The use of force escalated from pellet guns to live ammunition during protests, significantly raising the number of casualties, a doctor who treated injured demonstrators told the Center for Human Rights in Iran (CHRI).

Speaking after fleeing the country, the doctor said the use of live fire increased the death toll days after protests broke out on December 28.

“Law enforcement forces were firing pellet shotguns that spread pellets. During those days, I received five or six calls each day about people who had been hit by two pellets in the back or pellets to the head or scalp,” the doctor claimed.

The doctor noted that the situation changed on January 8, when authorities imposed internet blackouts and cut off nationwide communication.

“From around 8:10 to 8:20 pm, the sounds of bullets, gunfire, screams, and occasional explosions could be heard. I was called to the hospital. When I arrived, I saw that the nature of the injuries and the number of gunshot wounds had completely altered,” the doctor said of the period around the blackout.

“The situation was entirely different. Shots from close range, injuries resulting in death.”

Human rights groups state that thousands have been killed as security forces moved to suppress the demonstrations, with some estimates putting the death toll above 3,000, ’ chief foreign correspondent Trey Yingst reported Tuesday.

The protests were driven by anger over economic hardship, rising prices, and inflation before expanding into broader anti-government demonstrations.

“The calls I received on my home phone for medical advice were no longer about pellet wounds,” the doctor said. “People were saying they had been shot, with bullets entering one side of the body and exiting the other. Live ammunition.”

Describing scenes in Isfahan, which is a , the doctor said streets were stained with blood as security forces deployed heavier weapons.

“A large amount of blood, about a liter, had collected in the gutter and blood trails stretched for several meters,” the doctor claimed.

“The level and intensity of violence increased gradually,” he said before detailing a shift in aggression on January 9.

“On Friday night, I heard automatic gunfire. I am familiar with weapons and can distinguish their sounds. I heard DShK heavy machine guns. I heard PK machine guns.

“These weapons are in the possession of IRGC units — DShKs, PK machine guns, and Kalashnikovs,” the doctor said. “The trauma cases I saw were brutal, shoot-to-kill.”

Victims ranged from teenagers to elderly men, the doctor said. Some injuries were so severe that bodies were unrecognizable.

“One colleague said that during a night shift, eight bodies were brought in with gunshot wounds to the face; their faces were unrecognizable. Many bodies are not identifiable at all,” he added.

The account comes as President publicly expressed support for Iranian protesters. 

On Tuesday, their institutions, stating he had canceled all meetings with Iranian officials until the crackdown concludes.