At least 26 people died and 20 others were injured Sunday when a gunman opened fire at a church in a small town southeast of San Antonio, officials say.

The incident occurred at the First Baptist Church in Sutherland Springs, Texas, a small community located in Wilson County about 30 miles away from San Antonio. The gunman, identified by two law enforcement officials as 26-year-old Devin Kelley, is now deceased, but it remains unclear how he died.

Multiple victims with gunshot wounds were being treated at the Connally Memorial Medical Center, a representative for the hospital told TIME. She could not give further details on their conditions.

Four patients were later transferred to University Hospital in San Antonio for higher-level care, hospital spokesperson Megan Posey told AP. Another eight victims were taken by medical helicopter to the Brooke Army Medical Center.

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