Hurricane IanStorm Updates: Florida Death Toll Climbs as Ian Dumps Rain on the Mid-Atlantic

About 35 people in Lee County, Fla., were killed by the storm, the sheriff there said, and rivers swollen with rain from Ian continue to rise.

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The New York Times

Here’s what to know about Ian.

As the death toll from Hurricane Ian grows, a new threat has emerged, with rivers across hard-hit Florida continuing to rise, swollen with rainwater dumped by the storm. After sweeping parts of the Carolinas and Virginia with heavy rain on Saturday, a weakened Ian is expected to produce smaller amounts of precipitation in parts of West Virginia and Maryland into Sunday morning.

The latest:

  • Many people across Florida remain without clean drinking water, or their taps have run dry, after water systems across the state were polluted or failed in the storm’s wake. Officials warned that rain-drenched rivers could flood inland locations in the coming days.

  • The sheriff of Lee County in Florida said on Saturday that about 35 people there had been killed. At least a dozen deaths in other counties have been attributed to Ian, but with investigations continuing, no official statewide toll has been released.

  • The governor of South Carolina said on Saturday that his state had escaped significant damage after Ian made landfall there on Friday.

  • About 1 million customers in Florida, 64,000 in North Carolina and 18,000 in Virginia remained without power.

Livia Albeck-Ripka
Oct. 2, 2022, 3:55 p.m. ET

Floodwaters trapped North Port residents. A neighbor saved them by boat.

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Homes in North Port, Fla., surrounded by floodwaters on Saturday.Credit...Tannen Maury/EPA, via Shutterstock

As Hurricane Ian barreled toward Florida’s southwest coast early Wednesday, Mackenzie Richardson thought her home in North Port, a city about 10 miles inland, was safe.

“We were expecting just tropical storm winds,” Ms. Richardson, 23, said, adding that at the time, she did not believe her neighborhood was under mandatory evacuation orders. At about noon, the power went out. Then, her house began to shake.

In the early hours Thursday, Ms. Richardson awoke to the sound of water “gurgling” through the floor. The water was ankle deep. She turned on the flashlight on her phone, and “instantly knew it was going to be really bad.”

By that afternoon, Ms. Richardson and her boyfriend, Julian Williams, 26, were standing on chairs on the front porch, screaming for help. They had crafted a makeshift “SOS” sign using a Sharpie and a cutting board, Ms. Richardson said, and called 911 more than 100 times. “I was scared for my life,” she said.

Then, they saw the boat.

Heath Farabell, a neighbor, had decided to go out that morning to survey the damage. “I shut down my motor just to make sure I was hearing what I was hearing,” he said. “The closer I got to them, the more desperate they sounded.”

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Heath Farabell’s house in floodwaters the day after Hurricane Ian hit.Credit...Heath Farabell

Mr. Farabell, 50, had also spent an anxious night.

His family hunkered down in a closet while the shingles of their roof blew off, the clanking and the howl of the wind distressing their two dogs, cat and dove. “You don’t know where the eye is, or if it’s even hit you yet,” he said. “We went though the night blindfolded.”

On Thursday morning, Mr. Farabell awoke to a cool breeze, clear skies and destruction. Roofs torn apart, and fences and horses’ stables, collapsed. Outside his home, the floodwaters were still rising.

That afternoon, when his own home started taking on water, he realized many more must be in need of help.“One person led to another family, and another family,” he said. “Then we started going down each street.”

Mr. Farabell said he thinks he rescued more than a dozen people over Thursday and Friday with his five-seater jet boat — including a grandmother and her grandson, and one man who had sought refuge with his dog in a half-submerged truck.

Some people had to wade through the brackish, waist-deep waters to get into Mr. Farabell’s boat.

“You had no idea what’s in that water,” he said. “In Florida, we have gators.”

Once his passengers were aboard, Mr. Farabell said he ferried most of them to the highway, where they could catch a ride to safety.

On Saturday, authorities in North Port were still conducting water rescues and welfare checks, the North Port Police Department said on Facebook, adding that the authorities had taken hundreds of people to higher ground.

Mr. Farabell, who had stockpiled food, water and gas, said that he had believed he was prepared for what was coming. But, he added, “Everything I saw on TV and thought it would be like, it’s beyond that.”

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Michael D. Shear
Oct. 1, 2022, 10:57 p.m. ET

Biden will visit Puerto Rico and Florida to assess damage from storms.

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President Biden at the Federal Emergency Management Agency headquarters in Washington on Thursday. The agency’s administrator, Deanne Criswell, is at right.Credit...Kenny Holston for The New York Times

WASHINGTON — President Biden and the first lady, Jill Biden, will travel to Puerto Rico on Monday to survey damage to the island from Hurricane Fiona and will go on Wednesday to Florida, where Hurricane Ian left parts of the state in ruins, the White House announced on Saturday night.

White House officials did not provide details of the president’s visits to the sites of the two natural disasters. But Mr. Biden had said in the past several days that he expected to travel to both places to reassure residents that the federal government will help in their recoveries.

“In addition to what we’re doing for Florida and South Carolina, we remain focused on recovery efforts in Puerto Rico as well,” Mr. Biden said Friday at the White House. “We’re going to stay with and stay at it as long it takes.”

The president’s visit to Florida will be the first since he and Ron DeSantis, the state’s governor, have spent months clashing over transgender rights, abortion, immigration and other issues that are at the center of congressional elections next month. Mr. DeSantis has said that the storm, which made landfall on the state’s Gulf Coast as a powerful Category 4, will go down in history as one of the strongest to hit Florida because of the catastrophic flooding that wiped away whole towns and killed dozens.

As the hurricane approached in the last week, however, Mr. Biden and Mr. DeSantis have stayed away from political attacks. Asked by a reporter in Washington about his relationship with Mr. DeSantis, the president called it irrelevant.

“In fact, very fine. He complimented me,” Mr. Biden said. “He thanked me for the immediate response we had. He told me how much he appreciated it. He said he was extremely happy with what’s going on.”

The president added: “This is not about anything having to do with our disagreements politically. This is about saving people’s lives, homes, and businesses.”

Mr. DeSantis has changed his tone as well in recent days. In the past, he criticized federal hurricane assistance as a “boondoggle” and a “put it on the credit card mentality.” But last week, Mr. DeSantis urged the federal government to come to his state’s aid.

“You know, when people are fighting for their lives, when their whole livelihood is at stake, when they’ve lost everything — if you can’t put politics aside for that, then you’re just not going to be able to,” the governor said.

There is a long history of presidents from both parties visiting disaster areas, in part to demonstrate that they understand the magnitude of the crisis and that political affiliation will not determine how much help the state gets. Former President George W. Bush was criticized for flying over the devastation wrought in New Orleans by Hurricane Katrina in 2005 and not, initially, touring the damage on the ground.

But the reality is that it can be difficult for presidents to visit too soon after a disaster strikes. Their presence — along with the large number of vehicles, secret service officers, local police protection and other staff — can distract from the efforts to recover and rebuild.

After a visit to the Federal Emergency Management Agency headquarters on Thursday, just after Hurricane Ian made landfall, Mr. Biden said he would travel as soon as possible to support the local first responders and federal officials who were already rescuing people from rooftops.

“When the conditions allow it, I’m going to be going to Florida to thank them personally so we don’t get in the way.” Mr. Biden said at the time. “I’ll do our best — we’re going to do our best to build Florida back as quickly as possible. But we’re not going to be leaving.”

“We’re going to build it back with the state and local government,” he added. “However long it takes, we’re going to be there. That’s my commitment to you.”

The hurricanes wrought devastation in both places. But the damage in Puerto Rico may prove especially difficult to recover from since the island had yet to fully recover from Hurricane Maria almost five years ago.

