CHONGQING, China—The people of this city stood stock-still and bowed their heads for three minutes of silence beginning at 2:28 P.M. local time this afternoon, solemnly observing the one-week anniversary of the earthquake that the government estimates has killed nearly 35,000 people in Sichuan Province and injured nearly 250,000. Drivers honked their horns in solidarity as sirens and horns blared to mark the somber occasion.

Nearly 4,000 villages and cities have been affected by the quake, including this city of 30 million to the east of the epicenter. But few have been as hard hit as Mianzhu City where at least 1,500 have been killed and 10,000 remain missing. Nearly every building surrounding the city has collapsed and the streets are a tangled wreck of ruptured roads, rubble, among which survivors and soldiers live and work. And those buildings that are still standing are unsafe. "Not all crash down but those that do not, people cannot live in it," says Wave Chu, a Chongqing resident who grew up in the area.

Chu's parents were working in the fields when the earthquake struck last Monday "so they were not injured." But they now live in a small tent because their house was destroyed (more than 4.8 million people have lost their homes in Sichuan) and drink water that soldiers treat daily with antibiotics to kill bacteria.

Preventing an outbreak of disease among survivors has become a top priority as hope for victims not already found in the rubble dwindles to nil. Rescuers continue to comb through the debris, including spelunkers who are using cave-rappelling techniques to search shafts and other cavities. Many refugees and injured victims discovered so far have been evacuated to Chongqing for treatment or to stay with relatives in relative safety.

But this city can also feel the aftershocks, the most recent of which struck Saturday night, setting buildings swaying and inflicting more fear in survivors. "The earthquake has changed my attitude," says He "Jane" Jia, a lifelong resident of Chongqing. "When I see the people with nothing, not knowing whether their family is okay, I feel very lucky."

Of course, the earthquake has also shattered infrastructure throughout Sichuan and adjacent regions as well as imperiled everything from dams to nuclear facilities. Military officials said that the nuclear facilities have been shut down safely, though it remained unclear whether any had suffered damage.

Officials are still checking the dams and reservoirs in the region for damage but no overflows have been reported. And environmental officials have stated that there has been no impact from damage at various chemical facilities in the region.

But the psychological impact of such devastation will linger, and all of China has seen an outpouring of support and donations for victims, totaling more than $1.5 billion (10.8 billion yuan), according to the Xinhua News Agency. "We have raised 150 yuan ($21.50)," teacher Luo "Bonnie" Hua Yan told me in the village of Liming in Yunnan Province on Saturday. "It is not so much but we want to do something."

That money is needed to provide food, water, shelter and clothing to the millions of refugees. It is also being used to help resettle the thousands of children orphaned by the quake. "Many people want to adopt, and orphans have been sent all over the country," Chu says.

And that money will be needed when it is time to rebuild these shattered cities and villages. "I think [the government and people] will begin to rebuild in a month," Chu adds. "They are very busy right now rescuing people."

The earthquake damaged schools, hospitals, roads, railway lines, factories, chemical plants, power lines and dams. Many survivors are sleeping outdoors for fear of aftershocks—a powerful one that measured 6.1 on the Richter scale ripped through the province on Tuesday.

Additional aftershocks have wreaked further havoc, including the collapse of a middle school in the Sichuan city of Dujiangyan that trapped 900 children. Just east of the epicenter, 1,000 students and teachers were reportedly killed or missing at a collapsed high school in Beichuan County. China's Premier Wen Jiabao flew to the province Monday to direct disaster relief efforts and troops were dispatched to the area to help.

This earthquake was the worst to hit China since 1976, when a magnitude 7.5 temblor struck the northern Chinese city of Tangshan, leaving 240,000 dead. Despite decades of effort since then, seismologists still have not settled on a reliable  early warning system for such deadly quakes, though systems are used in Japan and Europe. Nevertheless, Chinese media have included anecdotal reports of unusual swarms of toads in the region immediately prior to the devastating quake.