The heat wave sweeping Pakistan’s southern province of Sindh since Saturday has continued to claim lives, with hundreds more dying on Monday, taking the total death toll to 445.

Heatstroke claimed 309 lives, 301 of which were in the provincial capital and country’s largest city, Karachi, the Dawn newspaper reported. The city’s temperature on Monday remained high at 43°C, with light rain in some areas not enough to lessen the impact of the heat wave.

Hundreds of others remained under treatment in various hospitals across the city, with the government declaring a state of medical emergency. Dr. Salma Kauser, senior director for medical and health at the Karachi Metropolitan Corporation (KMC), told Dawn that more than 400 people were undergoing treatment at KMC-run hospitals.

The effect of the unbearable heat was worsened by repeated power outages, with infuriated citizens staging protests against the government in several parts of the city. Protesters clashed with police, burning tires and stoning police vehicles, according to local news outlet Pakistan Today. The outrage extended to Pakistani netizens as well, with Vocativ reporting that over 3,000 tweets went out on Monday with the hashtag #KarachiWeepsGovtSleeps.

A spokesman for the Edhi Foundation, a nonprofit focused on social welfare, said the organization’s morgue was struggling to accommodate all the heat-wave victims and had to deny many families because of lack of space.

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Write to Rishi Iyengar at rishi.iyengar@timeasia.com.