Ten days after Hurricane Fiona struck on Sept. 16, more than 365,000 people on the island remained without power, raising questions about the inability of the federal and local efforts to rebuild the island’s fragile electric grid.

Mr. Biden noted the island’s difficult history with hurricanes on Sept. 22, just days after the storm swept through the island.

“To the people of Puerto Rico, who are still hurting from Hurricane Maria five years later, I know that we’re — they should know that this — we are with you,” he said. “We’re not going to walk away. We mean it.”

Frances Robles
Oct. 1, 2022, 6:14 p.m. ET

Reporting from Naples, Fla.

More than 3,500 residences are still cut off in DeSoto County, north of Fort Myers, where the Peace River, which bisects the county, overflowed. On Saturday, county emergency management officials and members of the National Guard delivered water and M.R.E.s to the inaccessible areas.

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Credit...Kristen Livengood
Nicholas Bogel-Burroughs
Oct. 1, 2022, 5:20 p.m. ET

In battered Port Charlotte, the wait for gasoline lasts hours.

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The line at a Wawa convenience store in Port Charlotte, Fla., on Saturday.Credit...Nicholas Bogel-Burroughs/The New York Times

PORT CHARLOTTE, Fla. — The parking lot of a Wawa convenience store here was transformed into a sea of red gasoline cans on Saturday as hundreds of residents waited for hours in hopes of powering generators and cars after the city, about 30 miles northwest of Fort Myers, was battered by Hurricane Ian.

The store, one of only a few purveyors of gas that had reopened since Wednesday’s storm, corralled cars into a line that stretched for more than a mile along a suburban road. One woman was pushing her van, which appeared to have run out of gas, as the line inched forward. Hundreds more people arrived carrying empty gas cans or pushing them in wheelbarrows.

“This is the furthest I’ve gotten,” said Mark Eidys, who had waited in his truck for hours on two other days but had to leave before ever reaching the pumps. On Saturday, he tried a new strategy: joining the walk-up line and bringing a lawn chair, as well as three gas cans.

As the line grew longer under the beating sun, several people fumed that much of the national attention appeared to be focused on wealthier areas like Naples or Cape Coral.

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One man at the very end of the line, who declined to give his name, said he had not seen any power company workers in his neighborhood and wondered aloud why federal aid had not arrived to help him. He said he needed gas to buy food, but he grew frustrated when he learned that the Wawa was accepting only cash.

At the front of the line was Gary Jaworski, who said he had waited for about six hours, beginning at 7 a.m., to fill up four cans of gas. He said that although he fully supported Gov. Ron DeSantis, he was frustrated at what he viewed as a broken promise by the governor — that gas stations would be able to quickly reopen after the storm.

“Where’s all the fuel?” he asked. “Every gas station or filling station was to have a generator prepared to go at all times.”

In a news conference on Saturday, Mr. DeSantis said 1.6 million gallons of fuel had been moved to southwest Florida, but he acknowledged that some stations “may not have the electricity to operate their pumps.”

Livia Albeck-Ripka contributed reporting.

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McKenna Oxenden
Oct. 1, 2022, 5:19 p.m. ET

The National Hurricane Center issued its last advisory for Post-Tropical Cyclone Ian. The storm is expected to continue moving east-northeast through Sunday and bring up to three inches of rain to parts of West Virginia and western Maryland.

Campbell Robertson
Oct. 1, 2022, 4:29 p.m. ET

Reporting from South Florida

On Saturday afternoon, the Florida Department of Transportation reopened a 14-mile stretch of Interstate 75 that was closed Friday night when the rain-swollen Myakka River had rendered it impassable. In a news release, officials said that they had “determined that water levels have receded far enough” to reopen the highway, but cautioned that there may be more road closures as the river levels change.

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Credit...Win Mcnamee/Getty Images
Campbell Robertson
Oct. 1, 2022, 3:03 p.m. ET

Reporting from South Florida

A rescue highlights that flooding continues, and in some areas, the worst is still to come.

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Osceola County authorities rescuing a 93-year-old resident from flooding on Friday in Kissimmee, Fla.Credit...Bryan R. Smith/Agence France-Presse — Getty Images

CLEWISTON, Fla. — When Brandon Arrington, chairman of the Osceola County Commission, went to bed at his home in Kissimmee, Fla., a little more than 20 miles south of Orlando, on Friday night, his neighborhood was mostly dry.

When he walked out to his car on Saturday morning, preparing to go to a 10 a.m. news conference, the entire landscape had changed.

“I was greeted with water up half my driveway,” he said.

Flagging down a city crew that was rolling through the neighborhood in a high-water vehicle, he was taken to dry land. But Mr. Arrington’s rescue on Saturday highlighted that the flooding from Hurricane Ian had not finished, and in some areas, the worst was still to come.

The heavy rainfall from the storm is moving slowly down rivers and creeks in central Florida, swelling waterways as it goes downstream, like a snake digesting an egg. Some areas that had not been flooded during the hurricane will see water in the coming days, and some areas that had flooded on Thursday are going to see even more water.

“It’s creating a lot of problems really all across the state,” Gov. Ron DeSantis said in a news conference on Saturday.

In Osceola County, Mr. Arrington said, an assisted-living facility was evacuated on Friday as the floodwaters around it grew ever deeper.

“The projections that I keep hearing is we will crest” on Tuesday, he said of several rivers and creeks in his area. “That’s obviously a few days away still.”

Livia Albeck-Ripka contributed reporting.

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Charles Ballaro
Oct. 1, 2022, 3:03 p.m. ET

Reporting from Port Charlotte, Fla.

Seville Place in Port Charlotte, Fla., is a combination of million-dollar houses and older, more colorful homes built in the 1970s. Hurricane Ian was expected to make landfall here, but the forecast 15-foot storm surge never materialized. Category 4 winds still wreaked havoc, though. Pool enclosures were torn off, trees came down, and roof shingles are lying on the ground or in a nearby swimming pool.

Livia Albeck-Ripka
Oct. 1, 2022, 2:58 p.m. ET

Inland flooding is becoming a bigger concern, Gov. Ron DeSantis of Florida said during a news conference on Saturday. “It’s creating a lot of problems, really all across the state.”

Eden Weingart
Oct. 1, 2022, 2:53 p.m. ET

Photos show the devastation that Ian left behind.

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Apr. 12: Redfish Rd., Fort Myers Beach, Fla.
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Sept. 29: Redfish Rd., Fort Myers Beach, Fla.

In some areas of southwest Florida, Hurricane Ian left barely a trace of what once stood before. Homes along the coast were reduced to splinters, with only faint hints of their foundations visible. From above, a bridge appeared erased by a violent brushstroke of sand, water and debris. The coastline is scarred with deep gashes of sand.

Aerial imagery from Thursday revealed the extent of devastation from Fort Myers Beach to Punta Gorda and Sanibel Island. The photos were taken by Nearmap, an aerial imagery company that uses a camera system attached to planes.

The coastal community of Fort Myers Beach absorbed a direct hit from Ian as it made landfall. Beachfront homes were blown apart by winds exceeding 100 miles per hour.

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Apr. 12: Estero Blvd.
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Sept. 29: Estero Blvd.

A section of the Sanibel Island Causeway was completely destroyed, isolating the barrier island from the mainland. Gov. Ron DeSantis said on Thursday that the bridge would require a “structural rebuild.”

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Apr. 12: Sanibel Causeway
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Sept. 29: Sanibel Causeway

On Sanibel Island, which had extensive flooding, neighborhoods were gutted, leaving little more than shells of several homes. Sand coated streets, and swimming pools were filled with dark gray water.

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Apr. 12: West Gulf Dr.
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Sept. 29: West Gulf Dr.

