Dozens of buildings collapsed and streets were buried in rubble, raising the likelihood that perhaps thousands of additional victims have not yet been discovered.
But a continuing series of aftershocks have followed the quake, which struck around 11:40 a.m. local time, and additional damage is expected.
Deaths also have been reported in Kalkota, neighboring India’s second-largest city, and in Tibet, according to Cable News Network (CNN).
The quake also reportedly caused avalanches on Mount Everest and that climbers on the world’s tallest peak were killed.
The United Nations Office for the Coordination of Humanitarian Affairs said 4.6 million people have been exposed to the quake and the aftershocks that followed, and that 30 of the country’s 75 districts were affected, CNN said.
Survivors reported feeling violent shaking for a very long time, and the U.S. Geological Survey said the quake was shallow and more damaging than a more-typical deeper quake.
Freelance photographer Thomas Nybo said he was in a coffeeshop in Kathmandu’s Temal district when the shaking started and grew steadily in intensity.
Nybo said thousands of people fled buildings and crowded into the streets of Temal, a tourist hub.
Nybo said a nearby building where locals went to get water and do laundry had collapsed, but that they could hear a voice from the rubble.
“A group of mainly tourists started gathering rocks, hammers and pickaxes and breaking through a re-enforced concrete wall to reach this guy,” Nybo said, “it took about two hours of smashing through wall and cutting rebar with a hacksaw to pull him out alive.”
“Who knows how many other bodies lie beneath the rubble?” he said.
Power was reportedly out across the city and there was no running water, CNN said.
Devendra Tak of the aid agency Save the Children said international help was needed immediately because there was little shelter for survivors.
“With every minute, the situation becomes worse,” Tak said.
U.S. Secretary of State John Kerry said the United States would provide $1 million in assistance to Nepal immediately and was dispatching disaster response teams to the region.
“To the people in Nepal and the region affected by this tragedy we send our heartfelt sympathies,” Kerry said in a written statement.
“The United States stands with you during this difficult time,” Kerry said.
Nepal’s historic Dharahara tower, which stood since 1832 and was a popular tourist attraction, had collapsed from the force of the quake.
India‘s prime minister, Narendra Modi promised help to survivors in his country and in Nepal and Tibet, CNN said.
“We are in the process of finding more information and are working to reach out to those affected, both at home & in Nepal,” Modi said on the social media website Twitter.
