CARACAS, Venezuela - Hospitals in the capital of Venezuela's main oil-producing state are filled with coronavirus patients and dozens of health workers have been infected, witnesses said this week in the first reports of the pandemic overwhelming the country's debilitated health care system.

Health experts have long feared the impact of COVID-19 on Venezuela, where hospitals are dilapidated and there are constant shortages of medicine and essential supplies after years of economic and political crisis.

Until now, Venezuela has appeared to avoid major outbreaks even as other South American countries see thousands of new cases daily. Observers have partially credited its isolation for protecting it from widespread infection.

This week, opposition figures and health care workers in the city of Maracaibo, capital of Zulia state, have reported that an outbreak that started in May has filled the city's hospitals and infected dozens of doctors and nurses. Officials have set up quarantine centres for asymptomatic patients in about 20 hotels.

According to official figures, Venezuela had 4,525 confirmed cases and 39 deaths as of Friday, although the true numbers appear to be significantly larger. President Nicolás Maduro has increased measures to limit the spread of the disease in Zulia state, the capital of Caracas and eight other states.

The outbreak in Maracaibo, the country's second most-important city, appears to have begun in Las Pulgas, a market that normally draws about 20,000 people a day.

The market was closed, and the official tally of cases in the city of 3 million stands at 600, with the actual number apparently much higher.

Maracaibo's University Hospital, once a state-of-the-art complex, suffers daily water shortages and air conditioning breakdowns, and rats, cockroaches, cats and dogs all can be found regularly in the hospital complex.

“This is a zoo,'' one doctor told The Associated Press, speaking on condition of anonymity for fear of official retaliation. Other medical workers also spoke on condition of anonymity to avoid repercussions from the state.

University Hospital has been closed to all patients except those with COVID-19, but even so, “the wards are filled to bursting,'' another doctor said.

In two other hospitals, the Chiquinquirá and Adolfo Pons, beds for virus patients have been set up in outpatient examination areas, a nurse said.

Dr. William Barrientos, a surgeon and opposition legislator, said 20 small and midsized hotels in Maracaibo are being used as quarantine centres for suspected virus patients.

Barrientos said more than 40 doctors have the virus, adding to an already severe staffing problem because of a lack of gasoline, public transportation and personal protective equipment, all of which have contributed to absenteeism.

The Maracaibo Military Hospital said a 46-year-old nurse had died. Health workers told AP she had been infected by a virus patient.

Health experts and human rights groups have been called for more international aid for Venezuela's health system because of the virus. A drop in oil prices and government mismanagement have generated a severe recession and hyperinflation, and nearly a third of the population is struggling to feed itself.

News from © The Associated Press, 2020