Millions of Americans remained without power and faced torrential flooding on Saturday, according to authorities, as powerful storm Helene moved across eastern and midwestern US states, resulting in at least 44 fatalities. At least 19 people perished in South Carolina, 15 in Georgia, seven in Florida, two in North Carolina, and one in Virginia, according to updated reports from local authorities compiled by AFP.

Repair crews were already working to restore services after Helene made landfall in Florida late Thursday as a Category 4 hurricane, then surged north, gradually weakening but leaving widespread devastation in its wake. The National Weather Service stated, "Conditions will continue to improve today following the catastrophic flooding over the past two days," but warned of potential "long-duration power outages."

Although power has been restored in some areas, over three million customers across 10 states were still without electricity as of midday Saturday, according to poweroutage.us. Helene initially hit Florida's northern Gulf shore with winds of 140 miles (225 kilometers) per hour. Even as a weakened post-tropical cyclone, it caused significant damage.

Record levels of flooding threatened to breach dams, with one dam in Tennessee on the brink of failure, prompting authorities to urge residents to move to higher ground. Massive flooding was reported in Asheville, a city in western North Carolina. Governor Ray Cooper described it as "one of the worst storms in modern history" to affect his state.

In Cedar Key, an island city of 700 people off Florida's northwest coast, the full destructive force of the hurricane was evident. Several pastel-colored wooden homes were destroyed by record storm surges and fierce winds. "I've lived here my whole life, and it breaks my heart to see it. We've not really been able to catch a break," said Gabe Doty, a Cedar Key official, referring to two earlier hurricanes in the past year.

In South Carolina, the fatalities included two firefighters and six residents of Spartanburg County. Georgia Governor Brian Kemp's office confirmed 15 deaths in his state, including an emergency responder. Florida Governor Ron DeSantis stated that the damage from Helene surpassed that of hurricanes Idalia and Debby, which both hit the same region southeast of Tallahassee in the last 13 months. "It's a real gut punch to those communities," DeSantis told Fox News.

In the Tennessee town of Erwin, a dramatic rescue operation took place as more than 50 patients and staff trapped on a hospital roof by rising floodwaters were rescued by helicopters. Up to 12 inches (30 centimeters) of rain was forecast in the Appalachian mountains, with isolated spots receiving 20 inches. The remnants of the weakened storm hovered over the Kentucky-Indiana border at midday Saturday, bringing up to 2 inches of rain.

In a statement on Saturday, President Joe Biden described Helene's devastation as "overwhelming." He announced the deployment of additional response personnel as the storm tracks north. Vice President Kamala Harris stated that the administration had already mobilized 1,500 personnel to support affected communities. September has been an unusually wet month globally, with scientists linking some extreme weather events to human-caused global warming.