Desperate Venezuelans are fetching water from a polluted river and drainage pipes, and lives hang in the balance in hospitals as a nationwide power outage enters its sixth day Tuesday.
Schools and many businesses are closed and stores have no power to keep fresh what food is available.
Venezuelans who are filling water bottles from a drainage pipe flowing into the filthy Guaire River are warned to use it only for flushing toilets or cleaning floors.
Some hospitals have generators and doctors are hoping to be able to transfer patients who need operations to save their lives to those facilities.
Power was restored to parts of the county Monday, but was reported to be unreliable. It is also hard to confirm reports of deaths and looting coming out of Venezuela because of communication difficulties.
President Nicolas Maduro blames the power outage on the United States and opposition, accusing them of a cyberattack on a hydroelectric dam.
Opposition leader and self-declared interim president Juan Guaido says government corruption and mismanagement are the cause. Engineers say a lack of maintenance and skilled experts fleeing the country have left the Venezuelan electrical grid in terrible shape.
The United States denies having anything to do with the power shortages and Secretary of State Mike Pompeo Monday blasted Cuba and Russia for backing the Maduro regime.
"No nation has done more to sustain the death and daily misery of ordinary Venezuelans, including Venezuela's military and their families, than the communists in Havana," Pompeo said. "Cuba is the true imperialist power in Venezuela."
Pompeo says Maduro sends up to 50,000 barrels of oil to Cuba per day to help prop up Cuba's "tyrant socialist economy while Maduro needs Cuban expertise and repression, to keep his grip on power. A match made in hell," said Pompeo.
Pompeo added that Russia joins Cuba in showing contempt for the rule of law and prosperity in Venezuela.
"Russia, too, has created this crisis. It, too, for its own reasons, is thwarting the Venezuelan people's legitimate democratic hopes and their dreams. ... The Kremlin is standing with its Venezuelan cronies against the will of the people of a sovereign nation to protect a Moscow-friendly regime."
Pompeo said oil-rich Venezuela's plunge from wealth to poverty has left economists with "amazement and horror."
The United States expanded sanctions against Venezuela Monday to include a Moscow-based bank jointly owned by the Venezuelan and Russian governments.
The Treasury Department says the bank allegedly tried to avoid earlier sanctions on Venezuela by backing Maduro's failed efforts.
Nike Ching at the State Department contributed to this report.