With hospitals overrun, Mexicans fighting the coronavirus at home face a deadly hurdle: a lack of oxygen tanks.
Children call him begging for oxygen for their parents. Grandparents call gasping for air in the middle of the night. People with no cash offer him their cars instead.
Juan Carlos Hernández tells them all the same thing: He has no oxygen tanks left.
After surviving his own bout with the coronavirus and then losing his job, Hernández began selling oxygen tanks out of his car. Then a second wave of the coronavirus slammed into Mexico this winter and demand for oxygen exploded, spawning a national shortage of devices that deliver the lifesaving resource.
Prices spiked. A black market metastasised. Organised criminal groups began hijacking trucks filled with oxygen tanks, or stealing them at gunpoint from hospitals, according to media reports. And for a growing number of Mexicans, the odds of survival were suddenly in the hands of amateur oxygen sellers like Hernández.
"We are in the death market," Hernández said. "If you don't have money, you could lose your family member."
The resurgence of the pandemic in Mexico left more people infected than ever — among them the country's president, Andrés Manuel López Obrador. With packed hospitals and a distrust of the health care system pushing many to face the disease at home, the number of casualties shot up. In January, Mexico recorded more than 30,000 deaths, the highest monthly toll to date.
Mexico's total number of deaths from Covid is now the third highest worldwide, higher than India's, a nation 10 times more populous.
Part of the reason so many more people are dying now, doctors and government officials say, is the shortage: There are simply not enough oxygen tanks.
"Oxygen right now is like water," said Alejandro Castillo, a doctor who works at a public hospital in Mexico City. "It's vital."
New outbreaks across the globe have stretched the supply of oxygen in hospitals from Los Angeles to Lagos, Nigeria, but in Mexico, the scarcity is being felt inside people's homes.
Eight in 10 hospital beds are full in Mexico City, the epicentre of the outbreak, and emergency rooms have been turning people away. Many patients refuse to seek medical care at all, driven by a fear of hospitals that runs deep in Mexico.
To survive at home, the sickest patients need to get purified oxygen pumped into their lungs 24 hours a day, sending friends and family members scrambling, often in vain, to find tanks and refill them multiple times a day.
David Menéndez Martínez had no idea how oxygen therapy worked until his mother became ill with Covid-19 in December. Now he knows that the smallest tank in Mexico can cost more than US$800 ($1,105), up to 10 times more than in countries like the United States. The oxygen to fill it up costs about US$10 ($14) — and can last as little as six hours.
Menéndez had a few tanks on loan from friends, but still spent hours waiting to refill them in lines that stretch across city blocks and have become a fixture in certain Mexico City neighbourhoods.
"You see people arrive with their tanks and they want to get in front of the line and they end up crying, they're desperate," he said, recalling the pleas he heard: "My father is at 60 per cent oxygen saturation. My brother is at 50 per cent saturation. My wife can no longer breathe. She's turning blue, her lips are blue, help me."
Menéndez only thought of his mother. "I imagined my mom suffocating," he said.
The outbreak in Mexico City began to flare in December, after authorities delayed shutting down nonessential businesses for weeks, despite figures that, according to the government's own rules, should have triggered an immediate lockdown. Officials eventually tightened restrictions in the capital, but then came the holidays, and many Mexicans defied government pleas to stay home.
In the first three weeks of January alone, demand for at-home oxygen nationwide rose by 700%, according to Ricardo Sheffield, head of Mexico's federal consumer protection office.
As need spiked, prices tripled. Scammers proliferated online.
"The surge came out of absolutely nowhere," said Sheffield, who noted that the price gouging worked only because people were so desperate. "If these people do not receive oxygen in time, they die."
After his grandmother fell ill after Christmas, Miguel Ángel Maldonado Hernández borrowed about US$800 from friends to pay an unlicensed seller US$1,600 for an oxygen concentrator — a machine that takes in air and pumps out purified oxygen. It didn't work. Then he paid a US$100 deposit to a seller on Facebook for a concentrator that never arrived.
Maldonado, who lives in a poor neighbourhood just outside the city limits, is still in debt to his friends after the shady deals.
"You're in a stressful situation, in anguish for your family," said Maldonado. "You run out of options and well, you fall for it." His grandmother died in her bed.
The government has sent the Mexican National Guard to protect trucks transporting oxygen tanks and required suppliers to prioritise oxygen produced for human consumption over industrial oxygen used by companies. Mexico City opened several stations where people can refill tanks for free.
But Mexico doesn't produce oxygen tanks and can't import them from the United States right now. "It's impossible," Sheffield said. "The demand is very high in the States." Orders from China will take months to arrive.
Mexicans are left to jostle for the limited supply of oxygen tanks being passed from household to household by entrepreneurial types like Juan Carlos Hernández.
A former tractor-trailer loan salesman, Hernández is conflicted about his present line of work. He readily admits he has "no training" and no license, but justifies doing the work because "it saves lives."
Hernández stopped selling tanks in December, when the distributors he buys from raised prices so high that he couldn't stomach passing on the cost to his clients. Now he sells concentrators, which are more expensive and draw a more affluent customer. On a good week, he makes double his old salary selling loans.
"You shouldn't be profiting off other's pain, it's inhuman," he said. "But at the end of the day, I'm doing it, too."
Hernández got so many calls on a recent Thursday that he had to put one on hold while he answered another. He finds it hard to shake the memory of how people's voices sound when he tells them he has no tanks available.
"You hear the desperation, the resignation, when they thank me just for answering," he said.
"I'm not doing what makes me happy — I'm taking advantage of an opportunity to make money," he added. "I have to eat."
For people stuck navigating the chaotic market, finding someone — anyone — with oxygen is a relief. In the time he spent scouring the city for oxygen, the only happiness Menéndez remembers was when he got to the front of the line and left with a full tank.
"It didn't matter if I had eaten," he said. "It didn't matter if it was cold. It didn't matter if I felt tired, or sleepy, if it was 3 in the morning. It was all worth it: I had a way to keep my mom breathing, to keep her in this world."
When he found a seller who would rent him a concentrator for US$100 a week, he felt a spark of hope. "It was a blessing," Menéndez said.
The machine kept his mother alive — for a while, until her lungs gave out. She was intubated on Christmas Eve, and died before the new year.
Written by: Natalie Kitroeff and Oscar Lopez
Photographs by: Luis Antonio Rojas
© 2021 THE NEW YORK TIMES