In Tefé, a rural Amazonian town, the rise in COVID-19 cases between January and February 2021 in the State left its regional hospital at a loss. Without ICU beds, the standard procedure in Tefé was to transfer all critical patients by air to Manaus, the state capital. However, the collapse of the capital's system meant there was no place to take them, so the hospital had to adapt. MSF teams helped establish protocols that allowed more comfort and better patient care, as well as trained and provided mental health assistance to local staff. MSF supported Tefé Regional Hospital between November 2020 and March 2021.