Novel coronavirus cases in Brazil have reached 241,080, including at least 16,122 deaths, as of Monday, according to the latest figures from Johns Hopkins University. The total confirmed cases increased by nearly 50 percent (48.1 percent) from May 10, when 162,699 infections were reported by Brazil's health ministry.

At a press conference on Sunday, Bruno Covas, the mayor of São Paulo, the country's most populous city, warned that the city's health system is close to collapse. Covas confirmed that 90 percent of its ICU (intensive care units) beds were occupied, noting there was an urgent need to slow the spread of the virus, according to Brazil's O Globo via Google Translate.

Joao Doria, the São Paulo governor, was also reported to have mentioned the possibility of a regionalized lockdown. Doria previously urged residents to stay indoors and ordered all non-essential services to remain closed through to May 31.

Brazil now has the fourth-highest number of the cases in the world, after the U.S., Russia and the U.K. The country's total confirmed cases overtook that of Italy and Spain on Saturday, reporting 14,289 new cases on May 16, according to figures from Brazil's health ministry.

Italy previously had the highest number of infections outside China, where the virus was first reported, while Spain formerly had the second-highest number of cases after the U.S.

Brazil also saw a record number of new cases on Friday, reporting 15,305 infections, the highest number of daily new cases since the outbreak began. The actual number of cases and deaths in Brazil is suspected to be higher than the reported figures due to the lack of testing in the country.

"Brazil is only testing people who end up in the hospital," said Domingo Alves, one of the authors of a study published earlier this month which estimated total cases in the country were 15 times higher than the official figure, Agence-France-Presse reports.

"It's hard to know what's really happening based on the available data. We don't have a real policy to manage the outbreak. The pandemic is passing through as it pleases," he told AFP last week.

On Friday, Nelson Teich resigned from his position as Brazil's health minister following recent clashes with President Jair Bolsonaro.

Last week the Brazlian leader demanded Teich issue federal guidelines for the early use of hydroxychloroquine, an anti-malarial drug yet to be proven for its effectiveness in fighting the novel coronavirus. Studies have also raised concerns over the drug's potential to cause heart problems.

Earlier this month Teich also revealed he was not consulted before Bolsonaro announced the reopening of gyms, beauty parlors and hair salons. The former health minister warned the country's hardest-hit regions required stricter lockdown orders.

Teich was reported to have resigned for "personal reasons" and the president was reported to have "had a different vision about which protocol to follow" as part of the country's response to the outbreak, Bolsonaro's chief of staff, Walter Braga Netto, told journalists on Friday.

Teich is the second health minister the country has lost. His predecessor, Luiz Henrique Mandetta, was fired last month for resisting Bolsonaro's demands to promote hydroxychloroquine and to go against lockdown orders issued by several state governments.

Bolsonaro told business leaders in a video conference on Thursday: "I was elected to make decisions. And the decision about chloroquine goes through me," also noting that his decision to end social distancing measures should be the final word.

"Just like a commander in battle: He has to decide. Are people going to die? Unfortunately, people are going to die," Bolsonaro said.

A physical education student in São Paulo, Brazil, conducting a rooftop fitness class to encourage people to use brooms, bottles filled with water and plant pots to exercise amid the pandemic, pictured on May 10, 2020.Getty Images

On Friday, the country's health ministry confirmed it was finalizing updated guidelines for the treatment of virus patients, including proposed medications, one of which includes hydroxychloroquine, a representative from the ministry told Reuters.

Earlier this month, videos emerged of Bolsonaro enjoying a floating BBQ, jet-skiing out to meet others on a boat and ignoring social distancing guidelines.

Brazil recorded the highest daily death toll in the Southern Hemisphere earlier this month. The country's first lockdown measures were introduced in three states a few days before then, by which time the country's death toll had climbed past 7,900.

Death tolls are feared to be the highest in the favelas, the slum areas of Rio de Janeiro (the capital of the state of the same name), São Paulo and other Brazilian cities where a vast number of people live crammed together in small areas.

The novel coronavirus, which was first reported in Wuhan, China, has infected more than 4.7 million people across the globe. Over 315,400 have died following infection, while more than 1.7 have reportedly recovered from infection, as of Monday, according to the latest figures from Johns Hopkins University.

The graphic below, provided by Statista, illustrates countries with the most confirmed COVID-19 cases.

Countries with the most confirmed COVID-19 cases. Getty Images