49-year-old Andrelina Bizerra da Silva is suspected to have died from COVID-19. Like so many others in remote parts Brazil, including the Amazon, she never had access to a coronavirus test.
Carrying her coffin back to their home village on a return trip from the hospital, her relatives wonder how many more are going to die before more help arrives.
Coronavirus cases in Brazil now soar past 1 million, more than anywhere in the world outside of the United States.
The frontlines have shifted increasingly from modern hospitals in major cities to remote, poor areas, like this one.
Here, Reuters spent a week accompanying medical professionals in their battle near Marajo Island, which splits the Amazon River in two as it approaches the Atlantic.
The coronavirus has taken root here, killing scores and infecting hundreds more. Reuters saw that severe infections are often identified and treated late, when odds are against the patients.
Nizomar Junior, the municipal health secretary in the small town of Portel, just across the river from Marajó Island, leads a team of medics who routinely travel hours on end, often battling unpredictable currents and fast-approaching weather fronts.
"We use the ambulance boats to get by river to places with difficult access, bringing services to preserve the lives of people in Marajó. This makes a difference when combating COVID-19, and today we are in a tireless fight during this time of the pandemic."
Social distancing is nearly impossible on the isolated settlements, built on stilts along the river. It can take a day or more to reach health clinics.
Maria Luiza Costa, who had recently been experiencing flu like symptoms, would never have known she had COVID-19 before the health team arrived. She's now in isolation.
"Yes, I'm surprised, we weren't expecting this, but thank God they've been coming. We're very happy to be able to get this service at home, and it's better for us here who live in riverside communities and who have access difficulty."
A negative result can be a huge relief for some families...
But for 25-year-old Andreza Lima de Cruz, watching as her father's transferred by ambulance boat to the hospital after his result came back positive, she doesn't know when - or if - he'll be back.