In Punta Gorda, structures that were rebuilt after Hurricane Charley in 2004 seemed to have fared better, with houses still standing among a smattering of debris.

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Apr. 12: Berry St.
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Sept. 29: Berry St.

Fort Myers Beach, a barrier island, was one of the hardest-hit areas. Storm surges nearly reached the roofs of some houses and many buildings were washed away.

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Apr. 12: Avenue A
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Sept. 29: Avenue A

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Eliza Fawcett
Oct. 1, 2022, 2:21 p.m. ET

Reporting from Charleston, S.C.

At Marion Square in downtown Charleston, S.C., there were only a few indications that Hurricane Ian had swept through on Friday. Pathways were littered with leaves, and a maintenance crew was clearing a large tree that had been destroyed by the storm. But it was a balmy weekend day, and people had returned to the city’s historic green space to walk dogs and lie on the grass. “This one was pretty tame,” said Jen Clabby, 26.

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Credit...Eliza Fawcett/The New York Times
Livia Albeck-Ripka
Oct. 1, 2022, 2:11 p.m. ET

In a news conference on Saturday, authorities in Florida said that people affected by Hurricane Ian would be eligible for disaster unemployment assistance.

Livia Albeck-Ripka
Oct. 1, 2022, 2:04 p.m. ET

Gov. Ron DeSantis of Florida said in a news conference on Saturday that the state had sustained more flood damage than wind damage as a result of Hurricane Ian.

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Credit...Hilary Swift for The New York Times
Livia Albeck-Ripka
Oct. 1, 2022, 1:57 p.m. ET

In a news conference in Fort Myers, Fla., on Saturday, Gov. Ron DeSantis said that power had been restored to 54 percent of the people who had lost electricity as a result of Hurricane Ian.

Livia Albeck-Ripka
Oct. 1, 2022, 2:03 p.m. ET

Some harder-hit areas were still largely without power, the governor added, including Lee County, where 73 percent of residents remain without power, and Hardee County, where 88 percent have no power.

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Rebecca Halleck
Oct. 1, 2022, 1:44 p.m. ET

Ian flooded her apartment building and dumped two yachts at the door.

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Savannah Ault

It wasn’t until Hurricane Ian had passed that Savannah Ault saw the extent of the devastation to her apartment in downtown Fort Myers, Fla.

The storm surge had almost entirely filled the first floor of her building. Windows were gone. Furniture and appliances had washed away. Two yachts had washed ashore into their parking lot.

Although the water never reached Ms. Ault’s second-floor unit, she has been told that she may have to move out by Monday. Many nearby businesses are closed because of damage and she’s unsure if the brewery where she works as a bartender will remain open. Her car will not start and there is a long line ahead of her to see a mechanic.

“When it started to hit Punta Gorda, that’s when we’re like, ‘Oh, shoot, maybe we should leave,’” Ms. Ault said. “But, I guess we had the universe decide against that for us.”

Ms. Ault, 23, has lived her entire life in Florida, so she’s used to hurricanes. She expected to ride this one out with her boyfriend, Jacob McDermott, and his mother in their apartment.

They had no plans to evacuate, since the storm was projected to hit Tampa, and she had heard that shelters would not accept animals without vaccination records, which she couldn’t get on such short notice. Since Ms. Ault’s apartment complex had not covered residents’ windows with plywood, during the storm they huddled in the bathroom, in darkness, with their dog, four cats, two sugar gliders and tropical fish.

Watching news reports on their smartphones of 14-foot surges and the storm’s shifting path, Ms. Ault began to regret their decision to stay.

Just to open their door, to catch a glimpse of the destruction, Ms. Ault and her boyfriend fought 100-mile-per-hour winds. She emerged on their second-floor landing to find that the storm surge had already swallowed cars and flooded their first-floor neighbors.

“We were inside 99 percent of the time,” Ms. Ault said. “I just went out to record those videos and I ran right back in.”

Eliza Fawcett
Oct. 1, 2022, 1:36 p.m. ET

Reporting from Charleston, S.C.

Gov. Henry McMaster of South Carolina said in a midday news conference that the state had avoided wide-scale destruction from Hurricane Ian. “We had no storm-related deaths, we had no hospitals damaged, all the water systems were and are OK,” he said. “We had only a few cellular problems. Most of the electricity has been restored.”

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Credit...Callaghan O'Hare for The New York Times
Kellen Browning
Oct. 1, 2022, 12:45 p.m. ET

Ian's death toll extended beyond Florida on Saturday morning, after a 65-year-old man in Clayton, N.C., southeast of Raleigh, died of suspected carbon monoxide poisoning. He was running a generator in his garage after the power went out during the storm, a Johnston County spokesman said.

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Campbell Robertson
Oct. 1, 2022, 12:23 p.m. ET

Reporting from South Florida

At least 130 homes in Seminole County, northeast of Orlando, Fla., sustained major damage, according to Alan S. Harris, the county’s emergency manager — a number that is likely to grow substantially as rivers swollen from Ian's rainwaters crest in the coming days. “Mother Nature is still moving water around, and homes that were not damaged when Hurricane Ian was on top of us are about to be damaged," he said. “And homes that were damaged are about to get worse.”

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Credit...Gerardo Mora/Getty Images
Kellen Browning
Oct. 1, 2022, 12:23 p.m. ET

After he flew a plane from Florida to escape the hurricane, it found him in South Carolina.

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Cullen Moorhead, a pilot from Clearwater, Fla., flew his parents to his grandmother’s house in Pawleys Island, S.C., in an attempt to escape the path of Hurricane Ian.Credit...Nicole Craine for The New York Times

PAWLEYS ISLAND, S.C. — On Monday, as Hurricane Ian approached Florida’s Tampa Bay region, Cullen Moorhead was feeling relieved.

A private pilot at a flight school in nearby Clearwater, Mr. Moorhead, 20, had been instructed to help move the school’s planes out of harm’s way. So at 7 a.m. he loaded his parents and their treasured possessions into a cramped Cessna at the airport there and flew them four hours northeast to Georgetown, S.C., near the oceanside sand spit of Pawleys Island, where his grandmother has a house.

There, far from the predicted destruction, he thought they would be safe.

Until they weren’t.

“You’re watching your hometowns be destroyed,” Mr. Moorhead said, recounting the footage from Florida. “Everyone you know is just in devastation.”

At the time, he thought the storm was expected to weaken and head toward Georgia. Then the forecast changed.

“Then you’re like, ‘That kind of looks like it’s headed toward me,’” Mr. Moorhead said.

On Friday morning, the vortex of wind, rain and roaring waves that the Moorheads had been trying to escape made landfall in South Carolina, just miles from Pawleys Island, flooding the vacation destination. Waves over seven feet crashed into their waterfront home. Meanwhile, the Tampa Bay area seemed to have escaped the worst of what had been forecast.

“How on Earth can you be so lucky?” Mr. Moorhead wondered sarcastically as he stood in the rain on Friday afternoon. “We were safe and going to be coming home today. Nope.”

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Debris from storm surge in Pawleys Island, S.C., on Friday.Credit...Nicole Craine for The New York Times

He said some of his friends at the University of South Florida, where he is a student, had teased him for fleeing the storm. Their amusement grew when he posted a video on Instagram of floodwater rising up the stilts of the South Carolina house: It was karma for leaving, they joked.

But no one was laughing. With his grandmother out of state, Mr. Moorhead and his parents bolted the windows and watched the water rise until it flooded the ground floor of the house. He and his father had to wade waist deep to stop the propane tank from floating away. Worst of all, mementos of his grandfather, who died several weeks ago, were damaged or lost in the flood.

