Immediate concerns remain with the casualties. Hospitals — already stretched from the ongoing coronavirus pandemic — are inundated with the wounded and while the death toll steadily rose through Tuesday and into Wednesday, the true cost of life may not be known for several days as more bodies are pulled from the wreckage and the scale of the devastation is realized. Relatives of the missing are scouring hospitals looking for their loved ones and aid agency Save the Children warned of children being among those unaccounted for.

The secretary-general of the Lebanese Red Cross, Georges Kettaneh, told Lebanon’s National News Agency Wednesday that at least 100 people have been killed, saying the disaster is “unprecedented and very large.”

The organization said it has set up multiple temporary shelters with food, hygiene kits and basic needs to receive 1,000 families who have lost their homes.

Lebanon’s Health Minister Hamad Hassan said Wednesday that hundreds of people have been reported missing and the death toll will likely increase. Four hospitals are out of service because of damage from the explosion, he said, adding that the health ministry has an emergency plan with field hospitals being sent from Qatar, Iran, Kuwait, Oman and Jordan. Hassan estimates that six to eight field hospitals will be ready “soon.”

Though Lebanon has only confirmed 5,062 coronavirus cases and 65 related deaths, according to data from Johns Hopkins University, pandemic-related restrictions have further exacerbated the country’s deep and long-running financial crisis.

Power outages are common in the capital, compounding pressures on basic services to provide for the injured.

Tuesday’s explosion in the Lebanese capital resulted in an estimated US$3-5 billion worth of damage, Beirut governor Marwan Abboud told reporters Wednesday.

Prime Minister Diab has launched an investigation into the blast, saying he “will not rest until we find those responsible for what happened, hold them accountable, and impose maximum punishment.”

Ammonium nitrate is a highly volatile material that’s used in agricultural fertilizer and high-grade explosives. Two US tons of the chemical was used in the 1995 Oklahoma City bombing, a domestic terror attack that killed 169 people. Following Tuesday’s explosion, the United States Embassy in Beirut urged those in the area to “stay indoors and wear masks if available” due to reports of toxic gases released from the blast.

However, Anthony May, a retired ATF explosives investigator for the US government, said that the bright or dark red cloud seen in videos of the blast “is not consistent with ammonium nitrate.” The telltale sign of the compound would be a yellow smoke cloud, he said.

“I’m not saying that ammonium nitrate was not involved in this, it may have been but it appears that there were other items in there as well,” May said.

The amount of explosives and the shockwaves created by the blast, May said, “is typical of what would be equivalent to a kiloton nuclear bomb going off as far as the explosive weight is concerned.”

“There was no nuclear material that we know of involved in this, but the shock wave generated, the blast wave generated is at equivalent to a small nuclear device,” May said.

Adding to the confusion of what caused the incident, US President Donald Trump offered sympathy and assistance to the people of Lebanon, referring to the incident as a “terrible attack.”

Other world leaders, including from Israel, the United Kingdom, France, Turkey, UAE, Jordan, Kuwait, Qatar, Russia and Spain have offered support and humanitarian medical assistance to Lebanon.

Apocalyptic scenes akin to ‘Hiroshima’

The explosion, which happened just after 6 p.m. local time (11 a.m. ET), tore through the city and wreaked havoc on nearly all of Beirut’s quarters, registering as a 3.3 magnitude earthquake in the Lebanese capital.

Footage captured the injured staggering through streets in the capital; and ambulances, cars and military vehicles packed with the wounded.

One resident said the scenes looked “like an apocalypse,” another said the port was “totally destroyed.”

“You can see injured people all over the streets in Beirut, glass all over the place, cars are damaged,” said Bachar Ghattas, another resident. “It is very, very frightening what is happening right now, and people are freaking out. The emergency services are overwhelmed.”

The official residence of Lebanon’s President, the headquarters of former Prime Minister Saad Hariri, and CNN’s bureau in downtown Beirut were damaged. Homes as far as 10 kilometers (6 miles) away were also damaged, according to witnesses.

The city’s governor Marwan Abboud said the scene reminded him of the atomic bomb blasts at the end of the Second World War in “Hiroshima and Nagasaki.”

“In my life I haven’t seen destruction on this scale,” Abboud said. “This is a national catastrophe.”

Hospitals in Beirut were overwhelmed with the wounded and doctors conducted triage on dozens of injured people in car parks and sidewalks. Some were so full they were turning people away, one witness said.

“The emergency room looked like a war had begun, the children — their hands, their legs, I couldn’t believe what I was seeing,” said Serge Mahdessian, a hairdresser in Beirut.

Open lots turned into makeshift field hospitals as people pulled themselves and their loved ones out of the rubble of their homes. Some had broken limbs, others had been showered with shards of glass. Some patients were unconscious. One of Beirut’s major hospitals, Hotel Dieu, received around 400 injured patients, an employee told CNN.

The Philippine Embassy in Beirut on Wednesday confirmed that two of its citizens died in the explosion. Eight other Filipinos suffered injuries, including one in critical but stable condition. Two of the injured were part of a group of 13 Filipino seafarers whose ship was docked “some 400 meters away from blast zone,” said the Embassy, who added that the other 11 have been reported as missing.

Australian Prime Minister Scott Morrison said at least one Australian was killed in the blast and the Australian Embassy building has been “significantly compromised.”

Among the injured are six Turkish citizens, a Chinese citizen, a Japanese national and an Indonesian, according to their respective governments. South Korea’s foreign ministry said its embassy in Beirut sustained minor damage but had not received any reports of South Korean victims.