Syrian President Bashar al-Assad has launched one of the bloodiest bombing campaigns against anti-government rebels the country has seen in the past three years, killing nearly 200 people in just three days — and it may be just the beginning.

The Syrian Observatory for Human Rights, a pro-opposition monitoring group based in the UK, says 194 people, including 52 children and 29 women, have been killed and hundreds more injured in three days of attacks on Eastern Ghouta, a rebel-held suburb of Damascus.

The Syrian state news agency SANA reports that rebel forces have responded to the bombings with mortar attacks, killing eight people, including three children.

But the worst may still be to come: SOHR told the Associated Press that pro-government forces have brought in reinforcements in the past few days and that a larger offensive by the Assad regime may be coming. A video showing the commander of an elite Syrian military force threatening an attack has also been circulating on pro-Assad social media accounts in recent days, according to the New York Times.

“I promise I will teach them a lesson, in combat and in fire,” Gen. Suheil al-Hassan, commander of the elite Tiger Forces, says in the video. “You won’t find a rescuer. And if you do, you will be rescued with water like boiling oil. You’ll be rescued with blood.”

Closing off supply routes and repeatedly conducting bombing and missile attacks was a similar tactic used by the Russia-backed Assad regime during the retaking of Aleppo, one of the largest cities in Syria that was once under rebel control.

The Syrian government has denied that it is preventing humanitarian organizations from entering Eastern Ghouta. However, the Syrian government has complete control over who is allowed to enter and who is not. The United Nations has made only one delivery to the regions since November 2017, according to a UN official.

After Assad recaptured Aleppo in December 2016, Eastern Ghouta became one of the final key areas held by the rebels — and it could now be facing a similar fate as Aleppo.

More than 800 people were killed and 3,500 injured in Assad's final efforts to retake Aleppo, according to a report shortly before the city was retaken.

These attacks could cripple the struggling region

Panos Moumtzis, the UN regional humanitarian coordinator for the Syria crisis, said in a statement Monday that there are nearly 393,000 people currently living in Eastern Ghouta and that these recent attacks could dramatically impact the delivery of humanitarian aid, which is already nearly nonexistent.

“Overall access to East Ghouta remains woefully inadequate,” Moumtzis said in the statement. “No convoys were undertaken in December and January due to limited access,” he added, and “just one convoy was allowed to the town of Nashabieh on 14 February.”

Moumtzis called for the attacks to stop and went on to say that this lack of aid delivery has led to food shortages and extreme increases in food prices. As an example, he said the price for bread in the area is 22 times Syria’s national average.

After a seven-year war, Assad continues to gain control of the country

The war in Syria began in March 2011 when Syrian citizens attempted to overthrow the government led by Bashar al-Assad after security forces fired on and killed anti-Assad protesters in the streets of Deraa.

More than 5 million people have fled Syria since the war began, and 6.1 million more are currently internally displaced within the country, according to the United Nations High Commissioner for Refugees.

The Assad regime has been criticized by the international community in the past for the use of chemical weapons and violations of human rights. President Donald Trump directly attacked Assad targets in April 2017 after reports that Assad had used chemical weapons on civilians.

In January, Secretary of State Rex Tillerson condemned Assad’s actions and said, "A stable, unified, and independent Syria ultimately requires post-Assad leadership in order to be successful."

Despite these actions and outcries, Assad continues to gain control of the country with the support of Russia and Iran.