PERRY, Fla. (AP) Hurricane Helene left an enormous path of destruction across Florida and the southeastern U.S. on Friday, killing at least 44 people, snapping towering oaks like twigs and tearing apart homes as rescue crews launched desperate missions to save people from floodwaters.

Among those killed were three firefighters, a woman and her 1-month-old twins, and an 89-year-old woman whose house was struck by a falling tree. According to an Associated Press tally, the deaths occurred in Florida, Georgia, North Carolina, South Carolina and Virginia.

The Category 4 hurricane knocked out power to some hospitals in southern Georgia, and Gov. Brian Kemp said authorities had to use chainsaws to clear debris and open up roads. The storm had maximum sustained winds of 140 mph (225 kph) when it made landfall late Thursday in a sparsely populated region in Floridas rural Big Bend area, home to fishing villages and vacation hideaways where the states panhandle and peninsula meet.

Moodys Analytics said it expects $15 billion to $26 billion in property damage.

The wreckage extended hundreds of miles northward to northeast Tennessee, where a dangerous rescue situation by helicopter unfolded after 54 people were moved to the roof of the Unicoi County Hospital as water rapidly flooded the facility. Everyone was rescued and no one was left at the hospital as of late Friday afternoon, Ballad Health said.

In North Carolina, a lake featured in the movie Dirty Dancing overtopped a dam and surrounding neighborhoods were evacuated, although there were no immediate concerns it would fail. People also were evacuated from Newport, Tennessee, a city of about 7,000 people, amid concerns about a dam near there, although officials later said the structure had not failed.