The death toll from flooding in Brazil has risen to 20 as thousands of people continue to remain without somewhere to live.

The deadly flooding was caused by heavy rainfall that began back in November. The flooding, which was expected to ease this week, impacted about 40 cities in the northeastern state of Bahia. More than 35,000 people have had to escape their residences to find safety on higher ground. So far, at least 358 people have been injured, according to CNN. On Sunday (Dec. 26), two dams in the northeastern cities of Itambe and Jussiape broke, causing the flooding to worsen.

“This is a massive tragedy,” said Gov. Rui Costa of Bahia. “I can’t remember seeing anything like this in Bahia’s recent history, given the amount of cities and houses involved. It’s truly terrifying, there are so many houses and streets that are completely under water.”

Costa also warned people about what’s to come as they deal with the effects of the flooding amid the pandemic. “We have the natural disaster and we have two pandemics happening at the same time: The Coronavirus pandemic and the flu virus — which have affected the entire country,” he said.

Some cities, such as Itororó, have now lost all of their medicines and COVID-19 vaccinations due to the natural disaster. On Tuesday (Dec. 28), Costa traveled to the municipality to survey the damage. He told reporters that their biggest focus was to restock medicines, vaccines “and supplies necessary to provide medical care.”

Relief efforts are now underway as rescue members are trying to maneuver through the floodwaters with jet skis. Costa said they are trying to save people who are trapped on top of their homes. The governor also stated that mattresses, food and warm clothing would be distributed to those in need.