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A massive tornado that tore a 6-mile path across southwestern Missouri killed at least 89 people as it slammed into the city of Joplin, ripping into a hospital, crushing cars like soda cans and leaving a forest of splintered tree trunks behind where entire neighborhoods once stood.Authorities warned that the death toll could climb as search and rescue workers continued their efforts. Their task was made more miserable as a new thunderstorm with strong winds, heavy rain pelted part of the city with quarter-sized hail.

City manager Mark Rohr announced the number of known dead at a pre-dawn news conference outside the wreckage of a hospital that took a direct hit from Sunday’s storm. Rohr said the twister cut a path nearly 6 miles long and more than a half-mile wide through the center of town. Much of the city’s south side was leveled, with churches, schools, businesses and homes reduced to ruins.

Jasper County emergency management director Keith Stammer said about 2,000 buildings were damaged, while Joplin fire chief Mitch Randles estimated the damage covered a quarter or more of the city of about 50,000 people some 160 miles south of Kansas City. He said his home was among those destroyed.

An unknown number of people were injured, and officials said patients were scattered to any nearby hospitals that could take them.