Deaths from the coronavirus outbreak have piled up so fast in the Amazon rainforest's biggest city that the main cemetery is burying five coffins at a time in collective graves.
Soon, the city may run out of coffins.
"It's chaos here," said Maria Garcia, who waited for three hours in a line of hearses to obtain a death certificate to be able to bury her 80-year-old grandfather, who died at dawn in his home of respiratory collapse.
Manaus, the capital of Amazonas state, was the first in Brazil to run out of intensive care units, but officials warned that several other cities are close behind as the country registered a record 6,276 new coronavirus cases on Wednesday.
Brazil's Health Ministry reported 449 related deaths in the prior 24 hours, bringing the death toll to 5,466 out of 78,162 confirmed cases.
In Rio de Janeiro, cemeteries have accelerated construction of above-ground vaults to entomb a wave of deceased patients. Undertakers in Manaus even resorted to burying coffins one on top of the other this week, but the city stopped the practice after grieving relatives protested.
Brazilian right-wing President Jair Bolsonaro, who has downplayed the gravity of the virus, calling it a "little cold," came under new criticism for his remarks on the soaring deaths.
"So what? I'm sorry, but what do you want me to do?" Bolsonaro told reporters on Tuesday, saying he could not "work miracles."
The accelerating death rate in Brazil is the most concerning of all emerging-market nations, Deutsche Bank analysts told clients in a note on Wednesday.
In Manaus, which is accessible only by plane or boat from the rest of Brazil, corpses are accumulating in a refrigerated container improvised as a morgue freezer as they await burial.
"Manaus is today an absolute priority" given the calamity the city is facing, Brazil's new health minister, Nelson Teich, told reporters. He said a plane with ventilators would be heading there on Thursday.
Too late for Garcia's grandfather, Amadeu Garcia.
Health authorities had been irresponsible, she told Reuters by telephone, and to make matters worse doctors were refusing to sign death certificates for people who died at home, creating a traffic jam of hearses at the only public health post providing them.
At the main Taruma cemetery, a new area has been opened where undertakers were digging rows of graves and now just trenches for five coffins at a time.
The mayor's office said the city's funeral system was collapsing and running out of coffins.
Only three relatives are allowed to attend Covid-19 burials, and sometimes there is nobody to accompany the coffins to the grave. The city is recommending that families cremate their dead.