The domestic death toll from Hurricane Ian has climbed to at least 48 with at least three others confirmed dead in Cuba, according to The New York Times on Sunday (Oct. 2) morning. Ian made landfall in Florida, where it claimed 44 lives starting on Wednesday (Sept. 28) as a Category 4 storm with sustained winds up to 150 mph.

Ian barreled across the state’s southwest coast, through central Florida, and back into the Atlantic Ocean before it hit the coasts of South and North Carolina, where it lost strength and was downgraded to a life-threatening tropical storm. As heavy rains fell and homes were destroyed, at least four others were killed in North Carolina.

All the while, the hurricane left a trail of devastation, downed power lines, and flood waters that left thousands stranded. According to The Washington Post, Ian is the 37th hurricane with a Category 3 or stronger designation that has struck the panhandle state. It is also one of the five most powerful storms to hit the United States.

By Sunday (Oct. 2), several rescue and relief efforts were in motion. Just under one million Florida residents are still without power with another 30,000 in South Carolina. At least 1,000 Floridians were rescued. “We’re flying and we’re operating in areas that are unrecognizable,” he said. “There’s no street signs. They don’t look like they used to look like. Buildings that were once benchmarks in the community are no longer there,” said U.S. Coast Guard Rear Adm. Brendan McPherson.

The state’s barrier islands, such as Sanibel and Captiva, are now cutoff from the mainland after Ian wrecked bridges and roads. Sanibel resident Andy Boyle told CNN, “When you go to the east end of the island, there’s just a lot of destruction. The houses surrounding the lighthouse are all gone.” Authorities have already estimated that the recovery process is among one of the most expensive in the state’s history. Check out images of Ian’s destruction in the posts below.