At least 44 people have died during fighting between police and gunmen in the current anti-drug offensive in Kingston, Jamaica's ombudsman says.
The city has seen days of running battles between security forces and fighters loyal to a suspected drug trafficker sought by the US.
The whereabouts of alleged drug lord Christopher "Dudus" Coke is unknown.
Police, backed by armoured cars and helicopters, have detained 200 people and seized guns in the operation.
The latest death toll was announced by the ombudsman, Bishop Herro Blair, after an independent evaluation of the situation was requested by Prime Minister Bruce Golding.
At any cost
Meanwhile, the hunt through Kingston's Tivoli Gardens district for Mr Coke is ongoing. He has thousands of loyal followers in the area who have promised to protect him at any cost.
It is believed that some of the civilians were gunmen who were killed while defending Mr Coke, but correspondents say the high casualty figure does raise questions about the heavy-handedness of the operation, which has involved thousands of security officials.
Although police came under heavy fire when they first entered the area to try and arrest Mr Coke on Tuesday, correspondents said the situation on Wednesday was mostly quiet.
Police were going house-to-house searching for information about the alleged drug king-pin's whereabouts.
Earlier, Mr Golding said he regretted the loss of life in the recent violence, and vowed to restore order.
A state of emergency has been in place in parts of Kingston since Friday, when several police stations were attacked.
Since the state of emergency was declared, people have not been allowed out of their homes to get food, water or other essential supplies.
The Red Cross sent a team into the area with Mr Blair to ensure security forces were facilitating the distribution of emergency goods.
But the ongoing security crisis has prompted cricket authorities to shift international matches between the West Indies and South Africa scheduled for next month from Kingston to Trinidad.
Businessman or baron?
Mr Coke, 41, insists he is a legitimate businessman and enjoys the support of many impoverished Kingston residents who see him as a benefactor.
The US justice department accuses him of being one of the world's most dangerous drug barons.
He is said to lead a gang called the Shower Posse - owing to the volume of bullets used in shootings - and operate an international smuggling network.
He faces a life sentence if convicted on charges filed against him in New York.
The gang has also been blamed for numerous murders in Jamaica and the US.
The BBC's Matthew Price in Kingston says Dudus is seen by many there as a kind of Robin Hood figure.
That is why it is hard to see what happens next, our correspondent adds: The authorities are intent on capturing Dudus, while those loyal to him are intent on stopping that at whatever cost.
The latest trouble started last week when Mr Golding said he was prepared to send Mr Coke to the US on drugs and weapons trafficking charges.
The decision reversed nine months of opposition to his extradition.
Mr Golding had argued that the evidence against Mr Coke was obtained illegally by intercepting mobile telephone calls.
But he changed his mind in the face of growing public discontent, and questions about his possible ties to Mr Coke.
He has denounced the unrest as a "calculated assault on the authority of the state that cannot be tolerated".