Doctors in China have described the chaos unfolding within hospitals as COVID-19 infections sweep the country.
Three health care professionals spoke anonymously to Sky News, painting a picture of emergency departments "packed" with patients, "ventilators and oxygen machines everywhere" and "not enough IV beds".
Strict zero-COVID restrictions were lifted just three weeks ago in China and the virus has been spreading rapidly.
But assessing the scale of the impact is difficult because accurate case and death numbers are not being released and speaking out comes with huge risk.
Despite this, some doctors have spoken exclusively to Sky News and described just how much pressure the system is under.
One doctor in the northern city of Shenyang explained how "our emergency room (ER) is packed with patients, dozens of times busier than usual".
"It is not easy for the elderly to get admitted" they said.
"There aren't enough ambulances. Ventilators and oxygen machines are everywhere in the ER.
"There are not enough IV beds. Before we had a doctor-patient ratio of 1:4 or 1:5, now it's more like 1:10."
They also described the high mortality rate being seen, contrary to the official numbers which state that just a tiny handful of people have died from the virus in the last few months.
A death from COVID in China is so narrowly defined that on a typical day the authorities will announce just one, two, three or even no deaths.
This is despite the fact an estimated 250 million people (18% of the population) have been infected with COVID in December alone, according to information leaked by sources close to the government.
What the doctor describes clearly disputes the official figures.
"This wave of COVID is lethal for the elderly, especially with underlying diseases and dysfunctions such as high blood pressure, diabetes and heart conditions," the doctor said.
"For every 10 elderly patients with severe conditions admitted to the ER, around 50% die."
'One person must stay on duty for days'
Another doctor in Beijing spoke about the huge pressures on hospital staff with so many patients arriving and many doctors and nurses also falling sick.
"There are not enough staff in the department as all the nurses have tested positive for COVID-19. Now one person must stay on duty for several days," the doctor said.
"The majority, if not all, patients for follow-up visits and consultations either have COVID or have recovered from COVID."
A third doctor spoke of extremely long waits for patients to be seen.
China announced on 7 December it would move to "optimise" its COVID response and has since dismantled almost all the rules and infrastructure that supported it, including removing quarantine and testing rules for international arrivals.
But it has left the 1.4 billion population exposed as there is limited herd immunity and large proportions of the elderly who are not fully vaccinated.
In addition, the healthcare system is under-resourced with not enough intensive care beds.
While the spread in Beijing is predicted to have peaked, it is expected that the countrywide peak will not come for another month or so and there are concerns about how smaller regional towns will cope.