At least two adults died when a bus carrying high school students from Long Island, New York, crashed while heading to band camp in Pennsylvania, state police said.
Dozens were hurt in Thursday's rollover accident in Orange County, which is about 60 miles north of New York City, officials said.
As of midday Friday, 18 people -- 16 children and two adults -- remain hospitalized, according to Nassau County Executive Bruce Blakeman.
Five students remain in critical condition, state police said on Friday.
The bus, carrying students from Farmingdale High School, rolled over and slid off Interstate 84, down into a 50-foot ravine around 1:12 p.m. on Thursday, New York Gov. Kathy Hochul said.
Multiple occupants were ejected from the motor coach, National Transportation Safety Board investigator John Humm told reporters on Friday.
The motor coach, operated by Regency Transportation, "departed the travel lane, penetrated a roadside cable barrier and came to a rest on its left side in the median," Humm said.
The two adult passengers, identified as Beatrice Ferrari, 77, from Farmingdale, New York and Gina Pellettiere, 43, of Massapequa, were killed, state police officials said.
"There's a lot of families that need some love tonight. And we extend that from 20 million New Yorkers," the governor said.
Pellettiere was listed as the school's Director of Bands on its website. She was the chairperson of the Nassau All-County Division 5 Symphonic Band for many years, as well as guest conductor for both Nassau and Suffolk All-County Festivals, according to the school's website.
She leaves behind a 2-year-old son, a family friend told reporters on Friday.
A faulty front tire was a factor in the crash, the governor and investigators said. The investigation is ongoing.
The National Transportation Safety Board is investigating the crash. Investigators will look at seatbelt usage, the mechanics of the bus and its "general crashworthiness," among other factors, Humm said.
A total of 40 students and four adults were aboard the bus, according to the state police.
"It really was a difficult scene to process," New York State Police's Greg Spak, who has been a state trooper for more than 20 years, told reporters Friday. "I've never seen anything like that before."
Spak said some of the children were "extremely hurt" and he felt an urgent sense to get them to help "right away."
Hochul said that it took 45 minutes for first responders to get all of the victims out of the ravine.
"These high school students, many of them freshmen, were surrounded by this chaos, but they endured. They were strong," she said.
Farmingdale School District officials were at the scene, the district said.
Five other buses from the school that were traveling to the camp returned to Farmingdale, but made a stop on the way to give students the chance to meet with grief counselors, the district said.
Donna Baltch, a Farmingdale resident, told WABC that her niece was on one of the buses that returned. Baltch, who is also the parent of a Farmingdale High School 10th grader, said she and other parents spent the afternoon trying to figure out what happened and support each other.
"These poor kids, these kids are going to be traumatized for the rest of their lives," Baltch told WABC. "All the families, we always, always come together for each other. I don't care if it's 3 o'clock in the morning, I will be there for these kids."
Farmingdale High School is open today, which Blakeman called a "very good and wise choice because they have so many good resources there for the children and the families."
"It was a way to bring the high school community together," he said at a press briefing Friday.
Additional counseling will be provided at the Howitt Middle School over the weekend and Farmingdale High School next week.
The Farmingdale-Freeport high school football game scheduled for Friday night is postponed with no makeup date announced.