UPDATED at 5:40 a.m. with death toll at 89; at 6:10 a.m. with information from fire chief.
JOPLIN, Mo. • A massive tornado that tore through the southwest Missouri city of Joplin killed at least 89 people, but authorities warned that the death toll could climb Monday as search and rescuers continued their work at sunrise.
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.
An unknown number of people were injured in the storm, and officials said patients were scattered to any nearby hospitals that could take them.
A door-to-door search of the damaged area was to begin Monday morning, but authorities were expected to move gingerly around downed power lines, jagged debris and a series of gas leaks that caused fires around the city overnight.
"We will recover and come back stronger than we are today," Rohr said defiantly of his city's future.
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Gov. Jay Nixon activated the National Guard and declared a state of emergency Sunday night. His office said that state and local law enforcement agencies were coordinating search and rescue and recovery operations in the stricken areas.
Emergency management officials rushed heavy equipment to Joplin to help lift debris and clear the way for search and recovery operations.
Jasper County Emergency Management Director Keith Stammer said St. John's Hospital on the city's south side had taken a "direct hit." He said there were multiple reports of injuries from the twister, which struck about 6 p.m. Sunday.
Cora Scott, a spokeswoman at the hospital's sister facility, St. John's Hospital in Springfield, said the tornado had hit a patient wing in Joplin.
Hundreds of windows were blown out at the hospital, where a few moments' notice gave staff time to hustle patients into hallways before the tornado struck the building. The patients were evacuated into the parking lot to be moved to other hospitals in the region.
The storm spread debris about 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.
Stammer said emergency responders were conducting search and rescue operations. The Joplin Globe reported that widespread damage could be seen along the city's most densely built commercial strip.
The paper cited catastrophic damage to Joplin High School, as well as major damage to an elementary and middle school in town.
Angie Besendorfer, assistant superintendent of the Joplin School District, said the twister damaged Joplin High, Cecil Floyd Elementary, Franklin Technology Center and the central office building. Some of the schools that escaped damage were being opened as shelters.
The high school graduation had been held at Missouri Southern State University in the afternoon. Many people barely got home before the twister hit.
There also were broadcast reports of damaged businesses and vehicles overturned on highway entrances elsewhere around or near the city. The roofs of two city fire stations collapsed.
The American Red Cross opened a shelter at Missouri Southern for people left homeless by the tornado. Red Cross shelter manager Perry Elkins said people were already waiting at the university's Leggett & Platt Athletic Center as he drove up about 11 p.m.
In addition to food and cots, the Red Cross had mental health counselors on hand at the shelter.
Missouri Southern and the regional Red Cross chapter signed an agreement just three weeks ago to work together in emergency preparedness and response.
President Barack Obama said the Federal Emergency Management Agency was working with state and local agencies in response to a tornado. He also issued a statement Sunday night sending condolences to families of those who died in storms in Joplin and others across the Midwest.
Earlier in the day, a weak tornado began to form near Higginsville, Mo., and dissipated just as it hit the town of Waverly, said National Weather Service meteorologist Andy Bailey. The twister caused minor damage to trees and removed the roof of a mobile home, Bailey said.
Waverly is about 55 miles east of Kansas City in Lafayette County.
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