Florence, which remained a hurricane for around half a day after making landfall on September 14, but is now a tropical storm, has deluged the Carolinas with rainfall, storm surges, and high winds.
The death toll climbed to at least five.
Seven buoy-tending cutters have been directed to North Carolina to survey and open the ports of Wilmington and Morehead City as well as the North Carolina ferry system.
A third person, a woman, died in Hampstead, NC, in Pender County.
Two more people were killed in Lenoir County.
Researchers and insurance experts say many Americans choose not to get flood insurance because of a belief that flooding will not happen to them, or if it does, federal disaster assistance cover their losses.
"It's hard to believe it's going to get that high", says Elizabeth Machado, who came to the bridge to check on the river.
Two others died in the state from carbon monoxide poisoning caused by a generator inside their home, according to a local coroner. "An investigation into the cause of death is underway, but it appears there is no reason for others at the shelter to worry". One was killed while checking on his dogs outside while another one was electrocuted while trying to connect two extension cords, emergency officials said.
Around 50 stranded people were airlifted by helicopter in North Carolina, said Petty Officer Michael Himes of the U.S. Coast Guard.
Officials fear the worst damage is yet to come.
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As a response to the extreme conditions, about 9,700 National Guard troops have been deployed to carry out rescue operations. Florence's top sustained winds remain at 70 miles per hour (110 kph) as it crawls west at just 3 miles per hour (6 kph).
Catastrophic flash floods and prolonged significant river flooding are likely over for portions of the Carolinas into west-central Virginia and far eastern West Virginia as Florence moves slowly inland, the hurricane center said.
As of Sunday evening, Florence was centered about 25 miles south-southeast of Greenville, South Carolina, the National Hurricane Center said. By Sunday morning Florence's winds had dropped to about 35 miles per hour (55 km per hour), the National Hurricane Centre in Miami said.
According to ABC, "more than 20,000 people in six states - North Carolina, South Carolina, Virginia, Georgia, Maryland and Tennessee - took shelter in 206 Red Cross and community shelters on Thursday". In Fayetteville, a North Carolina city of about 210,000 people some 90 miles (145 km) from the ocean, authorities told thousands of residents near the Cape Fear River and Little River to get out of their homes by Sunday afternoon because of the flood risk. The volunteer United Cajun Navy rescue group says it was helping in Leland, where about 200 people have made calls for help, after it made numerous rescues in Wilmington.
A senior assisted living facility in Cumberland County, NC, was evacuated Saturday, due to flooding concerns around the Cape Fear River, according to WTVD. A 73-mile stretch of the highway closed Saturday because of flooding and an accident involving a tractor-trailer.
"It's the first time we've ever had to move anything like this", Rose said.
More than 2 feet of rain had fallen in places, and the drenching went on and on, with forecasters saying there could be an additional 1½ feet by the end of the weekend.
In South Carolina there are more than 66,000 power outages because of Florence.
The rain and flooding expected Saturday could double the 10 to 20 inches that have fallen so far. Trump is expected to visit the areas once the storm weakens and the conditions improve thereafter. In South and North Carolina evacuated residents of coastal areas is just over 1.5 million people.
The eye of Florence directly struck Wrightsville Beach, NC, early Friday.
When Florence hit as a Category 1 hurricane early Friday, the community's rivers swelled, tides crested and the rain wouldn't stop. It was downgraded to a tropical storm later Friday. More than 15,000 people are staying at 150 emergency shelters.