Venezuela's western Zulia state has emerged as a hot spot for the COVID-19 pandemic as poorly supplied hospitals and chronic shortages of water and power make it difficult to prevent the disease from spreading.
The government of President Nicolas Maduro has identified Zulia as an epicenter of the pandemic, with official statistics showing 590 cases and 10 deaths in the sweltering border state that shares a frontier with neighboring Colombia.
But opposition leaders have questioned the official figures, noting a lack of transparency in the reporting of cases and persecution of reporters, doctors and nurses who have contradicted the authorities.
There are more deaths from coronavirus than the regime is announcing, said Juan Pablo Guanipa, an opposition legislator who represents the state of Zulia. The figures they are presenting are not credible.
Officials say many of the cases originated in a sprawling food market that supplies much of Maracaibo, the Zulia state capital and Venezuela's second city. Known as the Maracaibo Flea Market, it has long been known for its overcrowding and poor sanitation.
Venezuela on Monday reported 4,048 cases of coronavirus and 35 associated deaths.
In some cases, patients die of symptoms consistent with COVID-19, the disease caused by the coronavirus, but their death certificates only refer to pneumonia or other ailments, according to Zulia health workers.
The country no longer publishes epidemiological data, leaving no way to compare current death rates of pneumonia with those of previous years.
Earlier this month, 20 people diagnosed with coronavirus demanded to be released from forced quarantine at the University Hospital of Maracaibo, complaining about lack of food and running water.
When staff refused, the patients said they were leaving anyway - and threatened to cough on or touch anyone who attempted to stop them, according to a doctor and a nurse with knowledge of the incident.
Lacking protective equipment to prevent infection, the hospital staff had little choice but to let them out.
”Medical staff make four dollars (per month). They're not going to risk getting sick for the little money that they make,” said a doctor.
Zulia has been among states hardest hit by Venezuela's crumbling power and water services, hampering efforts to maintain basic sanitation even in hospitals.
Maduro says Venezuela has managed the outbreak better than other Latin American nations. He points to lower infection and death figures and insists that most cases can be traced to migrants returning from Colombia and Brazil.
But the Zulia state doctors' association on Sunday issued a statement denouncing insufficient hospital beds and supplies, limited use of face masks in public spaces, and the use of low-budget hotels to quarantine COVID-19 patients.