A crisis was unfolding in western North Carolina, where residents stranded by washed-out roads and by a lack of power and cellular service lined up for fresh water and a chance to message loved ones days after the storm that they were alive.

At least 133 deaths in six Southeastern states have been attributed to the storm that inflicted damage from Florida’s Gulf Coast to the Appalachian Mountains in Virginia.

The toll steadily rose as emergency workers reached areas isolated by collapsed roads, failing infrastructure and widespread flooding. During a briefing Monday, White House homeland security adviser Liz Sherwood-Randall suggested as many as 600 people hadn’t been accounted for as of Monday afternoon, saying some might be dead.

President Joe Biden said he will travel to North Carolina on Wednesday to meet with officials and take an aerial tour of Asheville.

He said earlier that the federal government would be with affected residents in the nation’s southeast “as long as it takes.”

Government officials and aid groups worked to deliver supplies by air, truck and even mule to the hard-hit tourism hub of Asheville and its surrounding mountain towns. At least 40 people died in the county that includes Asheville.

The destruction and desperation were overwhelming. A flattened cargo container sat atop a bridge crossing a river with muddy brown water. A mass of debris, including overturned pontoon boats and splintered wooden docks and tree trunks covered the surface of Lake Lure, a picturesque spot tucked between the mountains outside Asheville.

A woman cradled her child while people around her gathered on a hillside where they found cellphone service, many sending a simple text: “I’m OK.”

The North Carolina death toll included one horrific story after another of people who were trapped by floodwaters in their homes and vehicles or were killed by falling trees. A courthouse security officer died after being submerged inside his truck. A couple and a 6-year-old boy waiting to be rescued on a rooftop drowned when part of their home collapsed.

Rescuers did manage to save dozens, including an infant and two others stuck on the top of a car in Atlanta. More than 50 hospital patients and staff in Tennessee were plucked by helicopter from the hospital rooftop in a daring rescue operation.

How some of the worst-hit areas are coping

Several main routes into Asheville were washed away or blocked by mudslides, including a 4-mile (6.4-kilometer) section of Interstate 40, and the city’s water system was severely damaged, forcing residents to scoop creek water into buckets so they could flush toilets.

People shared food and water and comforted one another in one neighborhood where a wall of water ripped away all of the trees, leaving a muddy mess nearby. “That’s the blessing so far in this,” Sommerville Johnston said outside her home, which has been without power since Friday.

She planned on treating the neighborhood to venison stew from her powerless freezer before it goes bad. “Just bring your bowl and spoon,” she said.

Others waited in a line for more than a block at Mountain Valley Water, a water seller, to fill up milk jugs and whatever other containers they could find.

Derek Farmer, who brought three gallon-sized apple juice containers, said he had been prepared for the storm but now was nervous after three days without water. “I just didn’t know how bad it was going to be,” Farmer said.

Officials warned that rebuilding would be lengthy and difficult. Helene roared ashore in northern Florida late Thursday as a Category 4 hurricane and quickly moved through Georgia, the Carolinas and Tennessee. The storm upended life throughout the Southeast, where deaths were also reported in Florida, Georgia, South Carolina and Virginia.

Federal Emergency Management Agency officials said Monday that shelters were housing more than 1,000 people.

North Carolina Gov. Roy Cooper took an aerial tour of the Asheville area and later met with workers distributing meals.

“This has been an unprecedented storm that has hit western North Carolina,” he said afterward. “It’s requiring an unprecedented response.”

Officials implored travelers from coming into the region to keep the roads clear for emergency vehicles. More than 50 search teams spread throughout the region in search of stranded people.

Waiting for help and searching for a signal in North Carolina

Several dozen people gathered on high ground in Asheville, where they found one of the city’s hottest commodities — a cell signal.

“Is this day three or day four?” Colleen Burnet asked. “It’s all been a blur.”

The storm unleashed the worst flooding in a century in North Carolina. Rainfall estimates in some areas topped more than 2 feet (61 centimeters) since Wednesday.

Ten federal search and rescue teams were on the ground and another nine were on their way, while trucks and cargo planes were arriving with food and water, FEMA said. FEMA Administrator Deanne Criswell surveyed damage with Cooper Monday.

Volunteers were showing up, too. Mike Toberer decided to bring a dozen of his mules to deliver food, water and diapers to hard-to-reach mountainous areas.

“We’ll take our chainsaws, and we’ll push those mules through,” he said, noting that each one can carry about 200 pounds (90 kilograms) of supplies.

Why western North Carolina was hit so hard

Western North Carolina suffered relatively more devastation because that’s where the remnants of Helene encountered the higher elevations and cooler air of the Appalachian Mountains, causing even more rain to fall.

Asheville and many surrounding mountain towns were built in valleys, leaving them especially vulnerable to devastating rain and flooding. Plus, the ground already was saturated before Helene arrived, said Christiaan Patterson, a meteorologist with the National Weather Service.

“By the time Helene came into the Carolinas, we already had that rain on top of more rain,” Patterson said.

Climate change has exacerbated conditions that allow such storms to thrive, rapidly intensifying in warming waters and turning into powerful cyclones, sometimes within hours.

Destruction from Florida to Virginia

Along Florida’s Gulf Coast, several feet of water swamped the Clearwater Marine Aquarium, forcing workers to move two manatees and sea turtles. All of the animals were safe but much of the aquarium’s vital equipment was damaged or destroyed, said James Powell, the aquarium’s executive director.

Georgia Gov. Brian Kemp said the storm “literally spared no one.” Most people in and around Augusta, a city of about 200,000 near the South Carolina border, were still without power Monday.

With at least 30 killed in South Carolina, Helene was the deadliest tropical cyclone to hit the state since Hurricane Hugo made landfall north of Charleston in 1989, killing 35 people.

Tropical Storm Kirk forms and could become a powerful hurricane

Tropical Storm Kirk formed Monday in the eastern Atlantic Ocean and is expected to become a “large and powerful hurricane” by Tuesday night or Wednesday, the U.S. National Hurricane Center said. The storm was located about 800 miles (1,285 kilometers) west of the Cabo Verde Islands with maximum sustained winds of 60 mph (95 kph). There were no coastal watches or warnings in effect, and the storm system was not a threat to land.