Iran fired a new wave of missile attacks on Israel early Monday, triggering air raid sirens across the country as emergency services reported at least three killed and dozens more wounded in the fourth day of open warfare between the regional foes that showed no sign of slowing.

Nineteen Israelis have been reported killed in Iranian attacks since Friday, while Iran’s health ministry says 224 have died in Israeli strikes.

At least 34 people were injured, including two critically, following Iran’s missile strike on Israeli territory on Friday. Israeli emergency teams confirmed that multiple buildings in the Tel Aviv metropolitan area,