Rescuers have been working to save around 1,500 residents in North Carolina who were trapped when the Lumber River overflowed because of Hurricane Matthew.
Volunteer firefighters, US marshals and water rescue teams spent about 10 hours locating and ferrying to safety residents in inflated inflated dinghies or bass boats.
"We've got it nowhere near this bad," said Jimmy Hunt Jr, son of the chief of the volunteer fire department in Rayham.
The rescue teams were expected to be back at work across eastern North Carolina on Tuesday as the deluge rolled downstream toward the Atlantic Ocean. At least three rivers were forecast to reach record levels, some not cresting until Friday.
Hurricane Matthew killed more than 500 people in Haiti and at least 23 in the US - nearly half of them in North Carolina. At least three people were missing.
The full extent of the disaster in North Carolina was still unclear, but it appeared that thousands of homes were damaged, and more were in danger of flooding.
Robert Barnhill, 83, and his wife Katie, 81, left everything inside their Lumberton home but their medications, a couple of blankets and a pillow.
"The water's up to the porch now, so it's got one more step to go" before entering their home of 35 years, Robert Barnhill said after being rescued on Monday afternoon. "I've never seen a flood like this before."
Rescuers still had not made it to all the submerged cars or figured out exactly how many people are missing or dead, county emergency management director Stephanie Chavis said.
"I've been here right at 28 years," Ms Chavis said. "This seems to be the worst one we've had in my career."
Elsewhere in North Carolina, officials said a dam has been in danger of a breech after the storm was holding, so far. Crews worked until about 2am on Tuesday to get sandbags in place to reduce the threat at Woodlake Dam in Moore County near Vass, deputy public safety director Scott Brooks said.
Mr Brooks said crews would be out again later to finish. The work would need to be inspected before residents could return home.
In many areas, Matthew's aftermath was compared to Hurricane Floyd, which caused 3 billion US dollars in damage and destroyed 7,000 homes as it skirted the coast in 1999.
Officials were concerned that other cities could suffer the fate of Lumberton, a community of 22,000 people about 80 miles from the ocean. With electricity cut off in the storm's wake, there was virtually no gasoline, water or food for sale.
The Reverend Volley Hanson worried that stress from the lack of running water and electricity might push people over the edge. Robeson County, which includes Lumberton, had North Carolina's highest violent crime rate in 2014.
"The cash is going to be running out. We've already got street vendors hawking water, Cokes and cigarettes. Cigarettes are at seven bucks a pack," Reverend Hanson said. "It's nuts here, and it's going to get worse."
The Lumber River crested 4 feet above its record level Sunday in Lumberton and was forecast to remain there until Saturday. A levee appeared to fail early on Monday, but officials later concluded that floodwaters had flowed around it.
River flooding was happening in other places, too. In the tiny town of Nichols, South Carolina, downstream from Lumberton, at least 100 people spent the night on the third floor of the town hall.
Interstate 95 - a major artery for the East Coast - was closed in Lumberton and engineers had no estimate on when it would reopen. Driving was difficult, if not impossible because hundreds of roads were closed, in some cases isolating entire towns. Dozens of school districts and East Carolina University canceled classes for the entire week. Nearly 1 million people in North Carolina and South Carolina were without power, two days after the eye of the hurricane moved out to sea.
In addition to the 11 deaths in North Carolina, there were five in Florida and three each in Georgia and South Carolina. One death was reported in Virginia.
Authorities in coastal Georgia and South Carolina warned residents it may take days or even weeks to restore electricity and clean up all the debris. People who tried to go home but were blocked by authorities who said the damage was still too severe grew increasingly frustrated.
Maureen Miller, her family and dog finally did make it back to their coastal Georgia home. She now wishes she hadn't listened to the dire warnings to leave or drown after finding her house unscathed.
"I will never evacuate again," Ms Miller said. "If we stayed, we'd be fine. I'm sure there are a lot of people who feel the same way."
Matthew's flooding in North Carolina was made worse by heavy rains in September. Many areas east of I-95 got at least twice their normal amount of rain in September, in part because the remnants of Tropical Storm Julia parked off the coast for several days.