COLOMBO, Sri Lanka (AP) — The National Medical Association of Sri Lanka warned Thursday that hospitals will be unable to provide even emergency services in the coming weeks due to critical shortages of drugs and medical equipment caused by the country’s economic crisis, resulting in catastrophic death tolls if supplies are not replenished.

Sri Lanka is facing its worst economic crisis in decades and has endured months of shortages of fuel and other essentials. Protests over the economic turmoil have spread across the country and extended to criticism of President Gotabaya Rajapaksa and his politically powerful family.

The Sri Lanka Medical Association sent a letter to Rajapaksa on Thursday saying that hospitals have already decided to cut services such as routine surgeries and limit the use of available medical equipment to treating life-threatening illnesses.

Unless supplies are urgently replenished, “in a few weeks or even days, emergency treatment will also not be possible. This will result in a catastrophic number of deaths,” the letter reads.

Thousands of people, including health workers, marched this week demanding a solution to the crisis and the resignation of Rajapaksa over economic mismanagement.

Rajapaksa has resisted demands to step down, even after members of his own coalition joined them this week, with ruling party lawmakers calling for the appointment of a caretaker government to head off possible violence.

Rajapaksa earlier proposed the creation of a unity government, but the main opposition party rejected the idea. His cabinet resigned late on Sunday and on Tuesday nearly 40 ruling coalition lawmakers said they would no longer vote under the coalition’s instructions, significantly weakening the government.

This turned the economic crisis into a political one, with no functioning Cabinet comprising crucial finance and health ministers. Parliament failed to reach a consensus in three days of debate on how to handle the crisis.

The president and his older brother, Prime Minister Mahinda Rajapaksa, continue to hold power, despite their politically powerful family being the focus of public anger. Five other members of the family are lawmakers, including Finance Minister Basil Rajapaksa, Irrigation Minister Chamal Rajapaksa and a nephew, Sports Minister Namal Rajapaksa.

The government estimates that the COVID-19 pandemic has cost Sri Lanka’s tourism-dependent economy $14 billion over the past two years. The demonstrators also denounce poor budgetary management. The country has huge external debts after borrowing heavily for infrastructure and other projects. Its external debt repayment obligations amount to about $7 billion this year alone.

Debts and dwindling foreign exchange reserves make it unable to pay for imported goods.

Rajapaksa said last month his government was in talks with the International Monetary Fund and had turned to China and India for loans, and called on people to limit the use of fuel and electricity .