By Luis Bravo with Margioni Bermudez in Caracas
The pain of breathing made butcher Elkin cry. He caught the coronavirus in a street market where he works in Maracaibo, the main city in a once-prosperous oil-producing region of Venezuela that has been left destitute by a fuel shortage and frequent blackouts. It's also a virus hotspot.
The outbreak of cases in the western Zulia state that borders Colombia unleashed a "horrible" situation in Maracaibo's Hospital Universitario, a nurse of 15 years experience who asked to be called by her first name, Pilar, told AFP.
"We've collapsed," she said.
Several wings of the building have become a "hell" with no air conditioning in an area where temperatures can surpass 40 degrees Celsius (104 degrees Fahrenheit) and which is plagued by blackouts that can last hours, she said.
A lack of water and supplies complete the nightmare scenario for medical professionals, who trudged the hospital corridors drenched in sweat.
"If you don't bring water from your home, you can't wash," Pilar said.
Staff come to work carrying five-liter bottles of water.
The situation is so dire that some 20 patients diagnosed with the novel coronavirus have fled the hospital, she said.
Official figures—considered improbable by groups such as Human Rights Watch—show Venezuela's cases jumped from 1,500 on June 1 to 7,000 a month later.
President Nicolas Maduro's government has acknowledged the "worrying" increase.
It took 70 days to reach 1,000 cases from the first one reported, but just four to pass from 6,000 to 7,000.
Zulia, Venezuela's most populous region, accounts for almost a quarter of the country's COVID-19 cases.
Venezuela has been battered by seven years of economic recession and soaring inflation. Prices for oil, its main export, remain low, and there is no end in sight to the country's crippling political crisis.
Flies hover over stacked pieces of meat at Elkin's stall in the vast Las Pulgas market.
After catching the virus Elkin, 45, infected his wife, five of his eight children, his 84-year-old mother, and a nephew.
Multitudes of shoppers, many without face masks, used to flock to the hundreds of stalls in Las Pulgas, buying from vendors including some selling contraband smuggled in from Colombia.
"Seeing my whole family in hospital depresses me," said Elkin, who spent 40 days himself in the Hospital Universitario.
He was admitted on May 23, one day after authorities closed Las Pulgas due to the virus outbreak—a move that sparked protests among traders, who were met in response by police firing tear gas.
With no reopening date set, police and military are in charge of monitoring the trucks that queue up to enter the market to pick up merchandise.
State workers have entered the market to spray the site with chlorinated water, pick up trash and debris, and fix leaking sewers.
Fear of infection
Pilar has seen 14 colleagues leave her hospital "for fear of getting infected."
She's waiting for her own COVID-19 test results, but the most reliable PCR tests take weeks.
There's only one laboratory, in Caracas, performing PCR virus tests, while the less reliable rapid tests often produce errors.
Elkin, for example, passed five rapid tests despite showing COVID-19-like symptoms before finally having his infection diagnosed by a PCR test, which includes a nose swab.
Enrique, a Hospital Universitario maintenance worker, has shown no symptoms but fears contracting the disease.
"I don't think I'll be going to hospital any more," said Enrique, 65.
Like Pilar, he complains of the lack of personal protective supplies in the hospital.
The United Doctors of Venezuela NGO claims that seven of the 10 deaths among health workers in the country have been in Zulia state.
"There are a minimum of three changes per shift but they only give us one surgical suit, one surgical gown, two normal face masks, not the N95 face masks we should be using, and a pair of gloves," said Pilar.
The hospital's new administration has tried to improve things, but it's not enough.
Pilar has been keeping tabs on an infected colleague who has spent 30 days in a hotel converted into a quarantine center.
"One day she called me at five in the afternoon. She hadn't eaten all day," said Pilar.
Authorities in Zulia are struggling to cope with the growing pandemic and have started turning sports stadiums, universities, and even libraries into isolation centers for asymptomatic patients.