“My mom is devastated,” Mr. Moorhead said. “Everything of my grandpa’s is just floating in water.”

The plane, at least, was safe, stored at an airport 15 miles away.

Mr. Moorhead has been enamored with aviation since he was a small child. When he won a scholarship that gave him full college tuition, the money his family had saved up went to flight school instead, and he has been flying for nearly two years. He viewed flying as fun, and a way to escape from reality. Except this time.

“Of all the places flying has taken me so far,” he said, “I never thought it’d lead me right into the path of a hurricane.”

Trista Talton
Oct. 1, 2022, 12:11 p.m. ET

Reporting from Myrtle Beach, S.C.

Most businesses, from ice cream and candy shops to bargain beach stores, appear to be open in Myrtle Beach a day after Ian hit. In residential neighborhoods, homeowners are raking up leaves and palm branches. On the beach, heavy machinery, including a bulldozer, is being used to flatten the sand. A volleyball tournament is underway at the boardwalk.

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Trista Talton
Oct. 1, 2022, 11:36 a.m. ET

Reporting from Myrtle Beach, S.C.

Under sunny skies, tourists and residents strolled the serene sand of Myrtle Beach on Saturday morning, a day after Hurricane Ian made landfall south of there. On nearby Ocean Boulevard, workers are beginning to pick up scattered palms and roof debris on the sidewalks.

April Rubin
Oct. 1, 2022, 11:13 a.m. ET

Lee County in southwest Florida, where Hurricane Ian came ashore on Wednesday, has confirmed about 35 deaths as a result of the storm, Sheriff Carmine Marceno said on Saturday morning. Identities of the deceased have not been released publicly. Between 600 and 700 people have been rescued, the sheriff said. “We’re out in full force.”

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Credit...Hilary Swift for The New York Times
Campbell Robertson
Oct. 1, 2022, 11:04 a.m. ET

Reporting from South Florida

A 14-mile stretch of Interstate 75 between Tampa and Ft. Myers has been closed since Friday night due to flooding from the rising Myakka River, according to the Florida Department of Transportation. Flooding continues to impact roads around southwest Florida.

Ben Shpigel
Oct. 1, 2022, 11:01 a.m. ET

Ian, no longer a tropical storm, will continue to weaken but could still drop heavy rain near the Virginia-North Carolina border the rest of today and into Sunday, the National Hurricane Center said. Flood watches are in effect across southwest Virginia and southern West Virginia.

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Campbell Robertson
Oct. 1, 2022, 10:34 a.m. ET

Reporting from South Florida

A portion of a levee along the flood-swollen Myakka River appears to have been “compromised” and is threatening several dozen homes in Hidden River, Fla., said Kaitlyn Perez, a spokeswoman for the Sarasota County Sheriff’s Office. Water will soon rise in the area and residents were encouraged to evacuate, she said.

Charles Ballaro
Oct. 1, 2022, 9:10 a.m. ET

Reporting from Port Charlotte, Fla.

Here in Lehigh Acres, an area of about 110,000 people in unincorporated Lee County, Fla., power was restored to some around midnight. Many homes here received only minor damage, but not everyone is out of the woods just yet. Flooding has continued to be a problem, main roads remained flooded in several locations, and roads in residential areas were as bad, if not worse.

Eliza Fawcett
Oct. 1, 2022, 8:59 a.m. ET

Reporting from Charleston, S.C.

In Charleston, residents woke up to a sunny, cloudless morning, the day after Ian brought high winds and heavy rain to the area. “While the city was fortunate to avoid a direct hit from Hurricane Ian, the impacts are still significant, with a number of roads closed, residents without power and flooding damage,” Mayor John Tecklenburg said in a statement.

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Credit...Callaghan O'Hare for The New York Times
Daniel Victor
Oct. 1, 2022, 7:31 a.m. ET

About 1.3 million customers in Florida remained without power as of 7:30 a.m. Eastern time, along with 62,000 in South Carolina, 326,000 in North Carolina and 100,000 in Virginia.

Share of customers without power by county

Not Reported
Source: PowerOutage.us

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Jennifer Reed
Oct. 1, 2022, 6:50 a.m. ET

In the Fort Myers Yacht Basin, a man fought to safeguard his father’s boat.

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The storm damaged boats and buildings in the Fort Myers Yacht Basin, an area generally considered to be safe to dock a vessel. It also rocked boats lining Fort Myers Beach.CreditCredit...Shannon Stapleton/Reuters

FORT MYERS, Fla. — The Fort Myers Yacht Basin is generally considered one of the safer spots around to dock a boat, since it is upriver and far removed from the Gulf of Mexico. But Hurricane Ian tossed vessels there around like playthings, piling them up beneath the Edison Bridge and sending them careening into unlikely places like Joe’s Crab Shack Restaurant.

The fierce winds and waves bit away at the marina’s sea walls and piers, tearing off chunks as large as 12 feet long and depositing the debris into parking lots, playgrounds and even on city streets more than two blocks away.

John Pensy, 61, is one of the 30 or 40 people who reside in the yacht basin year-round, and he chose to ride out the hurricane aboard his 40-foot boat, Sea Chest, along with his daughter, 30.

“My father hand-built this boat from scratch,” Mr. Pensy said on Friday. “I think it took him 15 years, much to my mother’s chagrin. I wanted to stay here and protect it.”

He said he had worked 12 mooring lines throughout the storm, moving and adjusting them as the tide and wind shifted, to keep the boat secure. “I tied a line to myself so I wouldn’t blow off,” he said. “Then you just hang on for dear life.”

The empty boat beside his snapped loose, he said, and he saw two more untethered boats miss colliding with the Sea Chest by inches as they surged past. The second one snared another boat’s anchor and pulled it loose as well.

“You want to see where they ended up?” he asked, and then walked barefoot about 75 yards down the pier to point to a pileup of wrecked boats. “I’ve never seen winds like that. It was raw power.”

Amy Qin
Oct. 1, 2022, 5:53 a.m. ET

At ‘ground zero’ in Fort Myers Beach, a couple struggles with heartache and insurance troubles.

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Houses in a neighborhood in North Fort Myers, Fla., were swamped by the storm on Thursday.Credit...Hilary Swift for The New York Times

Amy Lazzell and her husband, Robert, had made preparations thinking that Hurricane Ian, based on earlier predictions, would track north, sparing their home on Fort Myers Beach. They stocked up on drinking water, coolers of ice and nonperishable food. Their elevated house had been reinforced with hurricane-resistant impact glass. They thought they were prepared.

Instead, the couple found themselves at the center of what Ron DeSantis, the governor of Florida, on Friday called “ground zero.”

Video taken by Ms. Lazzell just after the storm showed their second-story, turquoise-accented living room submerged in nearly three feet of floodwater. The water has since receded, but heartache has begun to set in.

“I’ve been crying a lot,” said Ms. Lazzell, 54, a retired emergency-room nurse. “Today has been more emotional than yesterday.”

Since Wednesday, the couple have been stuck at home with their three puppies, trying to get by. With the power still out, they have been living on burgers from the freezer cooked on a gas grill. They have been sleeping on a mattress almost entirely waterlogged, save for the top layer. Mr. Lazzell guessed that they had about two days of drinking water left.

They heard from a neighbor about a food station being set up at a grocery store about a mile away, but it was only a rumor. “We don’t know what’s true or not,” Ms. Lazzell said as the sound of search and rescue helicopters whirred in the background.

But they say their biggest headache in the aftermath of the storm has been dealing with their insurance companies. Mr. Lazzell said that, like many people in Florida, they had to buy separate insurance plans for their cars and home. And now, the companies were pointing fingers at one another, trying to pass on responsibility.

