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Some residents began returning home Saturday to salvage what they could from destroyed properties.
Officials in the Appalachian region of eastern Kentucky said the death toll could rise yet further in the region’s worst natural disaster in decades.
Governor Andy Beshear said search-and-rescue operations were ongoing with crews continuing to battle to get into hard-hit places, some of them among the poorest places in America.
Among the affected residents was Phillip Michael Caudill, who was working Saturday to recover what he could from his home in the tiny community of Wayland.
"We’re just hoping we can get some help," said Mr Caudill, who is staying with family for now.
Mr Caudill is a firefighter in the nearby Garrett community and went out on rescues around 1am Thursday. He then had to ask to leave around 3 am so he could go home, where waters were rapidly rising.
"That’s what made it so tough for me," he said.
"Here I am, sitting there, watching my house become immersed in water and you got people begging for help. And I couldn’t help.”
Hubert Thomas, 60, and his nephew Harvey, 37, said they feared the damage to their home was beyond repair.
Mr Thomas, a retired coal miner, said his entire life savings was invested in his home.
State governor, Mr Beshear, said: “We continue to pray for the families that have suffered an unfathomable loss.
“Some having lost almost everyone in their household."
He said the number would likely rise significantly and it could take weeks to find all the victims of the record flash flooding.
Crews have made more than 1,200 rescues from helicopters and boats, the governor said.
"I’m worried that we’re going to be finding bodies for weeks to come," he said in a briefing Saturday.
The rain let up early Friday after parts of eastern Kentucky received between 8 and 10 1/2 inches of rain over 48 hours.
President Joe Biden has declared a federal disaster to direct relief money to more than a dozen Kentucky counties.