The National Hurricane Center said Ian made landfall early Thursday as a tropical storm. But a hurricane warning was issued later in the day for the entire South Carolina coast as the storm’s center drifted off the coast of Florida and back out to sea. The most recent forecast from the National Weather Service put Ian’s winds at 112 km/h, just short of hurricane strength. Warm Atlantic waters are expected to help it gather strength as it curves back toward the US coast. Flood waters rose waist-high near Orlando, Florida, far inland, and tropical storm-force winds extended outward as far as 400 miles (665 km) from the center. Up to 30 cm of rain was forecast for parts of northeast Florida, coastal Georgia and South Carolina’s Lowtree. Up to 15 centimeters could fall in southern Virginia as the storm moves inland over the Carolinas, and the center said mudslides were possible in the southern Appalachian Mountains. Ian turned roads into rivers and toppled trees as it lashed southwest Florida with winds of 150 mph (241 km/h), the fifth-strongest hurricane ever to hit the US when measured by wind speed. A light pole downed by Hurricane Ian is seen in downtown Orlando, Florida, on Thursday. Hurricane Ian has left a path of destruction in southwest Florida, trapping people in flooded homes, destroying the roof of a hospital intensive care unit and knocking out power. (Willie J. Allen Jr./Orlando Sentinel/The Associated Press) “The Coast Guard had people who were in their attics and rescued from their roofs,” Florida Governor Ron DeSantis said. “We’ve never seen a storm surge of this magnitude. … The amount of water that’s rising, and will likely continue to rise today even as the storm passes, is basically a 500-year flood event.” Authorities have confirmed at least one storm-related death in Florida — a 72-year-old Deltona man who fell into a canal while using a hose to drain his pool in heavy rain, the Volusia County Sheriff’s Office said. US President Joe Biden said he approved DeSandis’ request that the federal government cover the full cost of removing the debris and the cost to save lives. “This could be the deadliest hurricane in Florida history. The numbers are still unclear, but we are hearing early reports of significant loss of life,” Biden said. The damage will be “catastrophic” and the Federal Emergency Management Agency (FEMA) is preparing for potentially thousands of people to be displaced in the long term, the agency’s director said Thursday. “I don’t think we can quantify it yet,” FEMA Director Dean Criswell told CNN.

“Keep trying”: calls for help don’t go through

Law enforcement officials in nearby Fort Myers, Florida, received calls from people trapped in flooded homes or from concerned relatives. Appeals were also posted on social media sites, some with videos showing water covered in debris heading towards the eaves of houses. With no electricity and patchy cellphone coverage, many calls for help didn’t get there, even as emergency crews sawed through downed trees to reach people in flooded homes. An aerial view of damaged and flooded homes after Hurricane Ian tore through the area, in this still image captured by video in Lee County, Florida, on Thursday. (WPLG-TV/ABC/Reuters) A piece of the Sanibel Causeway fell into the sea, cutting off access to the barrier island where 6,300 people normally live in Lee County. It is not clear how many of these people were left. South of Sanibel, towering waves destroyed the historic beach pier in Naples, even ripping out the pilings underneath. “Right now, there is no pier,” said Penny Taylor, a commissioner in Collier County, which includes Naples. Emergency crews sawed through uprooted trees to reach people in flooded homes, but with no electricity and almost no cell phone service, it was impossible for many people to call for help from the worst-hit coastal areas where the surge came. “Cell towers are in the way of cell service. Chances are your loved ones won’t be able to reach you,” said the sheriff’s office in Collier County, which includes Naples. “We can tell you, as daylight reveals the aftermath, it’s going to be a tough day.”

Hospitals face a number of problems

Thousands of people were evacuated from nursing homes and hospitals across Florida on Thursday, even as winds and water from Hurricane Ian began to recede. Hundreds of those evacuations were taking place throughout the hard-hit Fort Myers area, where damage cut off drinking water to at least nine hospitals. Kristen Knapp of the Florida Health Association says 43 nursing homes have evacuated about 3,400 residents as of Thursday morning, mostly in Southwest Florida. A storm flooded the lower-level emergency room at HCA Florida Fawcett Hospital in Port Charlotte, while high winds tore part of the fourth-floor roof off the intensive care unit, according to a doctor who works there. Dr. Birgit Bodine spent the night at the hospital, expecting the storm to be busy, “but we didn’t expect the roof to blow off on the fourth floor,” she said. Bodine plans to spend another night in the hospital when the upcoming storm injuries could make things worse. “Ambulances may be coming soon and we don’t know where to put them in the hospital right now,” he said. “Because we double and triple.” The heavily damaged boardwalk in Sanibel in Lee County is seen after Hurricane Ian tore through the area. (WPLG-TV/ABC/Reuters) While too much water was the problem across much of the state, at least nine hospitals in Southwest Florida had the opposite problem. “We have a large health system in Southwest Florida that is without water in all of their facilities. And so they’re quickly approaching a point where they’re not going to be able to safely care for their patients. So that’s an urgent focus for these patients to be moved,” said Mary Mayhew, president of the Florida Hospital Association. Mayhew said more than 1,200 patients were evacuated. Stedi Scuderi looks at her apartment in Fort Myers, Fla., early Thursday after it suffered flood damage. (Joe Raedle/Getty Images) In Orlando, residents of the Avante nursing home were taken to waiting ambulances and buses through flooding in a neighborhood that usually doesn’t flood. Paramedics took the residents out one by one on stretchers and wheelchairs.

Other states are preparing for the deluge

More than 2.7 million Florida homes and businesses were without power, according to the website PowerOutage.us. Most homes and businesses in 12 counties were without power. Airline tracking website Flightaware reported that 1,935 flights for Thursday were canceled and 738 flights for Friday were canceled. 9/29, 11 am EDT: There is a risk of life-threatening storm surge from pic.twitter.com/h7h6ZevGhx —@NHC_Surge Walt Disney said its Orlando theme parks will close again Thursday. The storm is forecast to make landfall in South Carolina on Friday. The governors of that state, North Carolina, Georgia and Virginia declared states of emergency as a precaution. “There will be water tomorrow in this city,” said Charleston Mayor John Tecklenburg. He asked the city to shut down in preparation for Ian’s approach. In Charleston, officials opened garages so residents could bring their cars over the impending flood. Forecasters predicted Friday afternoon’s seventh-highest water level in more than 120 years of record-keeping, at 2.7 meters above mean tide in the downtown harbor.