“When you’re sitting here with no electricity and no running water, and you don’t even know if your neighbors are alive or not, and you have to deal with this — it’s been a major disappointment,” said Mr. Lazzell, 64, a retired military veteran. “We could just use a little help.”

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Campbell RobertsonRichard Fausset
Oct. 1, 2022, 5:00 a.m. ET

Another challenge for hardest-hit parts of Florida: Finding clean drinking water.

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A Publix supermarket is open with limited hours in Cape Coral, Fla. The supermarket has no ice, propane or water.Credit...Jason Andrew for The New York Times

FORT MYERS, Fla. — Francine Cole’s problem was a depressingly common one this week in Florida: First, there was too much water. Now, there is not enough of it.

Ms. Cole, 50, lives in a two-story apartment on the western coast of Florida that was battered and flooded by Hurricane Ian. After the storm, she and her husband found themselves holed up on the second floor in a county where the water system was broken, the power was mostly out, and many of the taps, including hers, were dry.

The downstairs, Ms. Cole said, reeked of sewage. She had bought a couple of cases of water before the storm, but now she had to decide to whether use it to clean or to drink. She and her husband had tried to clean up with water from a small pond, but it proved to be an ineffective solution. The grime was unbearable. They were thirsty.

“We’re really worried,” she said.

Hurricane Ian, which made a second U.S. landfall Friday afternoon on the coast of South Carolina, visited tremendous visible devastation as it cut its northeastward path across the Florida peninsula earlier this week, leaving wrecked houses and businesses along the Gulf coast and thick tangles of tree limbs and debris further inland.

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A flooded backyard in Arcadia, Fla. Hurricane Ian left wrecked houses and businesses along the Gulf coast and thick tangles of tree limbs and debris further inland.Credit...Emily Kask for The New York Times

But some of the most potent problems in the state were less easy to see, including the effect on water systems, as the electricity needed to keep water flowing went out in some areas, and water lines were severed by the storm. The state’s water troubles were reflected on a regularly updated list of boil-water advisories maintained by the Florida Department of Health. On Monday, it had no such notices to report. On Friday, there were nearly 50 advisories in effect.

“As far as I’m aware, every single case is related to the hurricane,” Jae Williams, a Health Department spokesman, said on Friday.

Boil-water advisories, which alert residents to the possibility of biological contamination in a water system, can be issued for a number of reasons and are often prompted by malfunctions or damage that results in a loss of pressure or other problems. Residents at low elevations are typically told to boil any water used for drinking or cooking for at least one minute.

But in some of the hardest-hit places, water was not coming out of the taps. And owners of electric stoves had limited options in a state where more than 1.7 million power customers were without electricity as of Friday afternoon.

Some of the areas on the boil-water list were small, like the Spanish Main Travel Resort, an R.V. park in Hillsborough County, on the western side of the state. In other cases, the advisories covered entire cities, like Bartow, Fla., a city of about 20,000 near the geographic center of the peninsula, where the water system experienced several line breaks.

The Federal Emergency Management Agency announced Friday that it had sent 1.6 million liters of water to Florida and promised that another 6.6 million liters were on the way. The water was part of an enormous federal response focused on providing basic human services, including 5.5 million meals, more than 400 ambulances and four aircraft to evacuate medically vulnerable people from nursing homes and other facilities.

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The Matanzas Pass Bridge in Fort Myers, Fla. More than 1.7 million power customers were without electricity in Florida as of Friday afternoon.Credit...Johnny Milano for The New York Times

But the worst trouble was in Lee County, where a badly damaged water system was affecting a population of nearly 760,000, forcing residents to hunt through a tableau of ruin for bottled-water distribution sites and forcing state and federal officials to improvise some creative solutions.

Ms. Cole and others were given some water Friday at Next Level Church in Fort Myers, where orange-shirted volunteers — most of whom had no power or water in their own houses — piled cases of water and food into the trunks of waiting cars. The volunteers stuck a yellow sticky note with a number on each driver’s door reflecting the number of household residents, a running tally of desperation: 13, 6, 1.

Victoria Kent, 28, who pulled up with her 8-year-old daughter in the back seat, had subsisted on juice boxes over the last two days. She wouldn’t be paid until the end of the month and didn’t have the money to buy last-minute storm supplies, including extra water.

And anyway, she said, she had to keep working — selling insurance over the phone from her house — until the power had cut off. They were almost out of food and had run out of water completely. “We’ve just been driving around to see who can help us,” she said. “And I’m down below half a tank.”

The problem was affecting institutions as well as residents. As of Friday morning, three hospitals in Lee County were without water, forcing administrators to evacuate some patients, said Mary Mayhew, president and chief executive of the Florida Hospital Association. “The public water system has had breaks, and the hospitals are not getting access to water, or the water pressure is completely inadequate,” Ms. Mayhew said in a phone interview.

Later in the day, however, Kevin Guthrie, director of the Florida Division of Emergency Management, said in a news conference that the state had “solved the water problem temporarily” by setting up tanks at the hospitals and “ferrying 20,000 gallons of water about five times a day” to each hospital. Mr. Guthrie also said that more than 14,000 gallons of diesel fuel had been shipped to Fort Myers for use at a water plant that served the hospitals.

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Damage from Hurricane Ian in Pine Island, Fla. The electricity needed to keep water flowing went out in some areas, and water lines were severed by the storm.Credit...Hilary Swift for The New York Times

Down the road from the church on Friday, three large water tanker trucks were parked behind the Gulf Coast Medical Center, which was busy with the coming and going of ambulances and helicopters. The Florida National Guard was handing out bottled water and meals at the Lee County Sports Complex nearby.

In a news conference Friday morning, Gov. Ron DeSantis singled out water problems as among the most pressing issues he had discussed with federal officials, calling it “critical to get that infrastructure back up and running.”

The U.S. Army Corps of Engineers said in a tweet on Friday that its experts were meeting with county officials, noting that work crews had begun using water trucks to “pressurize critical facilities to locate and repair leaks.”

The water challenges were different farther inland. In Polk County, in Central Florida, Ian stormed through on Thursday night, leaving streets strewn with debris and thousands of people without power. Also without power Friday morning were 55 of the county’s 350-plus “lift stations,” which pump wastewater to the local treatment plant.

Mark Addison, a manager for utilities in Polk County, said one short-term solution was to warn people to conserve water and not overwhelm a system that could send dirty water back through their pipes and into their homes.

The ultimate solution — which speaks to another looming infrastructure challenge for Florida — was to work to get the power back on quickly.

Mitch Smith contributed reporting.

Daniel Victor
Oct. 1, 2022, 4:59 a.m. ET

Maximum sustained winds have decreased to 35 miles per hour, the National Weather Service said in an update shortly before 5 a.m. Eastern time. Forecasters expect the storm to weaken further before dissipating over south-central Virginia by Saturday night.

Victoria Kim
Oct. 1, 2022, 4:23 a.m. ET

Ian moves through North Carolina toward Virginia, bringing heavy rains and outages.

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A downed tree in Virginia Beach on Friday.Credit...Stephen M. Katz/The Virginian-Pilot, via Associated Press

A downgraded Ian continued to douse a swath of the Carolinas and the Mid-Atlantic states early Saturday after weather officials canceled all tropical storm and storm surge warnings but still warned of dangerous flash flooding and residual effects.

Despite losing much of its speed and force heading inland after making landfall in South Carolina on Friday, the storm, now a post-tropical cyclone, was continuing to cause problems. More than half a million customers lost power in North and South Carolina and Virginia, while strong winds and flooding remained a danger along the coast.

The center of the storm system was expected to move into Virginia on Saturday and move off the East Coast by late Saturday or early Sunday, said Bob Oravec, a meteorologist with the National Weather Service. Winds in central North Carolina were calming down after reaching 50 miles per hour and remained strongest off the coast, he said.

