TOPSHOT - Syrian volunteers carry an injured person on a stretcher following Syrian government forces airstrikes on the rebel held neighbourhood of Heluk in Aleppo, on September 30, 2016.
Syrian regime forces advanced in the battleground city of Aleppo, backed by a Russian air campaign that a monitor said has killed more than 3,800 civilians in the past year. / AFP / THAER MOHAMMED        (Photo credit should read THAER MOHAMMED/AFP/Getty Images)
PHOTO: THAER MOHAMMED/AFP/Getty Images
TOPSHOT - Syrian volunteers carry an injured person on a stretcher following Syrian government forces airstrikes on the rebel held neighbourhood of Heluk in Aleppo, on September 30, 2016. Syrian regime forces advanced in the battleground city of Aleppo, backed by a Russian air campaign that a monitor said has killed more than 3,800 civilians in the past year. / AFP / THAER MOHAMMED (Photo credit should read THAER MOHAMMED/AFP/Getty Images)
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Story highlights

NEW: "Hundreds of critical medical evacuations are urgently required," a U.N. official says

Activists report dozens more deaths across the besieged Syrian city

(CNN) —  

Russia warned the United States about taking direct action against the Syrian regime, saying it would cause negative consequences across the Middle East, Russia’s state-run Sputnik news agency reported Saturday.

Meanwhile, intense fighting continued in the besieged Syrian city Aleppo on Saturday, with one of the main hospitals bombed by Russian-backed Syrian forces.

Sputnik reported that Russian’s Foreign Ministry spokeswoman Maria Zakharova said, “If the US launches a direct aggression against Damascus and the Syrian army, it will lead to terrible, tectonic shifts not only on the territory of this country but also in the region in general.”

She said the United States risked creating a power vacuum in Syria were it to depose Syrian President Bashar al-Assad. Such a power vacuum would be filled by “terrorists of all sorts,” Sputnik reported.

01:01 - Source: CNN Business
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Secretary of State John Kerry, in a meeting with a group of Syrian civilians last week, expressed sympathy for their demands that the United States intervene more forcefully amid Syrian and Russian airstrikes, according to an audio recording obtained by CNN.

He told the group that he “lost the argument” for using military force against the regime of Syrian President Bashar al-Assad.

“I’ve argued for the use of force. I’m the guy who stood up and announced that we’re going to attack Assad for the use of weapons,” Kerry is heard telling the Syrian attendees, referring to internal deliberations within the administration of President Barack Obama that followed Assad’s use of chemical weapons in 2013.

How bad are the hospital attacks?

The M10, Aleppo’s largest surgical hospital, was hit Saturday for the second time in four days. The facility was struck by a “torrent” of weapons including two barrel bombs, two cluster bombs and at least one rocket, said Adham Sahloul, spokesman for the Syrian American Medical Society.

The facility was struck by a “torrent” of weapons including two barrel bombs, two cluster bombs and at least one rocket, said Adham Sahloul, spokesman for the Syrian American Medical Society.

One person died and 15 were wounded in the bombings, the Aleppo Media Center activist said.

M10, the largest surgical hospital in Aleppo, is now out of service, the activist said.

The city’s M2 hospital was also put out of service by shelling Wednesday, activists said.

The attacks on M2 and M10 have left only two surgical hospitals in Aleppo, the media center activist said.

Aleppo’s dire medical needs

On Friday alone, the M10 hospital saw 84 cases, including 22 children, Sahloul said. Sixteen of those died, including five children.

About 30 doctors now remain in eastern Aleppo for a population of about 300,000, Sahloul said.

Doctors have resorted to triage, prioritizing those they believe have the best chance of survival, the activist said.

Three other medical facilities in the al-Shaar neighborhood – a women’s hospital, a children’s hospital and the central blood bank – were also hit Friday, Sahloul said.

More than 450 people have been killed since a US-Russia brokered ceasefire collapsed September 22, he said.

Syrian government war jets have targeted gathering places such as markets, hospitals and mosques for three days, the Aleppo Media Center activist told CNN.

The United Nations’ aid chief Stephen O’Brien repeated a call for a 48-hour weekly pause in the fighting so that aid could enter the city.