Hurricane Ian left a trail of destruction across southwest Florida, trapping people in flooded homes, damaging the roof of a hospital’s intensive care unit and knocking out power to 2 million people before heading for the Atlantic coast .

One of the strongest hurricanes to ever hit the United States tore through the Florida panhandle overnight Wednesday, threatening catastrophic flooding inland, the National Hurricane Center warned.

In Port Charlotte, along Florida’s Gulf Coast, storm surge flooded a lower-level emergency room at a hospital even as high winds ripped part of the roof off its intensive care unit, according to a doctor working over there.

Water spilled over the ICU, forcing staff to evacuate the hospital’s sickest patients, some of whom were on ventilators, to other floors, said Dr. Birgit Bodine of HCA Florida Fawcett Hospital. Staff members used towels and plastic containers to try and clean up the soggy mess.

The medium-sized hospital has four floors, but patients were forced to stay on just two due to damage. Bodine planned to spend the night there in case people injured by the storm needed help arriving.

“As long as our patients are doing well and no one ends up dying or having a bad outcome, that’s what matters,” Bodine said.

Law enforcement officials in nearby Fort Myers received calls from people trapped in flooded homes or from concerned family members. Pleas were also posted on social media sites, some with videos showing debris-covered water sloshing toward the eaves of homes.

Brittany Hailer, a Pittsburgh journalist, contacted rescuers about her mother in North Fort Myers, whose home was inundated by 5 feet (1.5 meters) of water.

“We don’t know when the water is going to go down. We don’t know how they are going to leave, their cars are wrecked,” Hailer said. “His only way out is on a boat.”

Hurricane Ian turned streets into rivers and toppled trees as it slammed into Southwest Florida on Wednesday with 150 mph (241 kph) winds, pushing up a wall of storm surge. Ian’s strength at landfall was Category 4 and tied it for the fifth strongest hurricane, measured by wind speed, to hit the US.

Ian weakened Wednesday night to a Category 1 with 90 mph (144 kph) winds as it moved overland. Still, storm surges of up to 6 feet (2 meters) were expected on the opposite side of the state, in northeast Florida, on Thursday.

And hurricane-force winds were expected in central Florida through early Thursday with widespread catastrophic flooding, the Miami-based hurricane center said.

No deaths were reported in the United States from Ian as of Wednesday night. But a boat carrying Cuban migrants capsized Wednesday in stormy weather east of Key West.

The US Coast Guard launched a 23-person search and rescue mission and managed to find three survivors about two miles (three kilometers) south of the Florida Keys, authorities said. Four other Cubans swam to Stock Island, just east of Key West, the US Border Patrol said. Aircrews continued to search for possibly the remaining 20 migrants.

The storm previously hit Cuba, killing two people and bringing down the country’s power grid. The eye of the hurricane made landfall near Cayo Costa, a barrier island just west of densely populated Fort Myers. As it got closer, the water drained from Tampa Bay. More than 2 million Florida homes and businesses were without power, according to Nearly every home and business in three counties was without power.

Sheriff Bull Prummell of Charlotte County, just north of Fort Myers, announced a curfew between 9 p.m. and 6 a.m. “in order to save lives,” saying violators can face misdemeanor charges in second grade.

“I am enacting this curfew as a means of protecting the people and property of Charlotte County,” Prummell said.

The Weather Underground predicted the storm would pass near Daytona Beach and move out into the Atlantic before making landfall in South Carolina on Friday.

The governors of South Carolina, North Carolina, Georgia and Virginia preemptively declared states of emergency. Forecasters predicted Ian will turn toward those states as a tropical storm, likely dumping more torrential rain over the weekend.

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