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Fire officials have issued evacuation orders and warnings around Lake Tahoe Basin as the massive Caldor Fire continues to rage in Northern California, burning more than 177,000 acres and forcing one hospital there to begin evacuating patients. 

“Today has been a rough day. There’s no bones about it,” Jeff Marsolais, the supervisor of El Dorado National Forest, told reporters Sunday. “I think the team is doing an excellent job of trying to stay in front of a very evolving fire. Today, it let loose.”

The Caldor Fire, which is 14% contained, has destroyed more than 470 structures and damaged 39 others, according to CalFire. More than 3,500 firefighters are working to control the blaze, which left five people injured. 

Fire officials issued mandatory evacuations in El Dorado and Alpine counties on Sunday. Over 24,000 residents have been told to evacuate near Highway 50, which connects Sacramento and South Lake Tahoe. 

“To put it in perspective, we’ve been seeing about a half-mile of movement on the fire’s perimeter each day for the last couple of weeks, and today, this has already moved at 2.5 miles on us, with no sign that it’s starting to slow down,” Eric Schwab of CalFire said in a news conference Sunday.

The Barton Memorial Hospital in South Lake Tahoe was forced to close its doors and transfer all patients to partner hospitals. “Barton Memorial Hospital is now closed due to the ongoing threat of the Caldor Fire,” the hospital tweeted Sunday. “All patients have been transferred to regional partner facilities.”

Meanwhile, the Dixie Fire, the largest wildfire in the state, has burned more than 771,000 acres and was 48% contained as of Monday, CalFire said.

Tahoe is a popular tourist destination, where several resorts were forced to close. “Tourists should be gone,” said Chief Clive Savacool of South Lake Tahoe Fire. “If anybody is still here as a tourist, they need to pack up and leave. Anybody who doesn’t have to be in South Lake Tahoe needs to get out now.”