At least 131 people were killed and hundreds more injured after an earthquake hit northwest China, state media reported Tuesday, as rescue teams scrambled to reach survivors in sub-zero temperatures.

The quake, China’s deadliest in nearly a decade, rocked Jishishan county in Gansu province late Monday night, destroying homes, damaging roads and knocking out power and communication lines. Rescuers raced to search for survivors trapped under rubble, while residents rushed outdoors, huddling overnight in the bitter winter cold.

As of Tuesday morning, the quake has killed 113 people and injured 772 others in Gansu, state broadcaster CCTV said. Nearly 15,000 houses collapsed and tens of thousands of people had to be evacuated, according to the broadcaster.

In the neighboring province of Qinghai, 18 people have died and 198 were injured, with 16 more others missing, according to local officials.

The quake struck just before midnight while many would have been sleeping in their homes. It measured 5.9-magnitude at the shallow depth just over 6 miles, according to the United States Geological Survey. The China Earthquake Networks Center (CENC) gave a slightly higher reading of 6.2 magnitude.

The epicenter is located close to the border between Gansu and Qinghai, a mountainous region on the eastern edge of the Tibetan plateau. The quake was followed by nine aftershocks at magnitude 3 and above as of Tuesday morning, according to the CENC.

Electricity was restored in Gansu and Qinghai provinces, CCTV reported Tuesday. It is crucial to the areas amid the current need for heating.

Forecasts suggest temperatures could dip to as low as -19 degrees Celsius (-2.2 degrees Fahrenheit) in certain parts of the area affected by the earthquake over the next three days, according to the China Meteorological Administration.

The initial tremors lasted nearly 20 seconds and were felt in the provincial capital of Lanzhou 102 kilometers (63 miles) away, CCTV reported.

University students in Lanzhou shared photos on social media site Weibo of crowds gathering outside their dormitories.

A student at Lanzhou University said when the quake struck, she went to hide in the bathroom with her roommates, before running down 12 floors amid violent shakes.

“I’ve never felt such strong tremors,” she wrote in a Weibo post. “Wearing a down jacket, long underwear, and bare feet in slippers outdoors, where the temperature is lower than –10 degrees Celsius, (I’m) shivering with everyone.”

Some village homes in Gansu and Qinghai have collapsed into rubble, with firefighters pulling survivors out of the debris in the dark, footage from CCTV showed.

The quake initially also cut off water and electricity supply as well as cell phone signals in some areas, complicating rescue efforts.

At least 4,000 firefighters, police officers and soldiers have been dispatched to the disaster zone in Gansu, along with thousands of tents, folding beds, quilts and portable fire pits, according to provincial officials.

Bitter temperatures

In the epicenter of Jishishan, a county home to about 260,000 people, many rushed out of their homes to seek safety in open areas. Videos and images on state media and social media show families huddling together and wrapped in thick blankets on a public square.

A villager in Jishishan said she didn’t have time to put on extra clothes and ran out barefoot, rushing past bricks and glass shattered on the ground.

“There was a loud ‘boom’ and the wall on the second floor collapsed. (I was) nearly hit and trapped inside,” the villager told Jiupai News, a site affiliated with the state-run Changjiang Daily.

Authorities have set up tents at a temporary resettlement site on a square in Dahejia, a hard-hit town in Jishishan county, CCTV reported.

The lowest temperature in Jishishan was -14 degrees Celsius, or 6.8 degrees Fahrenheit, overnight, according to CCTV.

The below-freezing temperatures pose the “biggest challenge” to rescue efforts, Wang Duo, an expert involved in the rescue, told the state-run outlet China Newsweek. The first 72 hours are usually considered the “golden period” for rescue, but that precious window is shortened in this case due to the biting cold, Wang said.

Large swathes of China, including its northwest, have been gripped by a sudden cold snap in recent days, with temperatures plunging to near historic lows in some northern areas.

Chinese leader Xi Jinping on Tuesday urged authorities to “make all-out efforts” to search for survivors and treat the injured, noting the disaster took place in a high-altitude area with cold weather, according to Xinhua.

China’s Finance Ministry and Emergency Management Ministry allocated 200 million yuan ($28 million) in natural disaster relief funds to the two provinces hit by the quake, Xinhua reported.

China is no stranger to powerful quakes, especially in southwestern parts of the country where the Eurasian tectonic plate meets the Indian plate, a dramatic collision that creates the mighty Himalayas and the vast Tibetan plateau.

The quake is the deadliest to hit China in nearly a decade, according to publicly available reports, since an earthquake in the southwestern province of Yunnan killed around 600 people in 2014.

Yunnan’s neighboring province, Sichuan, witnessed a devastating magnitude 7.9 earthquake in 2008 that killed some 90,000 people.