Several COVID-19 burials are performed in the Vila Formosa Cemetery on the east side of São Paulo, Brazil, on Sunday. Brazil, which reported a large spike in cases on Monday, now ranks second after the U.S. for total infections and deaths.

Fotoarena/Sipa USA via AP

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Fotoarena/Sipa USA via AP

Several COVID-19 burials are performed in the Vila Formosa Cemetery on the east side of São Paulo, Brazil, on Sunday. Brazil, which reported a large spike in cases on Monday, now ranks second after the U.S. for total infections and deaths.

Fotoarena/Sipa USA via AP

Brazil on Tuesday reported a national record of nearly 35,000 new coronavirus cases in a 24-hour period, even as the government has insisted that the outbreak is under control.

The health ministry added 34,918 new cases, but Brazilian media, in collaboration with state health departments, said the figure was probably undercounted by a few thousand. The ministry also announced 1,282 additional COVID-19 deaths, bringing the total to more than 45,000 since the pandemic began.

In the number of confirmed cases and deaths attributed to the disease, Brazil now ranks second only to the U.S.

Meanwhile, Walter Braga Netto, a top Brazilian government official dealing with the response to the outbreak, said Tuesday: “There is a crisis, we sympathize with bereaved families, but it is managed.”

Netto’s statement is in line with President Jair Bolsonaro’s consistent efforts to downplay the danger posed by the disease. The right-wing Bolsonaro, who has called the new coronavirus “a little flu” and campaigned against shutdowns, has been widely accused of endangering the public.

He has said that the economic costs of remaining in lockdown outweigh the risk to public health.

In April, Bolsonaro fired then-Health Minister Luiz Henrique Mandetta over the official’s support of broad isolation measures recommended by the World Health Organization and international medical experts.

Most of the infections in Brazil have been concentrated in the heavily populated states of São Paulo and Rio de Janeiro and in the northeast.

Despite the uptick in cases, Brazil’s towns and cities, urged on by Bolsonaro, have been gradually re-opening for business.

NPR’s Philip Reeves contributed to this report.

Hannah can’t stop vomiting. The 22-year-old has Ehlers-Danlos syndromes, a complex disability that means she has intestinal failure and uses a feeding tube – and now has a blockage in her bowel. Surgery is her only option, but she’s been told she’ll have to wait eight months to have it because the NHS is focused on the coronavirus pandemic. Hannah has already been on the surgery waiting list for nine months and her condition is worsening: she’s in severe pain and is vomiting most days as she increasingly can’t keep food down.

Hannah doesn’t blame her doctors. “If you had two fires and one consumed a detached house, and the other was rampaging through a packed terrace, and you had limited resources, what would you choose?” she says. But she is “extremely disillusioned” with the government for leaving patients like her stranded during the pandemic.

If Hannah doesn’t have the surgery soon, she tells me, her bowel could rupture. “I fear that many people in my position will die due to a shortfall in care.”

This is Britain’s second public health emergency: the crisis that is quietly threatening lives alongside coronavirus. The government has spent recent weeks boasting that they have managed to protect the NHS during the pandemic, but what they’ve really done is shut it down. Almost two-thirds of Britons with common life-threatening conditions have been denied care by the NHS because hospitals have focused on fighting Covid-19. That’s people with breathing problems, high blood pressure and cancer.

Tens of thousands of non-urgent surgeries have been cancelled in recent months to free up space for coronavirus patients, while many diagnostic tests and outpatient appointments are on hold. Screening services for cancer have been formally paused in Scotland, Wales and Northern Ireland and are de facto suspended in England. NHS leaders say the waiting list for hospital treatment in England could soar to almost 10 million people by Christmas due to the huge backlog caused by coronavirus disrupting services. That’s double the current figure.

This comes on top of patients who have voluntarily stayed away; there was such concern about empty A&E wards during the height of lockdown that the government set up a campaign in April to encourage people with suspected strokes and heart attacks to still seek help.

The long-term consequences of reduced healthcare during the pandemic are reminiscent of an unexploded bomb, slowly waiting to go off. Greater health problems are being stored for the future, as individuals watch their chronic conditions worsen. In the worst cases, their lives are at risk. Doctors have warned of the likelihood of a “dramatic rise” in bowel cancer cases in Britain in the wake of the coronavirus outbreak. The effective halt to screening in March is predicted to lead to thousands of people dying early from the disease. One man with cancer told the Guardian last week that he is now “fighting for his life” because the pandemic meant he had to wait months for a scan. Sherwin Hall now has a tumour measuring 14cm in his pelvis and 30 small tumours in his lungs. He is 27.

The NHS was always in a deeply difficult situation. Many of the cancellations in recent months were intended to stop patients catching coronavirus by coming into hospitals. Staff had to be freed to help tackle the pandemic. The need for social distancing as well as shortages in PPE have also added further problems to the pile. But after years of being starved of funding, the NHS was in a precarious position to begin with. NHS England was short of about 40,000 nurses even before staff were spread thinner to cope with coronavirus; many patients were already waiting up to a year for treatment. Tackling a pandemic after a decade of cuts was the equivalent of being asked to fight with one hand behind its back.

This is a crisis for people who have become sick during the pandemic but also for those who had health problems before. Overall barely one in five of those who regularly receive NHS help for a long-term health condition were able to have a planned treatment in April. Meanwhile, new ONS research into shielding this week shows two in five report being unable to access certain types of care – such as tests and scans – while 10% are unable to access any care at all. It is the worst of ironies: the rightful rush to protect people from coronavirus has simply put their health at risk in another way.

A few days ago, Hannah got a call from the treatment decision team: her case has been “escalated for consideration”. If it is reclassified, she will get her surgery sooner. If not, she stays on the eight-month waiting list. “The pain is unbearable,” she says. “And the only thing that will stop it is the operation.”

• Frances Ryan is a Guardian columnist