Options to get out of Hong Kong by air are the most limited in at least two decades, just as the number of residents wanting to flee the city of 7.4 million surges.

Before the pandemic, a passenger plane would leave Hong Kong every three minutes, on average, making it almost as busy as New York’s John F. Kennedy International Airport. These days, a whole hour could pass without a single departure, according to the latest data.

The slump in services both in and out of what was once Asia’s busiest airport leaves few options for the swelling ranks of people trying to escape Hong Kong’s mounting Covid restrictions. As the healthcare system struggles to cope with Hong Kong’s worst outbreak since the pandemic began, authorities on Tuesday said they would mass test the entire city in a bid to root out cases and that schools would remain suspended.

With many routes barred and some destinations blacklisted because of high levels of Covid, airlines are planning just 592 flights out of Hong Kong for all of February, an average of only 21 a day, according to aviation data company Cirium. That’s the fewest on schedules stretching back to August 2003. Before the pandemic, there were more than 14,000 services taking off from Hong Kong almost every month.

Departures on Thursday were down to just 22, roughly half the daily total as recently as December, Cirium data show. On Friday, Cathay Pacific Airways Ltd. is flying just three services to Shanghai and one to Chengdu. Before the virus decimated travel, Hong Kong’s marquee carrier and its defunct sister Cathay Dragon operated more than 210 flights out of the city every day.

The dearth of overseas connections is deepening Hong Kong’s isolation as it mirrors mainland China’s strict Covid-Zero policy on controlling the virus. While other nations including rival hub Singapore open up in an attempt to co-exist with Covid, China is still trying to wall out cases with border and flight curbs as well as mandatory traveler quarantines.

Hong Kong requires anyone entering the city to undertake a weeks-long quarantine, which has severely dented demand for flights in and led to overseas airlines shunning the city as a destination. The carriers that still fly there risk joining a list of airlines including Singapore Airlines Ltd. and Thai Airways International Pcl to have services barred for carrying infected passengers.

A total flight ban on nine countries including the U.S., U.K. and Australia will be extended to April 20, Hong Kong Chief Executive Carrie Lam said Tuesday. Transit travel is also banned for all passengers except those from the mainland and Taiwan.

Despite the dearth of flights, departures from Hong Kong airport have reached their highest levels since the pandemic began. Separately, a net 21,698 people left the city last week, compared with a net inflow of 11,461 in the same week of 2021, government data show. Of those who left, 72% departed through the airport, with the rest leaving via two land crossings with mainland China.

That pressure and concerns it could lead to Covid spread is further crimping flight capacity. Shanghai has been the most popular route in and out of Hong Kong in recent times, yet bookings are hard to come by. As of Wednesday, all Cathay flights up to March 17 to China’s main financial hub were sold out, according to the airline’s website.

Hong Kong Airlines Ltd. said it was operating two daily flights to Shanghai until the end of March, but its website shows all tickets are sold out except March 25, despite upgrading one service to a wide-body aircraft to cater to strong demand.

The company also confirmed passenger capacity on flights to Shanghai is being capped at half. “Seat capacity is kept at 50% for flights departing from Hong Kong to comply with local authorities’ latest pandemic preventive measures,” a company spokeswoman said in a text message.