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A powerful earthquake shook central Italy overnight, killing at least 37 people, according to reports, and destroying large swathes of several towns. Victims are still being pulled from the rubble and the full extent of the devastation is not yet clear.

The U.S. Geologic Service estimates that the quake, which was centered about 100 miles northeast of Rome, had a magnitude of 6.2.

Amatrice, Accumoli and Pescara del Tronto, in the Apennine mountains, are among the hardest-hit towns. They’re small in size but popular as tourist destinations.

“A lot of the officials are lamenting that these are tiny towns but their populations swell in the summer, specifically because they are very sought-after vacation getaways,” Associated Press reporter Nicole Winfield told NPR.

“So the tiny town of Accumoli … the mayor said is only a population of 700 but it swells to about 2,500 in the summer,” she says, raising concerns about high casualty numbers.

The towns in the region are old, and some have been “completely razed,” Winfield says: “The buildings are old and they just crumbled.”

The earthquake struck just after 3:30 a.m. local time on Wednesday morning, Christopher Livesay reports for NPR.

“One of the town worst-hit is Amatrice,” Livesay reports from Rome. “The mayor says half the town ‘doesn’t exist’ anymore, and that all roads to and from have been cut off.”

Reports collected by the USGS show that the impact of the quake was felt from coast to coast in central Italy, and as far north as Bologna and as far south as Naples.

Hundreds of people have been injured and thousands of people need temporary housing, The Associated Press says, citing Italy’s civil protection agency.

Rescue crews are still trying to access some of the quake-damaged communities; roads are impassable in some regions.

The Associated Press reports that in the city of Amatrice, the air was choked with dust and thick with the smell of gas:

“Rocks and metal tumbled onto the streets and dazed residents huddled in piazzas as some 39 aftershocks jolted the region into the early morning hours, some as strong as 5.1.

” ‘The whole ceiling fell but did not hit me,’ marveled resident Maria Gianni. ‘I just managed to put a pillow on my head and I wasn’t hit luckily, just slightly injured my leg.’

“Another woman, sitting in front of her destroyed home with a blanket over her shoulders, said she didn’t know what had become of her loved ones.

” ‘It was one of the most beautiful towns of Italy and now there’s nothing left,’ she said, too distraught to give her name. ‘I don’t know what we’ll do.’

“As daylight dawned, residents, civil protection workers and even priests began digging out with shovels, bulldozers and their bare hands, trying to reach survivors.”

The Apennine mountains are “tectonically and geologically complex,” the USGS writes, and the region has experienced several major earthquakes.

In 2009, a major earthquake hit near the city of L’Aquila, not far from Wednesday’s quake.

The 2009 earthquake killed 300 people. Afterwards, seismologists were convicted of manslaughter for having said, days before the quake, that it was improbable a large quake was imminent. Their statement was in response to a widely publicized earthquake prediction by a layperson.

The convictions, which were criticized by scientists who said there is simply no reliable way to predict earthquakes, were later overturned.

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