In January 2021, Thalita Rocha stood by her mother-in-law, Maria da Cruz Lima, at a public health clinic in Manaus, Brazil. Lima, a 67-year-old retired nurse, had caught the highly contagious COVID-19 gamma variant (formerly called P.1) assailing the Amazon's largest city. She was waiting for a spot to open up at an intensive care unit but was feeling optimistic — a nurse had started her on oxygen, and she seemed to be improving. An oximeter clipped onto Lima's index finger measured her blood oxygen saturation and was finally showing healthy levels, around 98%.

That afternoon, though, Rocha noticed her mother-in-law's skin turning purple. Lima also broke out in a cold sweat and was feeling breathless. A sense of panic filled the room. Lima was not the only one: The oxygen at the unit had run out.

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