PERRY, Fla. (AP) – Hurricane Helene The storm caused dozens of deaths and billions of dollars in damage across much of the southeastern U.S., leaving more than three million customers without power over the weekend and some still at risk of flooding.

Helene blown ashore A Category 4 hurricane struck Florida’s Big Bend region late Thursday with winds of 140 mph (225 km/h) and then moved quickly through Georgia, the Carolinas and Tennessee, uprooting trees, splintering homes, damaging streams and sent rivers over their banks and strained dams.

Western North Carolina was largely cut off due to landslides and flooding that forced the closure of Interstate 40 and other roads. There have been hundreds of water rescues, none more dramatic than in rural Unicoi County in East Tennessee, where Dozens of patients and employees were rescued by helicopter from the roof of a hospital surrounded by water from a flooded river.

The storm, now a post-tropical cyclone, was expected to hover over the Tennessee Valley Saturday and Sunday, the National Hurricane Center said. Multiple flood and flash flood warnings remained in effect in parts of southern and central Appalachia, while high wind warnings also covered parts of Tennessee and Ohio.

Among the at least 44 people who died in the storm were three firefighters, a woman and her one-month-old twins and an 89-year-old woman whose home was hit by a falling tree. The deaths occurred in Florida, Georgia, North Carolina, South Carolina and Virginia, according to an Associated Press tally.

In North Carolina, a lake from the film “Dirty Dancing” towered over a dam and surrounding neighborhoods were evacuated, although there were no immediate concerns of failure. People were also evacuated from Newport, Tennessee, a town of about 7,000 people, amid concerns about a nearby dam, although officials later said the structure had not failed.

Tornadoes struck some areas, including one in Nash County, North Carolina, critically injuring four people.

A record 11.12 inches (28.24 centimeters) of rain fell in Atlanta in 48 hours, the most the city has seen in a two-day period since records began in 1878, Georgia’s Office of the State Climatologist said on the social platform X. Some parts of the city were so badly flooded that only car roofs were sticking out of the water.

Moody’s Analytics expects property damage to range from $15 billion to $26 billion.

Climate change has exacerbated the conditions that allow such storms to thrive. They intensify quickly in the warmer waters, sometimes turning into strong cyclones within a few hours.

Florida’s Big Bend is a part of the state where salt marshes and pine forests stretch to the horizon and where the residential developments and shopping centers that have dotted much of the state’s coastline are largely absent.

It’s a place where Susan Sauls Hartway and her four-year-old Chihuahua mix, Lucy, could afford to live within walking distance of the beach on their housekeeper salary.

At least until her house was carried away by Helene.

On Friday afternoon, Hartway strolled down her street near Ezell Beach, looking for the spot where the storm might have struck her home.

“It’s gone. I don’t know where it is. I can’t find it,” she said of her house.

Born and raised in rural Taylor County, Hartway said there is no place in the world she would rather be, even after Helene. But she has watched wealthier residents from other states buy second homes here. She wonders how many of them will sell out — and what will happen to the locals who have nowhere else to go.

“There are so many people down here that they have nowhere to go now. That was all they had,” she said.

Since August 2023, the community has been directly impacted by three hurricanes.

All five people who died in a Florida county were in neighborhoods where residents were ordered to evacuate, said Bob Gualtieri, the sheriff in Pinellas County in the St. Petersburg area. Some who stayed ended up having to hide in their attics to avoid the rising water. He said the death toll could rise as crews go door-to-door in flooded areas.

Additional deaths were reported in Georgia and the Carolinas, including two South Carolina firefighters and a Georgia firefighter who died when trees crashed into their trucks. Virginia Governor Glenn Youngkin reported at least one death in his state.

When the water reached knee height in Kera O’Neil’s home in Hudson, Florida, she knew it was time to escape.

“There’s a moment where you think, ‘If this water rises above the level of the oven, we won’t have much room to breathe,'” she said, recalling how she and her sister waded through chest-deep water with one cat in a plastic box and another in a cardboard box.

President Joe Biden said he was praying for survivors, and the head of the Federal Emergency Management Agency traveled to the area. The agency deployed more than 1,500 personnel and assisted in 400 rescues as of late Friday morning.

Officials urged those trapped to call rescuers and not step into floodwaters, warning that live wires, sewage, sharp objects and other debris could pose a danger to them.

In Georgia, a utility warned of “catastrophic” damage to utility infrastructure, with more than 100 power lines damaged. And officials in South Carolina, where more than 40% of customers were without power, said crews had to pick their way through rubble to find what remained in some places.

The hurricane came ashore near the mouth of the Aucilla River, about 20 miles (30 kilometers) northwest of there Hurricane Idalia hit last year with almost the same intensity. Florida Gov. Ron DeSantis said the damage from Helene appears to be greater than the combined impacts of Idalia and Hurricane Debby in August.

The destruction reached far beyond Florida.

A mudslide in the Appalachian Mountains has washed out part of a highway at the North Carolina-Tennessee state line.

Another slide rocked homes in North Carolina and left residents waiting more than four hours to be rescued, said Ryan Cole, deputy director of Buncombe County Emergency Services. His emergency call center received more than 3,300 calls within eight hours on Friday.

“This is something we will be dealing with for many days and weeks to come,” Cole said.

Meteorologists warned of flooding in North Carolina that could be worse than anything seen in the past century. The Connecticut Army National Guard sent a helicopter to assist.

Helene was the eighth named storm of the Atlantic hurricane season, which began June 1. The National Oceanic and Atmospheric Administration has predicted an above-average season this year because of the record warm sea temperatures.

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Payne reported from Tallahassee, Florida, and Hollingsworth reported from Kansas City, Missouri. Associated Press journalists Seth Borenstein in New York; Jeff Amy in Atlanta; Russ Bynum in Valdosta, Georgia; Danica Coto in San Juan, Puerto Rico; Andrea Rodríguez in Havana; Mark Stevenson and María Verza in Mexico City; and Claire Rush in Portland, Oregon, contributed.