Peru carried out a nationwide safety drill on Thursday to see how authorities respond to a cataclysmic 8-magnitude earthquake with an epicenter just west of the capital, and the resulting tsunami.

Authorities fear that such a quake and tsunami could kill more than 50,000 people, destroy about 200,000 homes, and leave some two million people homeless.

"This toll represents the worst case scenario if we are not prepared," Lima Mayor Susana Villaran, who leads civil defense efforts, told AFP.

Thousands of workers streamed onto the streets of Lima, population eight million, when the drill kicked off at 10:00 am (1500 GMT).

At that moment the pretend quake struck 190 km (118 miles) west in the Pacific, unleashing a tsunami that would take 15 to 20 minutes to hit the coast.

Officials said some 80 percent of residents actively participated in drill.

Goals of the exercise included evaluating how authorities respond, how prepared the public was, and how the emergency and evacuation routes worked, especially in areas that could be flooded by a tsunami.

"We left the hospital quickly but in an orderly fashion, taking scores of patients with us," said Milagros Perez, a doctor at Lima's maternity hospital.

Perez carried a child down four floors and stood in the middle of the street, following advice from civil defense officials, after the "quake" struck.

Every year the Andean nation of more than 28 million is rattled by low-intensity quakes because it sits on the edge of the Nazca tectonic plate.

It is critical "to know what to do, and who should do it, in the first 24 to 72 hours after an earthquake," Villaran warned.

Part of the sense of urgency is that Lima has not had a major earthquake in more than 250 years.

"We have to consider that earthquakes are cyclical beasts," explained Hernan Tavera, top quake expert at the Geophysical Institute of Peru earlier this week.

The last powerful quake to strike Lima was in October 1746, and is believed to have been as strong as the 8.8 magnitude quake that hit southern Chile in February 2010, Tavera said.

The quake and the tsunami wave that followed, which devastated the nearby port city of Callao, killed between 15,000 and 20,000 people.

Lima has experienced two strong quakes in living memory: a 7.5 magnitude quake in October 1966 that left 200 dead and caused a minor tsunami, and another in October 1974 at 7.2-magnitude which killed 252 people. Another 300,000 lost their homes.

Jitters about a potentially devastating quake have been mounting in Lima, in part because of the 2007 earthquake that hit Pisco -- 250 kilometers to the south -- that left more than 500 people dead, and intense coverage of the Chile's 2010 earthquake and Japan's devastating 2011 quake and tsunami.