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"Everybody's going to know people who are dead," said CNN iReporter Zach Tusinger, who said his aunt and uncle died in the tornado. "You could have probably dropped a nuclear bomb on the town and I don't think it would have done near as much damage as it did."
As many as a quarter of the buildings in the southwest Missouri city suffered major or significant damage, fire and emergency management officials said.
Parts of the city were unrecognizable, according to Steve Polley, a storm chaser from Kansas City, Missouri, who described the damage from the Sunday night tornado as "complete devastation."
Joplin Fire Chief Mitch Randles said he believes people were still trapped in buildings Monday morning. Authorities warned the death toll was likely to rise.
Complicating the situation, broken natural gas lines were causing fires throughout the city, and a new round of severe weather was bearing down on the city of 50,500.
The tornado struck about 6 p.m. Sunday. It demolished the 1,800-square-foot house that the Rev. C.J. Campbell and his foster sister were in when the storm hit. He called the tornado an "evil monster vortex."
It began as a low roar, he said.
"Then it got louder and louder until it sounded like about 50 semi tractor-trailer trucks fully laden going about 70 miles per hour about 10 feet outside the front door," he said. "The floor began to vibrate and then shake very violently and seemingly buckle and we thought we were going to be sucked up the chimney."
President Barack Obama ordered Federal Emergency Management Agency Administrator Craig Fugate and an incident management team to Joplin to coordinate federal disaster relief assistance efforts, White House spokesman Nicholas Shapiro said Monday.
Obama also called Gov. Jay Nixon to "personally extend his condolences and to tell all of the families of Joplin affected by the severe tornadoes that they are in his thoughts and prayers," Shapiro said.
Nixon dispatched a specialized search-and-rescue team to the city, along with 140 National Guard troops and state troopers from other parts of the state. City officials said they were being supported by at least 40 public safety agencies from Kansas, Arkansas, Oklahoma and Missouri.
Mike O'Connell, spokesman for the Missouri Department of Public Safety, said Sunday night that authorities were trying to get additional search-and-rescue teams to the area.
"The priority is to get every available resource there ... as quickly as possible," O'Connell said.
The Red Cross has established a shelter at Missouri Southern State University in Joplin and was offering shuttle service to bring people there, city spokeswoman Lynn Onstot said.
The tornado struck along Rangeline Road, the main commercial strip in the city. It affected both commercial and residential areas, she said.
Aerial footage from CNN affiliate KOTV showed houses reduced to lumber and smashed cars sitting atop heaps of wood. Some structures were engulfed in flames.
"The particular area that the tornado went through is just like the central portion of the city, and it's very dense in terms of population," Joplin Emergency Management Director Keith Stammer said on CNN's "American Morning."
St. John's Regional Medical Center in Joplin was hit directly by the tornado and suffered significant structural damage, city officials said. CNN affiliate KSHB said there were reports of fires throughout the hospital.
One facade of the building made of glass was blown out, and authorities evacuated the medical center, said Ray Foreman, a meteorologist with CNN affiliate KODE in Joplin. Makeshift triage centers were set up in tents outside, witness Bethany Scutti said.
Patients were being moved to Springfield, Missouri and other medical centers, officials said.
Residents 70 miles away from Joplin in Dade County, Missouri, found X-rays from St. John's in their driveways, said Foreman, indicating the size and power of the storm. Gurneys were blown several blocks away.
Stores including a Home Depot and Wal-Mart were severely damaged.
"I remember at one point walking around the Wal-Mart to the south and seeing the area that used to be Home Depot, and just standing there not knowing what to think or do," said CNN iReporter Andrew Boyd.
The storm also overturned as many as a dozen tractor-trailers on Interstate 44 as it barreled through the town, a major trucking center. The interstate, shut down for nearly 12 hours, reopened Monday morning, according to Mike Watson with the Missouri State Highway Patrol. No motorists were severely hurt, he said.
Amber Gonzales was driving through southwest Missouri when she heard tornado warnings on the radio. She took refuge at a gas station before getting back on the road and seeing the aftermath of what she narrowly missed.
At a shopping center, she saw people pulling people from rubble and rushing them to the hospital as overwhelmed emergency workers were unable to reach everyone in need.
"I saw an older woman taken on the back of a truck bed, speeding down the road," Gonzales said. "I can't get the lady out of my mind. ... I don't know if she made it."
The tornado caused significant damage to several Joplin schools, including Joplin High School, whose seniors were scheduled to graduate Sunday afternoon at Missouri Southern, according to the school district's Facebook page. The district canceled all classes for Monday as officials evaluated the situation, according to a posting on the page.
Pastor Jim Marcum of Citywide Christian Fellowship church said he was delivering a sermon to about 100 people when a man jumped in and said, "It's coming this way."
"I didn't know which was louder, us praying or the wind outside," Marcum said late Sunday. He said those inside the church could feel the pressure of the wind.
After the storm left, church members went out to help.
"Every time people would leave and go out to help as part of a search and rescue, people would return and they would be emotional," Marcum said. "We have one couple still at the church late into the night because their home was completely destroyed. They don't have a home to go to."
The tornado was part of a line of severe weather that swept across the Midwest on Sunday, prompting tornado watches and warnings that stretched from Wisconsin to Texas. High winds and possible tornadoes struck Minneapolis and other parts of Minnesota, leaving at least one person dead and injuring nearly two dozen others, police said.
Elsewhere, reports of tornadoes came in from Forest Lake, north of the Minneapolis-St. Paul area, and near Harmony, more than 120 miles to the south. In Minneapolis, witnesses reported numerous downed trees and neighborhoods without power.
Minneapolis police spokeswoman Sara Dietrich said the storm left one fatality, with 22 people reported hurt.
LeDale Davis, who lives on the north side of Minneapolis, told CNN, "This is the first time we can remember a tornado touched down in this area. They aren't usually in the heart of the city."