Chinese hospitals were under intense pressure on Wednesday as a surge of COVID-19 infections strained resources in the last major country to move towards treating the virus as endemic.

In an abrupt change of policy, China this month began dismantling the world’s strictest COVID regime of lockdowns and extensive testing, putting its battered economy on course for a complete re-opening next year.

The easing of restrictions, which came after widespread protests against them, means COVID is spreading largely unchecked and likely infecting millions of people a day, according to some international health experts.

The speed at which COVID rules have been scrapped has left China’s fragile health system overwhelmed and prompted countries around the world, which have been “living with the virus”, to consider travel restrictions for Chinese visitors.

China reported three new COVID-related deaths for Tuesday, up from one for Monday - numbers that are inconsistent with the experience of much less populous countries after they re-opened.

Staff at Huaxi, a big hospital in the southwestern city of Chengdu, said they were extremely busy caring for patients with COVID, as they have been ever since curbs were eased on December 7.

“I’ve been doing this job for 30 years and this is the busiest I have ever known it,” said one ambulance driver outside the hospital who declined to be identified.

There were long queues inside and outside the hospital’s emergency department and at an adjacent fever clinic on Tuesday evening. Most of those arriving in ambulances were given oxygen to help with their breathing.

“Almost all of the patients have COVID,” one emergency department pharmacy staff member said.

The hospital has no stocks of COVID-specific medicine and can only provide drugs for symptoms such as coughing, she said.

Zhang Yuhua, an official at the Beijing Chaoyang Hospital, said most recent patients were elderly and critically ill with underlying diseases. She said the number of patients receiving emergency care had increased to 450-550 per day, from about 100 before, according to state media.

Pictures published by state-run China Daily showed rows of mostly elderly patients, some breathing through oxygen tubes, receiving treatment from medical staff in white hazmat suits in the hospital’s intensive care unit.