(NEXSTAR/AP) — Even as Helene was downgraded from a powerful Category 4 hurricane to a tropical storm, it continued to dump heavy rain as it blew through the South Friday. Emergency crews were rushing to rescue people trapped in flooded homes amid a massive storm surge and millions of customers in several states were left without power.

As officials and residents took stock of the damage, the death toll mounted to at least 41 victims Friday. At least seven people were killed in Florida, Nexstar’s WFLA reported. At least two of the people killed appeared to have drowned.

In North Carolina, one person was killed by a falling tree and a second person died in a motor vehicle crash on a flooded roadway, according to Gov. Roy Cooper. To make matters worse, a “significant tornado” also touched down near Rocky Mount, injuring at least 15 people.

Falling trees also took lives in South Carolina, where at least 17 storm-related deaths were being investigated. Two firefighters were among those killed, Gov. Henry McMaster said. They were trying to “serve the community during the hurricane,” the Lugoff Fire Department said, when a tree came down on their truck.

Gov. Brian Kemp’s office confirmed to Nexstar that at least 15 people died in Georgia. Multiple hospitals in southern Georgia were without power, and authorities were “having a hard time getting to places,” so teams with chainsaws were “working to free up roads,” Gov. Brian Kemp told a news conference. Tornadoes were also confirmed in the state, killing at least two when a mobile home was overturned in Wheeler County.

Helene made landfall late Thursday in a sparsely populated region with maximum sustained winds of 140 mph in the rural Big Bend area, home to fishing villages and vacation hideaways where Florida’s Panhandle and peninsula meet. But the damage extended hundreds of miles to the north, with flooding as far away as North Carolina. One Georgia county was almost entirely without power.

“Thank God we’re both alive to tell about it,” Rhonda Bell said after a towering oak tree outside her home in Valdosta, Georgia, smashed through the roof.

Video on social media sites showed sheets of rain coming down and siding coming off buildings in Perry, Florida, near where the storm arrived.

First responders were out in boats early Friday to rescue people trapped by flooding in Citrus County, some 120 miles south of Perry. Another video, shared by the Coast Guard, showed a man and his dog being pulled out of the Gulf Coast waters.

“If you are trapped and need help please call for rescuers – DO NOT TRY TO TREAD FLOODWATERS YOURSELF,” the sheriff’s office warned in a Facebook post. Authorities said the water could contain live wires, sewage, sharp objects and other debris.

Rescuers in Tampa also used boats to reach stranded residents. “Flooding was what we had warned everyone about,” Mayor Jane Castor said.

The threat of catastrophic flooding moved north from Florida to the Carolinas Friday as rivers threatened to break their banks and dams were at risk of failing.

Lake Lure Dam’s failure was “imminent,” emergency officials in Rutherford County, North Carolina warned. As of 3:45 p.m., officials said water was going over the dam and flowing around the side walls. Evacuation sirens were sounding downstream of the dam and emergency personnel are going door to door to ensure that everyone has been evacuated.

Mandatory evacuations were also in place near Asheville, North Carolina, due to flooding of the Swannanoa River valley.

Forecasters expected the system to continue weakening as it moves into Tennessee and Kentucky and drops heavy rain over the Appalachian Mountains, with the risk of mudslides and flash flooding. The Nashville area was experiencing serious flooding Friday morning.

In Unicoi County, Tennessee more than 50 people were sent to the roof of the Unicoi County Hospital to be rescued after flooding cut the hospital off from the land. “The hospital has been engulfed by extremely dangerous and rapidly moving water,” Ballad Health stated in a news release.

People in the hospital were ordered to evacuate after “unusually high rising water from the Nolichucky River,” according to emergency management officials.

The hurricane came ashore near the mouth of the Aucilla River on Florida’s Gulf Coast. That location was only about 20 miles northwest of where Hurricane Idalia hit last year with nearly the same ferocity and caused widespread damage.

As the hurricane’s eye passed near Valdosta, Georgia, a city of 55,000 near the Florida line, dozens of people huddled early Friday in a darkened hotel lobby. The wind whistled and howled outside.

Electricity was out, with hallway emergency lights, flashlights and cellphones providing the only illumination. Water dripped from light fixtures in the lobby dining area, and roof debris fell to the ground outside.

Fermin Herrera, 20, his wife and their 2-month-old daughter left their room on the top floor of the hotel, where they took shelter because they were concerned about trees falling on their Valdosta home.

“We heard some rumbling,” said Herrera, cradling the sleeping baby in a downstairs hallway. “We didn’t see anything at first. After a while the intensity picked up. It looked like a gutter that was banging against our window. So we made a decision to leave.”

In Thomas County, Georgia, where residents had been under a curfew, the sheriff’s office said it was extended until noon Friday. “Please shelter in place,” the office posted online.

Helene is the third storm to strike the city in just over a year. Tropical Storm Debby blacked out power to thousands in August, while Hurricane Idalia damaged an estimated 1,000 homes in Valdosta and surrounding Lowndes County a year ago.

“We’ve seen some storms and grown some thicker skins,” Herrera said.

Soon after it crossed over land, Helene weakened to a tropical storm, with its maximum sustained winds falling to 70 mph. At 11 a.m. Friday, the storm was about 105 miles northeast of Atlanta, moving north at 32 mph with maximum sustained winds of 45 mph, the National Hurricane Center in Miami reported.

Even before landfall, the storm’s wrath was felt widely, with sustained tropical storm-force winds and hurricane-force gusts along Florida’s west coast. Officials begged residents to evacuate.

“Please write your name, birthday, and important information on your arm or leg in a PERMANENT MARKER so that you can be identified and family notified,” the sheriff’s office in mostly rural Taylor County, Florida, warned those who chose not to evacuate in a Facebook post. The dire advice was similar to what other officials have dolled out during past hurricanes.

School districts and multiple universities canceled classes. Airports in Tampa, Tallahassee and Clearwater were closed Thursday, and cancellations were widespread elsewhere in Florida and beyond.

At one point, forecasters feared that hurricane conditions could extend as far as 100 miles north of the Georgia-Florida line. Overnight curfews were imposed in many cities and counties in south Georgia.

“This is one of the biggest storms we’ve ever had,” Georgia Gov. Brian Kemp said.

Helene is the eighth named storm of the Atlantic hurricane season, which began June 1. The National Oceanic and Atmospheric Administration has predicted an above-average Atlantic hurricane season this year because of record-warm ocean temperatures.

The Associated Press contributed to this report.