Record-high air pollution in Pakistan’s cultural capital, Lahore, is sending more people to hospitals and private clinics, doctors said on Wednesday, as authorities warned a complete lockdown could be imminent if residents fail to wear face masks and follow other guidance related to smog.

The warning came after residents on the streets in Lahore, which has a population of 14 million, were seen overwhelmingly without masks.

Doctors say most people are complaining of either having a cough or that they feel their eyes are burning.

“Tens of thousands of patients suffering from respiratory diseases were treated at hospitals and clinics in a week,” said Salman Kazmi, vice president of the Pakistan Medical Association.

Smog in Pakistan
Motorcyclists as smog envelops the city (K.M. Chaudary/AP)

You can see people coughing whenever you go, but they still hardly wear face masks, he said.

Lahore remained the world’s most polluted city on Wednesday, with air-quality index hitting a record high of more than 1,100. Anything over 300 is considered hazardous to health.

A toxic smog has shrouded the city since last month.

Marriyum Aurangzeb, a senior minister in the Punjab province, asked people to wear face masks to avoid a complete lockdown in the city. Lahore is the provincial capital.

Authorities in the city have already banned barbecuing food without filters, as well as the use of motorised rickshaws, and wedding halls must close by 10pm.

The government said it was also looking into methods to induce artificial rainfall to combat the pollution.