“It’s transitioning into a run-of-the-mill storm,” Mr. Oravec said. “It won’t be like those rains in Florida or even South Carolina, but there’s still potential for heavy rains.”

About 330,000 customers in North Carolina and more than 100,000 in Virginia were without power as of 3 a.m. Saturday, according to PowerOutage.us. About 70,000 remained in the dark in South Carolina, where Ian hit as a Category 1 hurricane with less force than had been feared but swept away vehicles, inundated coastal areas and downed power lines.

“We expect winds, rain and flooding to continue to impact us into Saturday,” Gov. Roy Cooper of North Carolina said at a Friday news conference.

The storm’s long tail will be felt throughout Saturday and Sunday and possibly into early Monday, with several inches of rain expected in North Carolina, West Virginia, Virginia, Maryland, Pennsylvania and even the New York City area, Mr. Oravec said.

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Sept. 30, 2022, 8:03 p.m. ET

Facing a dire storm forecast, Florida officials delayed evacuation orders.

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Tristan Stout, 22, surveying the damage to his father’s boat after it was moved across the street on San Carlos Island in Fort Myers Beach.Credit...Jason Andrew for The New York Times

FORT MYERS, Fla. — As Hurricane Ian charged toward the western coast of Florida this week, the warnings from forecasters were growing more urgent. Life-threatening storm surge threatened to deluge the region from Tampa all the way to Fort Myers.

But while officials along much of that coastline responded with orders to evacuate on Monday, emergency managers in Lee County held off, pondering during the day whether to tell people to flee, but then deciding to see how the forecast evolved overnight.

Lee County Announced Evacuation Orders After Other Coastal Counties

In the days before Hurricane Ian made landfall, forecasters predicted significant storm surge along Florida’s coast. Despite the warnings, officials in Lee County waited a day later than other coastal counties to announce evacuation orders.

Monday, 8 a.m. forecast

Tuesday, 8 a.m. forecast

2-4 ft.

FLA.

FLA.

2-4 ft.

1-3 ft.

Other coastal

counties

5-8 ft.

Peak storm

surge forecast

Actual

path

Actual

path

5-10 ft.

5-8 ft.

Possible

track area

LEE CO.

LEE CO.

4-7 ft.

Forecast

path

Forecast

path

4-7 ft.

3-5 ft.

3-5 ft.

2-4 ft.

2-4 ft.

Monday, 8 a.m. forecast

Tuesday, 8 a.m. forecast

2-4 ft.

FLORIDA

2-4 ft.

1-3 ft.

FLORIDA

5-8 ft.

Other coastal

counties

Peak storm

surge forecast

Actual

path

Actual

path

5-8 ft.

Possible

track area

5-10 ft.

LEE CO.

LEE CO.

4-7 ft.

Forecast

path

Forecast

path

4-7 ft.

3-5 ft.

3-5 ft.

2-4 ft.

2-4 ft.

Monday, 8 a.m. forecast

FLA.

Other coastal

counties

Actual

path

Peak storm

surge forecast

5-8 ft.

LEE CO.

4-7 ft.

Forecast

path

3-5 ft.

Possible

track area

2-4 ft.

Tuesday, 8 a.m. forecast

2-4 ft.

FLA.

2-4 ft.

1-3 ft.

5-8 ft.

Actual

path

5-10 ft.

LEE CO.

Forecast

path

4-7 ft.

3-5 ft.

2-4 ft.

Source: National Oceanic and Atmospheric Administration

By Lazaro Gamio

The delay, an apparent violation of the meticulous evacuation strategy the county had crafted for just such an emergency, may have contributed to catastrophic consequences that are still coming into focus as the death toll continues to climb.

Dozens have died overall in the state, officials said, as Ian, downgraded to a post-tropical cyclone, moved through North Carolina and Virginia on Saturday, at one point leaving nearly 400,000 electricity customers in those states without power.

About 35 of Florida’s storm-related deaths have been identified in Lee County, the highest toll anywhere in the state, as survivors describe the sudden surge of water — predicted as a possibility by the National Hurricane Service in the days before the storm hit — that sent some of them scrambling for safety in attics and on rooftops.

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Destruction on San Carlos Island after Hurricane Ian tore through the area.Credit...Johnny Milano for The New York Times

Lee County, which includes the hard-hit seaside community of Fort Myers Beach, as well as the towns of Fort Myers, Sanibel and Cape Coral, did not issue a mandatory evacuation order for the areas likely to be hardest hit until Tuesday morning, a day after several neighboring counties had ordered their most vulnerable residents to flee.

By then, some residents recalled that they had little time to evacuate. Dana Ferguson, 33, a medical assistant in Fort Myers, said she had been at work when the first text message appeared on her phone Tuesday morning. By the time she arrived home, it was too late to find anywhere to go, so she hunkered down with her husband and three children to wait as a wall of water began surging through areas of Fort Myers, including some that were well away from the coastline.

“I felt there wasn’t enough time,” she said.

Ms. Ferguson said she and her family fled to the second floor, lugging a generator and dry food, as the water rose through their living room. The 6-year-old was in tears.

Kevin Ruane, a Lee County commissioner and a former mayor of Sanibel, said the county had postponed ordering an extensive evacuation because the earlier hurricane modeling had shown the storm heading farther north.

“I think we responded as quickly as we humanly could have,” he said.

Gov. Ron DeSantis and his state emergency management director also said the earlier forecasts had predicted the brunt of the storm’s fury would strike farther north.

“There is a difference between a storm that’s going to hit north Florida that will have peripheral effects on your region, versus one that’s making a direct impact,” Mr. DeSantis said at a news conference on Friday in Lee County. “And so what I saw in southwest Florida is, as the data changed, they sprung into action.”

But while the track of Hurricane Ian did shift closer to Lee County in the days before it made landfall, the surge risks the county faced — even with the more northerly track — were becoming apparent as early as Sunday night.

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Diana Kauth, 65, was helped off a rescue rig by the Florida Forest Service after she rode out Hurricane Ian in her neighbor’s two-story home on San Carlos Island.Credit...Jason Andrew for The New York Times

At that point, the National Hurricane Center produced modeling showing a chance of a storm surge covering much of Cape Coral and Fort Myers. Parts of Fort Myers Beach, even in that case, had a 40 percent chance of a six-foot-high storm surge, according to the surge forecasts.

Lee County’s emergency planning documents had set out a time-is-of-the-essence strategy, noting that the region’s large population and limited road system make it difficult to evacuate the county swiftly. Over years of work, the county has created a phased approach that expands the scope of evacuations in proportion to the certainty of risk. “Severe events may require decisions with little solid information,” the documents say.

The county’s plan proposes an initial evacuation if there is even a 10 percent chance that a storm surge will go six feet above ground level; based on a sliding scale, the plan also calls for an evacuation if there is a 60 percent chance of a three-foot storm surge.

Along with the forecasts on Sunday night, updated forecasts on Monday warned that many areas of Cape Coral and Fort Myers had between a 10 and a 40 percent chance of a storm surge above six feet, with some areas possibly seeing a surge of more than nine feet.

Over those Monday hours, neighboring Pinellas, Hillsborough, Manatee, Sarasota and Charlotte counties issued evacuation orders, while Sarasota County announced that it expected evacuation orders to be in effect for the following morning. In Lee County, however, officials said they were waiting to make a more up-to-date assessment the following morning.

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A woman riding her bike past a Chevron One Stop station that was destroyed during Hurricane Ian.Credit...Jason Andrew for The New York Times

“Once we have a better grasp on all of that dynamic, we will have a better understanding about what areas we may call for evacuation, and, at the same time, a determination of what shelters will be open,” the Lee County Manager, Roger Desjarlais, said on Monday afternoon.

