Tropical Storm Helene brought life-threatening flooding to the Carolinas on Friday after leaving widespread destruction as a major hurricane in Florida and Georgia overnight that killed at least 33 people, swamped neighborhoods and left more than 4 million homes and businesses without power.
Helene hit Florida's Big Bend region as a powerful Category 4 hurricane on Thursday and left a chaotic landscape of overturned boats in harbors, felled trees, submerged cars and flooded streets.
Police and firefighters carried out thousands of water rescues throughout the affected states, including in Atlanta, where an apartment complex had to be evacuated due to flooding.
Helene came ashore in Florida with 140 mph (225 kph) winds, weakening to a tropical storm as it moved into Georgia early on Friday. As of early afternoon, the storm had been downgraded to a tropical depression and was packing maximum sustained winds of 35 mph (55 kph) as it slowed over Tennessee and Kentucky, the National Hurricane Center said.
Helene's heavy rains were still producing catastrophic flooding in the southern Appalachians, the NHC said.
More than 50 people were trapped on the roof of a hospital at midday on Friday in Unicoi County, Tennessee, about 120 miles northeast of Knoxville, local media reported, as floodwaters swamped the rural community.
Rising waters from the Nolichucky River were preventing ambulances and emergency vehicles from evacuating patients and others there, the Unicoi County Emergency Management Agency said on social media, but emergency crews in boats were conducting rescues.
In western North Carolina, Rutherford County emergency officials warned residents near the Lake Lure Dam just before noon to immediately evacuate to higher ground, saying "Dam failure imminent."
In nearby Buncombe County, landslides forced interstates 40 and 26 to close, the county said on X.
The extent of the damage in Florida began emerging after daybreak.
In coastal Steinhatchee, a storm surge - the wall of seawater pushed ashore by winds - of eight to 10 feet (2.4-3 meters) moved mobile homes, the NWS said on X. In Treasure Island, a barrier island community in Pinellas County, boats were grounded in front yards.
The city of Tampa posted on X that emergency personnel had completed 78 water rescues of residents and that many roads were impassable because of flooding. The Pasco County sheriff's office rescued more than 65 people overnight.
The US Coast Guard said it had saved nine people from storm waters. Video posted online showed a Coast Guard crew pulling a man and his dog wearing life vests from the ocean on Thursday after his sailboat became disabled off Sanibel Island.
Kevin Guthrie, Florida's emergency management director, urged residents in the affected areas to stay off the roads. "I beg you, do not go out," Guthrie said at a morning press briefing. "We have 1,500 search and rescue personnel in the impacted areas. Please get out of the way so we can do our jobs."
Officials had pleaded with residents in Helene's path to heed evacuation orders, describing the storm surge as "unsurvivable," as NHC director Michael Brennan warned.
In Taylor County, the Sheriff's Department wrote on social media that residents who decided not to evacuate should write their names and dates of birth on their arms in permanent ink "so that you can be identified and family notified."
Two other people in Florida died, Governor Ron DeSantis confirmed. Georgia Governor Brian Kemp cited 11 storm-related fatalities in his state so far, while North Carolina Governor Roy Cooper said there had been two deaths in his state.
At least 13 people had died during the storm across South Carolina, the Charleston-based Post and Courier newspaper reported, citing local officials.
Helene was unusually large for a Gulf hurricane, forecasters said, though a storm's size is not the same as its strength, which is based on maximum sustained wind speeds.
A few hours before landfall, Helene's tropical-storm winds extended outward 310 miles (500 km), according to the National Hurricane Center. By comparison, Idalia, another major hurricane that struck Florida's Big Bend region last year, had tropical-storm winds extending 160 miles (260 km) about eight hours before it made landfall.
Airports in Tampa, Tallahassee and St. Petersburg suspended operations on Thursday and remained closed early on Friday. Hundreds of flights into and out of Charlotte, North Carolina, and Atlanta were delayed or canceled, according to the tracking website FlightAware.com.
More than 4 million homes and businesses were out of power in Florida, Georgia and the Carolinas, with tens of thousands more facing outages in Virginia, Tennessee and Kentucky, according to the tracking website Poweroutage.us.
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