Facing the imminent collapse of its health system, Amazonas state in northern Brazil started transferring coronavirus patients to other regions Friday as hospitals run out of beds and oxygen.

Nine patients out of 235 identified for transfer were flown in the early morning hours to the state of Piaui on an air force plane, state authorities reported, with further flights planned to other states later Friday.

Amazonas state, with Manaus as its capital, has been hard hit by a resurgence of the virus.

It has a death rate of 143 per 100,000 inhabitants, one of the highest in Brazil, with a national average of 98.5 deaths per 100,000.

During the first wave of the Covid-19 epidemic last April, the Amazon rainforest city saw haunting scenes of mass graves and corpses piled into refrigerator trucks.

With hospitalizations in Manaus reaching even higher levels this time round, the city has again had to deploy refrigerator trucks.

It is also the origin of a new virus variant recently detected in Japan, and which scientists warn is likely more contagious than the original, though it is not clear if this is the reason for the resurgence.

Images of people bringing oxygen tanks to hospitals and of patients complaining about a lack of medical assistance have angered Brazilians and augmented criticism of President Jair Bolsonaro's handling of the pandemic.

The country has recorded more than 207,000 deaths from Covid-19, second only to the United States.

Amazonas state, with Manaus as its capital, has been hard hit by a resurgence of the virus, with a death rate of 143 per 100,000 inhabitants
Amazonas state, with Manaus as its capital, has been hard hit by a resurgence of the virus, with a death rate of 143 per 100,000 inhabitants AFP / Michael DANTAS

Bolsonaro, who has downplayed the virus and railed against lockdowns, face masks and other "hysteria," on Friday told supporters in Brasilia it was "terrible the problem there" in Amazonas.

"Now we have done our part with resources, means," he said.

A ten-day curfew of 7:00 pm to 6:00 am enters into force in the state Friday in a bid to stop the rapid viral spread.

A court on Saturday forced Amazonas state government to shut non-essential businesses for 15 days.

In the early morning of Friday, an air force plane brought nine oxygen cylinders for Amazonas hospitals, adding to more than 400 delivered in the last five days. Oxygen is needed to treat people who suffer breathing problems as the coronavirus attacks their lungs.

According to official figures, Manaus on Wednesday saw a fourth straight day of record burials -- 198, with 87 of them deaths from Covid-19.

Brazil hopes to launch its coronavirus vaccination campaign this month, but the government is waiting on the Anvisa health regulator, meeting on Sunday, to approve two shots -- AstraZeneca and Oxford University's Covishield and China's CoronaVac.

A commercial plane was standing by as the authorities hoped it could take off later Friday -- two days later than initially planned -- to collect two million doses of Covishield from India, where it is produced by the Serum Institute.

The inventory would add to some 10 million doses of China's CoronaVac Brazil has already received, and tens of millions more it plans to produce itself.