Rescue experts, on Wednesday, said the survival window for those trapped under the rubble or otherwise unable to obtain basic necessities was closing rapidly as death toll surges to over 11,000.
At the same time, they said it was too soon to abandon hope for more rescues.
Turkey’s President, Recep Tayyip Erdogan, said the country’s death toll has passed 9,000.
The Syrian Health Ministry said the death toll in government-held areas has climbed past 1,200. At least 1,400 people have died in the rebel-held northwest, according to the volunteer first responders known as the White Helmets.
That brought the overall total to 11,600. Tens of thousands more are injured.
Erdogan visited the especially hard-hit Hatay province, where more than 3,300 people died and entire neighborhoods were destroyed. Residents there have criticized the government’s response, saying rescuers were slow to arrive.
Erdogan, who faces a tough battle for reelection in May, acknowledged “shortcomings” in the response to Monday’s 7.8 magnitude quake but said the winter weather had been a factor. The earthquake destroyed the runway in Hatay’s airport, further disrupting the response.
“It is not possible to be prepared for such a disaster,” Erdogan said. “We will not leave any of our citizens uncared for.” He also hit back at critics, saying ”dishonorable people” were spreading “lies and slander” about the government’s response.
Search teams from more than two dozen countries have joined tens of thousands of local emergency personnel in Syria and Turkey. But the scale of destruction from the earthquake and its powerful aftershocks was so immense and spread over such a wide area — including a region isolated by Syria’s ongoing civil war — that many people were still awaiting help.
“The first 72 hours are considered to be critical,” said Steven Godby, a natural hazards expert at Nottingham Trent University in England. “The survival ratio on average within 24 hours is 74%, after 72 hours it is 22% and by the fifth day it is 6%.”
Rescuers at times used excavators or picked gingerly through debris. With thousands of buildings toppled, it was not clear how many people might still be caught in the rubble.
In the Turkish city of Malatya, bodies were placed side by side on the ground, covered in blankets, while rescuers waited for vehicles to pick them up, according to former journalist Ozel Pikal, who said he saw eight bodies pulled from the ruins of a building.
Pikal, who took part in the rescue efforts, said he thinks at least some of the victims froze to death as temperatures dipped to minus 6 degrees Celsius (21 Fahrenheit).
“As of today, there is no hope left in Malatya,” Pikal said by telephone. “No one is coming out alive from the rubble.”
Road closures and damage in the region made it hard to access all the areas that need help, he said, and there was a shortage of rescuers where he was. Meanwhile, cold weather hampered the efforts of those who were there, including volunteers.
“Our hands cannot pick up anything because of the cold,” said Pikal. “Work machines are needed.”
Unidentified bodies were to be buried within five days after being photographed and undergoing DNA tests and finger printing, Turkey’s disaster management agency said. Islamic funeral rites prescribe quick burial.