But forecasters with the National Hurricane Center were growing more explicit in their warnings for the region. In a 5 p.m. update on Monday, they wrote that the highest risk for “life-threatening storm surge” was in the area from Fort Myers to Tampa Bay.

“Residents in these areas should listen to advice given by local officials,” the hurricane center wrote. New modeling showed that some areas along Fort Myers Beach were more likely than not to see a six-foot surge.

Mr. Ruane, the county commissioner, said that one challenge the county faced was that the local schools had been designed to be shelters and that the school board had made the decision to keep them open on Monday.

By the following morning, at 7 a.m. on Tuesday, Mr. Desjarlais announced a partial evacuation order but emphasized that “the areas being evacuated are small” compared with a previous hurricane evacuation.

The county held off on further evacuations, despite a forecast that showed potential surge into areas not covered by the order. Officials expanded their evacuation order later in the morning.

By the middle of the afternoon, Lee County officials were more urgent in their recommendation: “The time to evacuate is now, and the window is closing,” they wrote in a message on Facebook.

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Pete Neelon, a resident of Lee County for more than a decade, pointing to where the water level rose past his headboard on San Carlos Island.Credit...Johnny Milano for The New York Times

Katherine Morong, 32, said she had been prepared earlier in the week to hunker down and ride out the storm based on the guidance from local officials. The sudden evacuation order on Tuesday morning left her scrambling, she said, as she set out in her car in the rain.

“The county could have been more proactive and could have given us more time to evacuate,” she said. On the road toward the east side of the state, she said, she was driving through torrents of rain, with tornadoes nearby.

Joe Brosseau, 65, said he did not receive any evacuation notice. As the storm surge began pouring in on Wednesday morning, he said, he considered evacuating but realized it was too late.

He climbed up a ladder with his 70-year-old wife and dog to reach a crawl space in his garage. He brought tools in case he needed to break through the roof to escape.

“It was terrifying,” Mr. Brosseau said. “It was the absolute scariest thing. Trying to get that dog and my wife up a ladder to the crawl space. And then to spend six hours there.”

Some residents said they had seen the forecasts but decided to remain at home anyway — veterans of many past storms with dire predictions that had not come to pass.

“People were made aware, they were told about the dangers and some people just made the decision that they did not want to leave,” Mr. DeSantis said on Friday.

Joe Santini, a retired physician’s assistant, said he would not have fled his home even if there had been an evacuation order issued well before the storm. He said that he had lived in the Fort Myers area most of his life, and that he would not know where else to go.

“I’ve stuck around for every other one,” he said.

The water rushed into his home around dusk on Wednesday night, and on Friday, there was still a high-water mark about a foot above the floor — leaving Mr. Santini a little stunned. “I don’t think it’s ever surged as high as it did,” he said.

Lee County is now an epicenter of devastation, with mass destruction at Fort Myers Beach, the partial collapse of the Sanibel Causeway and entire neighborhoods reduced to rubble. With water mains broken, the county utilities agency has advised residents to boil their water.

President Biden said on Friday that the destruction from the storm was likely to be among the worst in U.S. history.

“It’s going to take months, years to rebuild,” he said.

Lauren Sweeney, Nicholas Bogel-Burroughs and Mitch Smith contributed reporting. Kirsten Noyes contributed research.

Emily Baumgaertner
Sept. 30, 2022, 7:15 p.m. ET

Some Florida hospitals hit by Ian are still scrambling to evacuate patients, or just provide care.

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Paramedics and volunteers provided aid to a man who ran out of oxygen after power outages in North Fort Myers, Fla., on Thursday.Credit...Hilary Swift for The New York Times

As water cascaded through the roof and down the stairwell of a Port Charlotte hospital on Wednesday, it became clear to doctors that moving intensive care patients to other floors would no longer keep them safe.

Staff members at the facility, HCA Florida Fawcett Hospital in Port Charlotte, north of Fort Myers, waded through floating ceiling tiles and medical equipment, their scrubs rolled up to their knees, as they transferred 160 remaining patients to nearby hospitals.

Threatened by rising floodwater and utility outages in the Fort Myers region, officials at a number of hospitals and nursing homes had to make quick decisions to move hundreds of patients to safer ground.

Even hospitals that weren’t inundated are facing serious problems. Water utilities in Lee County were permanently damaged, officials said, and at least nine hospitals lost access to potable water. The facilities were “fast approaching a point where they will not be able to safely take care of their patients,” Mary Mayhew, the president of the Florida Hospital Association, said on Thursday.

Lee Health, the largest health care provider in the county, is scheduled to evacuate about 400 patients to facilities in Naples or elsewhere in the state, according to Dr. Larry Antonucci, the chief executive of the health system. Its pediatric facility, Golisano Children’s Hospital, is without water and has begun transferring fragile newborns.

The system’s emergency departments had over 130 visitors waiting for beds as of Friday morning, and more were expected. The emergency room at Gulf Coast Medical Center had seen about 70 storm-related injuries — most of them minor lacerations — but expected more severe injuries to begin arriving as the day wore on.

And even when patients are ready for discharge, Dr. Antonucci said, “they don’t have any safe place to go.”

Dialysis treatment, which requires large volumes of clean water, posed a major challenge at Lee Health, and the hospital system referred some patients to the five operating dialysis centers nearby. The water supply and power loss have put “incredible strain on our health system,” Dr. Antonucci said. “We cannot run a health system without running water.”

At HealthPark Medical Center in Fort Myers, four feet of water in the parking lot pooled against the hospital’s doors. Officials relocated the emergency department to the third floor.

Nursing homes in the region were struck badly as well. Rescue teams waded through floodwaters to ferry hundreds of assisted living facility residents and staff to safety. Outside the Life Care Center of Orlando, workers dragged wheelchairs and stretchers through flooded parking lots, their fluorescent vests flapping in the wind.

More than 40 nursing home facilities have evacuated at least 3,400 residents, according to the Florida Health Care Association.

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Sept. 30, 2022, 4:42 p.m. ET

Jennifer ReedPatricia Mazzei and

On hard-hit Fort Myers Beach, a terrified couple fled as the waters rose. One didn’t make it.

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Rescue workers in Fort Myers Beach on Thursday.Credit...Hilary Swift for The New York Times

FORT MYERS BEACH, Fla. — Mitch Pacyna and his wife had weathered other hurricanes in their 27 years on this sandy stripe of barrier island and decided to ride out Hurricane Ian at home.

But as the monster storm began to mow down houses around them, Mr. Pacyna posted videos of the churning floodwaters sweeping away an open-air bar he had built. “WE’RE TERRIFIED!!” he wrote in a final Facebook post on Wednesday afternoon.

Mr. Pacyna, 74 — a gregarious fixture of beach life known to friends as “the mayor” — was killed as he and his wife, Mary Wojciechowski, who survived, tried to flee to safety during the storm, Michelle Schuline, his daughter, said. His death was part of a grim toll that began to emerge on Friday, as officials in Florida said that at least three dozen deaths had likely been caused by the storm — a toll they expected to rise.

“The building they were in was being torn apart,” Ms. Schuline said, recalling her father as a devoted Chicago Cubs and Blackhawks fan who had recently traveled to see his granddaughters graduate from high school and college. “They were trying to get to higher ground.”

Gov. Ron DeSantis described the island as “ground zero” in a briefing on Friday.

As southwestern Florida struggled to restore even basic functions like power and water, and rescue workers continued their search for people trapped or killed during the storm, Hurricane Ian hit South Carolina on Friday as a much weaker Category 1 storm, making landfall between Charleston and Myrtle Beach. Storm surge and flash flooding remained threats as Ian was quickly downgraded to a post-tropical cyclone, but initial damage reports were far less dire than what Florida experienced.

