MSF began its response activities to COVID-19 in the state of Amazonas on April 25. In Manaus, the state capital, MSF run a floor of the 28 de Agosto hospital with 12 ICU beds and 36 beds for severe cases that did not require intensive care. In addition, MSF teams screened patients periodically in 20 shelters of the city, where refugees and homeless people live. Due to the special vulnerability of the Warao indigenous population, who came from Venezuela to Brazil and lives mostly in shelters, MSF created a specific isolation center for Waraos with symptoms of COVID-19.

In Tefé, MSF worked mainly with the training of health professionals and of the staff of the regional hospital. A MSF team also joined the first trip of the primary healthcare boat that assists the population around Tefé when it resumed its operations after the lockdown. MSF helped to implement infection prevention and control (IPC) measures and offered training for the health team and the boat crew.

In São Gabriel da Cachoeira, MSF has set up a care center for patients with mild and moderate cases of COVID-19. The facility was specifically adapted to suit local traditions; over 90 percent of the population of São Gabriel da Cachoeira is of indigenous origin. In the care centre, for example, indigenous patients with COVID-19 can remain for the duration of treatment with a carer, something that is not usually allowed in hospitals. Hammocks are available for patients and companions. In addition, traditional medicines used by many people in the region are accepted at the centre and can be taken together with the treatment offered by MSF, as long as their combination does not cause any adverse effects. Shamans, spiritual leaders of indigenous communities, can visit and perform rituals. The only requirement is that they use personal protective equipment to avoid being contaminated while in contact with the patient.