BEIJING — Hong Kong hospitals cut services as thousands of medical workers went on strike for a second day Tuesday to demand the border with mainland China be shut completely, as a new virus caused its first death in the semi-autonomous territory and authorities feared it was spreading locally.

All but two of Hong Kong’s land and sea crossings with the mainland were closed at midnight after more than 2,000 hospital workers went on strike Monday. Hong Kong health authorities reported two additional patients without any known travel to the virus epicenter, bringing the number of locally transmitted cases up to four.

The growing caseload “indicates significant risk of community transmission” and could portend a “large-scale” outbreak, said Chuang Shuk-kwan, head of the communicable disease branch at the Center for Health Protection.

More than 7,000 health personnel joined the strike Tuesday, according to the Hospital Authority Employees’ Alliance, the strike organizer.

Hong Kong’s Hospital Authority said it was cutting back services because “a large number of staff members are absent from duty” and “emergency services in public hospitals have been affected.”

Hong Kong was hit hard by SARS, or severe acute respiratory syndrome, in 2002-03, an illness from the same virus family as the current outbreak. Trust in Chinese authorities has plummeted following months of anti-government protests in the Asian financial hub.

The territory’s beleaguered leader, Carrie Lam, criticized the strike and said the government was doing all it could to limit the flow of people across the border.

"Important services, critical operations have been affected," including cancer treatment and care for newborns, Lam told reporters. "So I'm appealing to those who are taking part in this action that let’s put the interests of the patients and the entire public health system above all other things."

The leader of the nearby gambling enclave of Macao asked the city's casino bosses to suspend operations to prevent further infections after a worker at one of the resorts tested positive for the virus. Macao has recorded 10 cases in all.

China's latest figures of 425 deaths and 20,438 confirmed cases were up sharply from the previous day. Outside mainland China, at least 180 cases have been confirmed, including two fatalities, one in Hong Kong and the other in the Philippines.

The patient who died in Hong Kong was a 39-year-old man who had traveled to Wuhan, the mainland city where the outbreak started. The Hospital Authority said Tuesday he had pre-existing health conditions but did not give details.

Dr. David Heymann, who led the World Health Organization’s response to the SARS outbreak, said it’s too early to tell when the new virus will peak, but that it appears to still be on the increase. 

In the United States, more than 10 cases of Coronavirus have been confirmed.