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On Pine Island, the largest of Florida’s Gulf Coast islands, volunteers with the Cajun Navy looked for people in distress.Credit...Hilary Swift for The New York Times
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On Pine Island, drinking water and food were scarce, and the only bridge to the mainland was impassable. Credit...Hilary Swift for The New York Times

In places like Fort Myers Beach, Sanibel Island and Pine Island, just west of Fort Myers, an easygoing existence that once revolved around seashell hunts, shrimping, turtle-watching, taking in sunsets over the Gulf, and the ebb and flow of a seasonal tourist economy had been obliterated.

A search team combing buildings on Fort Myers Beach recovered at least one body on Thursday; on Friday, a paramedic spotted a woman’s body floating in the water off Pine Island, while Sanibel officials confirmed several storm-related fatalities there. Drinking water and food were scarce on Pine Island, whose only bridge to the mainland was impassable. And many residents were now uncertain about how long — if ever — it might take to recover.

“It looks like a bomb went off,” said Dana Gosford, a managing partner of Shucker’s, a century-old seafood restaurant and bar in Fort Myers Beach that was flattened by the storm. “We’re just — I don’t know if we’re going to be rebuilding at this point. We’re just still in shock.”

Hurricane Ian’s Category 4 winds and deadly rains hammered communities from Florida’s southwestern coast to the Orlando region, but it was this archipelago of barrier islands that took the most ferocious hit.

In Fort Myers Beach, whose streets jam when the population of about 5,600 swells to tens of thousands during the busy season, beach bars and restaurants that had survived Hurricanes Irma and Charley lay in ruins on Friday.

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Rescue workers have visited at least 3,000 homes in the worst-hit areas up and down Florida’s western coast.Credit...Hilary Swift for The New York Times
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In Fort Myers Beach, beach bars and restaurants that had survived Hurricanes Irma and Charley lay in ruins.Credit...Hilary Swift for The New York Times

A fishing pier had been stripped to its concrete pilings. All that remained of some homes were the stairs leading up to what had once been a door.

After surveying the damage from the air, Jared Moskowitz, a former state emergency management director, estimated that 80 percent of Fort Myers Beach and Sanibel Island might need to be rebuilt. A causeway that had been Sanibel’s only road to the mainland was shorn apart by the storm, further isolating anyone who remained.

Mr. DeSantis, who earlier described the storm surge on the Sanibel as “biblical,” on Friday offered a sobering assessment of the toll.

“If a house just washes away into the ocean, into the water, with 155-mile-per-hour winds, if that person evacuated, that’s great,” Mr. DeSantis said. “If they didn’t, I don’t know how you survive that.”

Mr. DeSantis said on Thursday night that at least 700 people had been rescued, and later said rescuers had visited at least 3,000 homes in the worst-hit areas up and down the coast. He said that some residents who had survived the storm were declining the offers of rescue, insisting that even now they wanted to stay.

On Friday, some residents of Fort Myers Beach trickled back on foot, pulling wagons and carts over the Matanzas Pass Bridge in the hopes of salvaging what they could from what was once their homes. Some had no clue yet whether anything was left to salvage.

“What do you do when you don’t have a building to go back to?” asked Krissy Simone, who owns a spa and salon on Fort Myers Beach. She had been told that the floods reached near the top of her first floor.

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Damage on San Carlos Island, Fla.Credit...Johnny Milano for The New York Times
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“It’s a war zone,” Darrell Hanson, who runs several businesses, said of San Carlos Island. “It couldn’t really be any worse.”Credit...Jason Andrew for The New York Times

Anita Cereceda, a former mayor of Fort Myers Beach who owns three boutiques, said the storm had obliterated many historic homes and businesses that predated sturdier concrete high-rises, demolishing what was left of beloved old traditional, wood frame cottages.

“There is devastation like no one has ever seen,” Ms. Cereceda said. “It is a sickening feeling to think your life’s work has been erased.”

On San Carlos Island, Darrell Hanson began the work on Friday of cleaning up his businesses — Salty Sam’s boat rentals and two restaurants. Storm surge had trashed his shop from floor to ceiling and left behind layers of slippery gray-brown mud.

His employees grabbed brooms while Mr. Hanson worked his phone to find someone — anyone — with heavy machinery.

“It’s a war zone,” Mr. Hanson said. “It couldn’t really be any worse.”

After spending the storm on the mainland, he still did not know how his home on nearby Sanibel Island had fared. He and other Sanibel residents wanted to ride out in a boat since the bridge was impassable, but the marina was so jammed with storm-tossed boats that Mr. Hanson did not think he could safely navigate from San Carlos Island.

In a mobile home park nearby on San Carlos, Tammy Clements, 57, had lost everything she owned, including her cat, Double Dip Oreo.

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Tammy Clements, who lived in a mobile home park on San Carlos Island, narrowly escaped the rising floodwaters but lost her home and her cat. Credit...Johnny Milano for The New York Times
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Peter Neelon, Ms. Clements’s boyfriend, recalling the water that had risen inside his trailer after the hurricane made landfall. Credit...Johnny Milano for The New York Times

The floodwaters inside her trailer had reached her neck, and she was forced to swim to another neighbor’s trailer where she regained her strength by resting on a floating couch before setting out yet again to her boyfriend’s trailer. Her back and legs were bruised from the harrowing escape.

“I didn’t die,” she said, still astonished. Her dog, Nugget, had also survived.

As helicopters whisking people out of Fort Myers Beach thumped overhead, Ms. Clements and her boyfriend, Peter Neelon, 75, surveyed the damage inside his damp-smelling trailer, where the flood had left a mark three-quarters of the way up the wall. His television and car were both destroyed. He was air-drying underwear on a rack outside.

“I don’t know what I’m going to do,” Ms. Clements said, but she pointed at Mr. Neelon, who had bought her now-wrecked trailer for her. “He will make sure I won’t be homeless.”

On Pine Island, scenes of desperate rescue were still unfolding as volunteers with the Cajun Navy sought out addresses of people potentially in distress.

They rescued a 28-year-old man who rode out the storm with his mother, and a 98-year-old man who had been with his son and daughter-in-law when their house flooded. The older man shivered in the cold spray of the surf as the volunteer rescuers whisked him to the mainland.

Off the island, residents who had fled the storm have been turning to Facebook community groups and watching the news for word of whether their homes survived.

One resident, Kevin McVey, had not wanted to leave home but evacuated when his wife, Cheryl, insisted. They and their 20-year-old daughter left with the clothes on their backs, their dog and a couple of gas cans. They thought they would be gone for a few days, but now they did not know when they would be able to return since the bridge to the mainland was destroyed.

Ian was their first Florida hurricane.

On Friday, a neighbor managed to reach them by hiking to a cellphone hot spot near Matlacha, a quirky, pastel-hued community that was now heavily damaged. The McVeys had lost a lot of trees, but their home itself, which sits on the middle of the island about 12 feet above sea level, appeared undamaged.

Hilary Swift, Amanda Holpuch, Ruth Graham and Vimal Patel contributed reporting. Susan C. Beachy, Kitty Bennett and Kirsten Noyes contributed research.

Mitch Smith
Sept. 30, 2022, 4:39 p.m. ET

Photographs of a Florida barrier island show the damage from Hurricane Ian.

Hurricane Ian damaged homes on Sanibel Island and destroyed parts of the causeway connecting the area to the Florida mainland, leaving residents stranded amid the wreckage.

The storm tore roofs off houses and left rubble scattered across yards. Rescue crews continued to survey the island, in southwest Florida near Fort Myers, and search for survivors.

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