Like Hurricanes Harvey and Katrina before it, most of Hurricane Florence's damage will not be from the wind but the water.
Yes, some people died when they were crushed by trees felled by Florence's winds as it swept across the Carolinas and some homes were destroyed. But most of Florence's victims died in the massive floods that will cause wide and long-term damage to houses, businesses, roads and other infrastructure and produce a spike in water-borne illness. Tens of thousands of Carolinians have been evacuated from the rising floods, and there are worries that some dams might fail. Feces, urine and the decaying carcasses of hogs, chickens and other animals from the states' industrial-scale farms may pollute the water supply.
A house buried in water will likely need to be demolished and replaced. It's unknown how many homes are damaged and destroyed, but even in the best of circumstances furniture, refrigerators and other appliances will almost certainly be ruined. Water can compromise or ruin wallboard, electrical systems, insulation, doors, windows and cabinets. Wooden floors warp, swell and can even float away; mold grows in the moist, humid interior, posing the risk of respiratory problems.
Forty inches or more of water pounding the pavement in less than a week can undermine streets. The relentless pressure can loosen the foundation — compacted soil, gravel or sand — leading to cracking and potholes. Pieces of pavement can slide away, requiring the roads be rebuilt.
Water from Katrina and Harvey transformed New Orleans and Houston. Neighborhoods were destroyed, and people had to move -- some temporarily and some permanently. That will likely be the fate of some Carolina towns and communities.
Long after the danger of drowning subsides, water, oddly enough, can wreak havoc on your health — by forcing you to dry places. Storm survivors who fled flooded homes found refuge in large shelters, but those temporary living quarters can become incubators for infections. Experts warn that evacuees in crowded shelters can develop norovirus, a highly contagious intestinal infection marked by vomiting and diarrhea — an illness that has been known to occur on cruise ships.
New health problems can arise once flood victims return homes. Inside, mold can cause breathing troubles, but that can be avoided by wearing a mask. Outside, standing pools of stagnant water contaminated by chemicals and garbage become ideal breeding spots for mosquitoes. Their bites can create serious diseases such as encephalitis.
Superstorm Sandy. Katrina. Harvey. The epic disasters in the New York metro area, New Orleans and Houston left residents wrestling with the emotional anguish of losing their homes, their livelihoods and their sense of security. The same psychological trauma is likely to emerge in the Carolinas.
Those feelings can linger for years. One study found that residents in the path of Sandy suffered from depression and post-traumatic stress. Another concluded that children displaced by Katrina still had serious emotional or behavioral problems five years later.
Being in a large shelter, though, can boost the spirits of storm survivors because they can share stories and turn to each other for support.