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The Amazon River is South America’s essential life source, the central artery in a vast network of tributaries that sustains some 30 million people across eight countries, moving supplies, people and industry deep into forested regions often untouched by road.

But once again, in a painful echo of history, it is also bringing disease.

The pandemic has overwhelmed Brazil, with more than two million infections and more than 84,000 deaths, an outbreak second only to the United States in severity. The six Brazilian cities with the highest coronavirus exposure are all on the Amazon River, according to an expansive new study from Brazilian researchers that measured antibodies in the population.

A Times photographer traveled the river for weeks, documenting how the virus has spread so quickly and thoroughly along the river that in remote fishing and farming communities like Tefé, people have been as likely to get the virus as in New York City, home to one of the world’s worst outbreaks.

“It was all very fast,” said Isabel Delgado, 34, whose father, Felicindo, died of the virus shortly after falling ill in the small city of Coari.

In the past four months, as the epidemic traveled from the biggest city in the Brazilian Amazon, Manaus, with its high-rises and factories, to tiny, seemingly isolated villages deep in the interior, the fragile health care system has buckled under the onslaught.

Cities and towns along the river have some of the highest deaths per capita in the country — often several times the national average.

The virus is exacting an especially high toll on Indigenous people, in a parallel to the past. Since the 1500s, waves of explorers have traveled the river, seeking gold, land and converts — and later, rubber, a resource that helped fuel the Industrial Revolution. But with them, these outsiders brought violence and diseases like smallpox and measles, killing millions and wiping out entire communities.