getting up to feed their children.
In many cases, health workers who are supposed to help them have accidentally spread the virus.
In the hamlet of São José da Fortaleza on the riverside, Chief Iakonero Apurinã's relatives successively sent word that they could not eat, that they heard voices, that they were too sick to get up.
It soon seemed to the boss that everyone in her community was sick.
54-year-old chief Apurinã said her group of 35 Apurinã families survived generations of violence and forced labor. They had arrived in São José da Fortaleza decades ago and believed that they would finally be safe.
It was the river, said the chief who had supported, fed, washed, and spiritually purified it.
Then the new illness came and the boss brought traditional teas home. Soon her own cough and exhaustion came. A test in Coari confirmed that she had been infected with the virus.
Chief Apurinã didn't blame the river. She accused the people who traveled there.
"The flow to us is purification," she said. "It is the most beautiful thing there is."
Miraculously, she said in mid-July, not a single person among the 35 families had died.
The virus had arrived in Tefé, a city of 60,000 people, almost 400 miles along the river from Manaus, with violent violence.
In the small public hospital, which was originally supposed to accommodate 12 patients, almost 50 people crowded into the provisional Covid-19 unit. Dr. Laura Crivellari, 31, the only infectious disease specialist in the hospital, took her in and did what she could with two respirators, no intensive care unit, many sick colleagues – and no one to replace her.
In one of the worst moments, for two days she was the only doctor on duty to monitor dozens of critically ill patients.
Constant death brought Dr. Crivellari to its breaking point. On some days, she barely stopped eating or drinking.
At home, she shared her fear with her partner. She was thinking of giving up the medicine, she said. "I can't go on like this," she said to him.
The pandemic was brutal for medical professionals around the world, and it was particularly difficult for doctors and nurses to navigate long distances, frequent communications cuts, and deep supply shortages along the Amazon.
Without proper training or equipment, many nurses and doctors have died along the river. Others have infected their families.
Dr. Crivellari knew that her city was vulnerable. It's a three-day boat trip from Manaus to Tefé, with ferries often carrying 150 people at a time.
"Our fear was that an infected person would contaminate the entire boat," she said, "and that's exactly what happened."
In early July, daily deaths in Tefé decreased, and Dr. Crivellari began to celebrate the patients she had saved. She no longer thinks of quitting medicine.
Tefé took a careful breath as a whole.
For the moment, at least, the virus had moved to a new location on the river.