A massive tornado - the deadliest single U.S. tornado since 1953 - tore through the city of Joplin on Sunday, killing at least 89 people. Amid fears the death toll could climb, a fresh round of storms lashed the town early Monday, hampering search and rescue efforts.

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 six 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.

Fire chief Mitch Randles estimated that 25 to 30 percent of the city was damaged, and said his own home was among the buildings destroyed as the twister swept through this city of about 50,000 people some 160 miles south of Kansas City.

"It cut the city in half," Randles said.

"People are just scrambling. Multiple homes and businesses destroyed, mangled vehicles and debris everywhere you look," Weather Channel meteorologist Mike Bettes reported. "The damage is absolutely immense here in Joplin."

Monday's storm brought strong, gusty winds, heavy rain and quarter-size hail to parts of the southwest Missouri city. The Joplin area was under a severe thunderstorm warning through mid-morning, the National Weather Service said, adding that the storms could produce winds in excess of 60 mph.

An unknown number of people were injured in Sunday's deadly storm, and officials said patients were scattered to any nearby hospitals that could take them.

The same storm system that produced the Joplin tornado spawned twisters across a broad swath of the Midwest, from Oklahoma to Wisconsin. At least one person was killed in Minneapolis. But the devastation in Missouri appeared to be the worst of the day, eerily reminiscent of the tornadoes that killed more than 300 people across the South last month.

As the toll currently stands, the Joplin storm is the deadliest single tornado since the Worcester, Mass., tornado of June 9, 1953, which killed 90 people. If Joplin's toll increases further, it would surpass Worcester and start approaching the toll from a deadly storm that hit the previous day in 1953, when 115 died in Flint, Mich.

"We will recover and come back stronger than we are today," Rohr said defiantly of his city's future.

St. John's Regional Medical Center appeared to suffer a direct hit from a tornado. The staff had just a few moments' notice to hustle patients into hallways before the storm struck the multistory building, blowing out hundreds of windows and leaving the facility useless.

Triage centers and shelters were set up around the city.

Emergency management officials rushed heavy equipment to Joplin to help lift debris and clear the way for search and recovery operations. Missouri Gov. Jay Nixon declared a state of emergency, and President Barack Obama sent condolences to families of those who died in storms in Joplin and across the Midwest.

Jeff Lehr, a reporter for the Joplin Globe, said he was upstairs in his home when the storm hit but was able to make his way to a basement closet.

"There was a loud huffing noise, my windows started popping. I had to get downstairs, glass was flying. I opened a closet and pulled myself into it," he told The Associated Press. "Then you could hear everything go. It tore the roof off my house, everybody's house. I came outside and there was nothing left."

Joplin resident Ken Ayton told NBC's TODAY that he credits his dogs with helping him survive.

"They were going crazy, and I realized something was wrong, so I brought them in, and then the sirens went off."

As the tornado ripped through his neighborhood, Ayton, who could see the oncoming storm from his bathroom, decided to seek shelter in his bathtub.

"I had heard of houses being leveled and people being saved by being in the bathtub...I covered up with the pillows, and waited to see what would happen."

The tub - near an outside wall of his home - kept Ayton safe, but it was a harrowing experience.

"I was scared to death. I really, quite frankly, did not think I would be standing here today talking to you."

Hospital hit

The twister hit a hospital packed with patients and a commercial area including a Home Depot construction store, numerous smaller businesses and restaurants and a grocery store. Jasper County emergency management director Keith Stammer said an estimated 2,000 buildings were damaged in this city.

"We are not sure of the safety of the building," the News-Leader quoted hospital spokeswoman Cora Scott as saying.

In the hospital parking lot, a helicopter lay crushed on its side, its rotors torn apart and windows smashed. Nearby, a pile of cars lay crumpled into a single mass of twisted metal. Matt Sheffer dodged downed power lines, trees and closed streets to make it to his dental office across from the hospital.

"My office is totally gone. Probably for two to three blocks, it's just leveled," he said. "The building that my office was in was not flimsy. It was 30 years old and two layers of brick. It was very sturdy and well built."

Details about fatalities and injuries were difficult to obtain even for emergency management officials, because the tornado knocked out power, landline phones and some cellphone towers, said Greg Hickman, assistant emergency management director in Newton County.

Triage centers and shelters were setup around the city. At Memorial Hall, a downtown entertainment venue, nurses and other emergency workers were treating critically injured patients.

Debris was carried up to 60 miles away, with medical records, X-rays, insulation and other items falling to the ground in Greene County, said Larry Woods, assistant director of the Springfield-Greene County Office of Emergency Management.