Note: This story has been updated to reflect the latest information given by Gov. Roy Cooper on Sunday.
First responders have confirmed "multiple" people were killed in flood events or landslides caused by Hurricane Helene, and search and rescue operations continue in Asheville and Buncombe County, in the hardest-hit part of the state. The scope of the disaster and the scale of the devastation were becoming apparent through the weekend, with washed out roads and highways, no potable water, fuel shortages and an effective communications blackout covering much of the state's western region.
On Sunday afternoon, Gov. Roy Cooper said in a news conference that 11 people have been confirmed dead in North Carolina. That's the number reported by the North Carolina Medical Examiner's Office.
"Tragically, we know there will be more. Our prayers and condolences go out to those families in this terrible time," Cooper said.
The Buncombe County Sheriff's Office said Sunday morning the death toll in Buncombe County alone is now 10 people.
Hundreds in the western part of the state have been rescued from floodwaters by aircraft and boat. In the largest rescue mission, 41 people were rescued from an area just north of Asheville. Other states have added 15 aircraft to the operations.
"Many people are cut off, because roads are impassable," Cooper said. "They don't have power or communications. Please know that we are sending resources ... to help those impacted by this tragic storm."
As of Sunday morning, there were 280 state-maintained roads closed, the majority in Henderson, Ashe, Buncombe, Lincoln, Cleveland, Jackson, Transylvania and Yancey counties. Interstate 40 remains closed near the Tennessee border where part of the highway washed out at Old Fort. Crews opened up I-26 just south of Asheville. Officials urged people to avoid all travel, consider all roads in the western part of the state closed, and conserve fuel.
"Besides endangering yourself, you could also be interfering with emergency responders or repair crews. Please let the professionals do their jobs," said William Ray, the state's emergency management director.
Food and water are being airlifted into Asheville and surrounding areas, Cooper said, and officials are opening a 20-bed temporary hospital in Caldwell County to help.
"This is an unprecedented tragedy," Cooper said.
The fatalities include a man who drove his truck on a flooded road, Cooper's office said Saturday, and officials urged people to stay home.
“They are our friends and our neighbors and they are our loved ones. If you are a praying person, this is the time to pray," Buncombe County Sheriff's Office Chaplain Winston Parrish said.
Those who were killed have not been publicly identified as of Sunday afternoon. Officials say they are attempting to make contact with relatives.
“This is a time for us to come together as a community," Parrish said. “We’re still in a very difficult time ... This is not the time for us to process everything ... We have to process it day by day."
President of Cannon Hospital Stephanie Pate Greer said that for Watauga and Avery counties, communication is the biggest challenge, as well as fuel shortages. The hospital is running on backup power.
"In Avery County, the only communication mechanism that is working is our 911 system. So that means that emergency communications, the emergency manager, county manager, EMS, hospital services, local electric companies cannot communicate with the people coordinating services, " she said. "We are struggling because generator power at a hospital level covers essential functions, but not non-essential functions. So things like being able to provide food to the masses is not something we are able to do consistently."
Philip Adams is the director of the Avery County Senior Center in Newland, which was destroyed. He said he doesn't know how the center's largely homebound clients are faring.
"We do 90-plus home-delivered meals a day and I don’t know when we’ll be able to get that going again. They’re the clients I worry about the most. Because we have a lot of homebound clients, we’re the only person they see. I’m hoping to maybe in the next couple of days start getting out to them, seeing who’s okay," he said.
Boone Mayor Tim Futrelle said the town's business center was flooded. It's the start of the busiest time of year for the mountains' tourist season, adding an economic blow to the storm's toll.
"Never thought I'd see a river running down King Street, but unfortunately, that is exactly what we saw. And just thinking a lot about our small business owners and our folks that are the backbone of our community that help keep us thriving, we're going to need a lot of help to support them as well to recover and rebuild," he said.
The damage is extreme, Cooper said.
“The catastrophic devastation to western North Carolina is like nothing we have ever seen,” said Cooper. “Emergency responders are working around the clock coordinating rescues and getting resources to help people with their immediate needs as they work to save lives.”
Fifty-two water systems are without power and 93 systems were under boil-water advisories as of Sunday morning.
"The N.C. Department of Transportation is prioritizing work to reopen interstates, U.S. and state highways before getting to secondary routes, but the department also is working with utility companies and local emergency officials to find alternative routes and to assist in maintaining access to shelters and restoring power," Gov. Cooper's office said in a statement.
The state has activated the North Carolina Disaster Relief Fund, managed by the United Way of North Carolina.
Some residents were shocked by the level of destruction, and felt caught off-guard.
"Our governor said we were ready. This is not ready. Everybody here in this town, they don't have electricity. The whole county. How does that happen? What's going on?" said Terrence Howard, charging his phone outside a Dollar Tree in Shelby.
Cell service remained spotty throughout western North Carolina, and Cooper urged cell companies to restore service as quickly as possible. Officials said it could be "several days" before repairs are complete or backup systems are in place.
UNC Asheville is closed through Oct. 9, though the campus remains open for stranded students.
Buncombe County Manager Avril Pinder on Saturday described Helene's assault — floods, landslides, and widespread destruction — on her community as: "Buncombe County's own Hurricane Katrina."
The county's assistant emergency services director said there is "biblical devastation through the county."
"We've had biblical flooding," said Ryan Cole, with Buncombe County government.
On Saturday, people continued to flee east to the Charlotte region. Power was out Saturday afternoon around Shelby, with people queuing for gas and gathering around the few working public outlets to charge cell phones. Store shelves were bare as far east as parts of Gastonia.
Duncan McFadyen, Zachary Turner and WFDD contributed.