Fires in the northern state of Acre, in September 2019. Photo by Katie Maehler/Mídia NINJA, CC-BY-NC This story, written by Izabel Santos and Bruna Melo, was originally published by Amazônia Real. It is republished here as part of a content partnership with Global Voices. The highest rates of deforestation in the last decade in the Amazon were recorded last year. But 2020 could be even worse. A study by Brazil's Amazonian Environmental Research Institute (Ipam), a non-profit NGO, estimates that there are at least 4,500 square kilometres of the deforested area in the Amazon that could be burned this year. This area is equivalent to three times the size of the city of São Paulo. Ipam's scientists add that if 2019's pace of deforestation is maintained in the next few months, this area could double in size by the end of July, the height of the dry season and when most of the burning begins. The report notes that if just 60 percent of this 9,000 square-kilometre area burns, the situation will be similar to that of 2019, when Amazon fires ignited global outrage. The study, published on June 8, states: Se tudo virar fumaça, a região pode enfrentar estado de calamidade pública na saúde devido a sobreposição de queimadas com pandemia de Covid-19, o que sobrecarregará ainda mais a rede saúde já em colapso nos atendimentos à população. If everything burns, the region may face a public health crisis situation because of the combination of fires and the COVID-19 pandemic, which will further overburden the already collapsed healthcare system caring for the population. Combating fires and deforestation has become, as well as an environmental protection, a health measure, according to one of the authors of the study, the researcher Paulo Moutinho, a member of Ipam who has a Ph.D. in ecology. Last year, the towns that burned the most in the Amazon saw their air become 53 percent more polluted, on average, compared to 2018. Moutinho emphasized that if authorities do not act, this could lead to deaths in addition to those caused by COVID-19. Since March, the region's public healthcare system has been overwhelmed with cases of COVID-19, and three states in the Amazon are among those with the highest number of cases in Brazil. According to IPAM, as of the end of May 2020, 20 percent of Brazil's deaths from the new coronavirus occurred in the northern region, which also had the highest infection and mortality rate per 100,000 inhabitants. As of July 6, Brazil had 64,867 deaths and over 1,6 million recorded cases, according to the Ministry of Health. IPAM stated: No Amazonas, no Pará e em Mato Grosso, mais de 20% das pessoas moram em áreas que exigem um deslocamento de até quatro horas para chegar ao município mais próximo com condições de atendimento em casos graves de Covid-19. As pequenas e médias cidades, se atingidas simultaneamente por fumaça das queimadas e infecções pelo novo coronavírus, tendem a não conseguir absorver a necessidade da população. In the states of Amazonas, Pará and Mato Grosso, over 20 percent of people live in areas that require up to four hours of travel to reach the nearest town with facilities to deal with serious cases of COVID-19. Small and mid-sized towns, if affected simultaneously by smoke from the fires and infections of the new coronavirus, tend to be unable to meet the population's needs. In the history of forest destruction in the Amazon, after deforestation a fire is set, explains Ipam's Science Director Ane Alencar, who also signed the study's technical report. As such, whenever the rate of deforestation increases, there is a direct link with the increase in fire outbreaks. Alencar says: Ninguém vai gastar dinheiro para derrubar vários hectares de floresta para depois não usar essa área, mesmo que seja para especulação. Essa área vai ser queimada. Foi o que vimos acontecer em 2019 e, infelizmente, se nada for feito, é o que deveremos ver em 2020, já que a derrubada continua num ritmo elevado. Nobody will spend money to cut down several hectares of forest and then not use that area, even if it is for speculation. That area will be burned. That is what we saw happen in 2019 and, unfortunately, if nothing is done, that is what we will see in 2020, as the felling continues at a high pace. The fires increase the amount of smoke in the air, releasing fine particulate material. In the areas most affected by the pollution, there is an explosion in the number of patients seeking medical care for respiratory problems. Another researcher, physicist Paulo Artaxo, from the University of São Paulo, who collaborated in the study, said: Durante a temporada de fogo, extensas áreas da Amazônia têm qualidade do ar pior que no centro da cidade de São Paulo devido às queimadas.