A lengthy lockdown and shortages of food prompted residents to take to the streets in China’s southern manufacturing hub of Guangzhou, a rare protest that reflected the growing public frustration with disruptions caused by the country’s COVID restrictions.

China maintains the world’s most stringent approach to COVID, a policy that relies heavily on mass lockdowns, quarantines and mandatory near-daily testing across the country. Whole regions and cities, including Shanghai, have been placed under strict lockdowns, derailing millions of people’s lives, forcing businesses to close and stirring public outrage.

The psychological toll of China’s “zero-COVID” policy is mounting. Earlier this month, a poorly managed outbreak in the world’s largest iPhone assembly complex in Zhengzhou led to a worker exodus and a delay in iPhone shipments around the world.

The restrictions have periodically prompted unrest, such as in Guangzhou on Monday evening, when throngs of residents marched down Qiaonanxin Street to protest the lack of food and daily necessities after being confined at home for three weeks, according to four owners of restaurants and shops on the street who were interviewed by phone.

A surge of COVID cases in Guangzhou in recent weeks prompted officials to enforce lockdowns in several districts that are home to roughly 6 million people, according to government announcements on social media. In the southern district of Haizhu, where Qiaonanxin Street is, the 1.8 million residents were ordered to stay at home and undergo daily testing. Travel was restricted. Schools moved online. Authorities put up barricades around neighborhoods where positive cases were recorded.

Some of the protesters tore down the fencing and the barricades that had been erected outside their housing compounds, according to two restaurant owners who would only give their surnames, Hu and Zhao. It was unclear if there were any casualties.

Many of the protesters were migrant workers from Hubei and its neighboring provinces working in Guangzhou’s textile industry, said Hu as well as another restaurant owner, whose surname is Dai.

Videos circulating on social media showed an overturned police vehicle, ransacked food provisions and altercations between residents and health officials. Officers at a police station in Haizhu, reached by phone, said that they did not know about the incident.

The police arrived a few hours later, said the four people, and the crowd soon dissipated.

As of Wednesday, over a dozen neighborhoods in the area near Qiaonanxin Street remained under lockdown, and officials have not provided a date for lifting the order.

Guangzhou officials said 95% of COVID cases found in the city on Monday were in the Haizhu district, according to a news conference on Tuesday. Food and other daily necessities had been distributed free of charge, and the supplies of fruits and vegetables have been increased on top of the original provisions, said Fu Xiaochu, a Haizhu district official.

Huang Kunming, the Communist Party leader of Guangdong province, of which Guangzhou is the capital, visited the city on Tuesday and urged health officials to “win the battle” of pandemic prevention.

The central government pledged last week to refine its COVID rules in an attempt to limit the disruption caused to people’s lives and to reduce the strain on public health care. Officials relaxed China’s quarantine period for inbound travelers to a minimum of five days from seven and said that contacts of contacts would no longer be tracked.

But as case counts nationwide reached 19,609 on Wednesday, the highest daily total in more than six months, how far the government may go in easing restrictions remains unclear. Investors rejoiced at the easing of quarantine rules that have been a major drag on the economy, but for most Chinese, the daily reality of having one’s movements restricted has not changed.

Nor has China’s rhetoric. On Tuesday, days after some COVID rules were changed, the People’s Daily, China’s state newspaper, published an article with a familiar headline: To “unswervingly implement the ‘zero-COVID’ policy.”

This article originally appeared in The New York Times.