PENSACOLA, N.C. (AP) — Rescue crews and volunteers facing obstacles at every turn in North Carolina’s remote mountains paddled canoes across swollen rivers and steered horses past mudslides in the rush to reach those stranded or missing by Hurricane Helene’s rampage that killed more than 200 throughout the Southeast.

Now a week since the storm first roared onto , the search continued for people who have yet to be heard from in places where phone service and electricity were knocked out. Pleas for help came from people running low on medicine or in need of fuel for their generators. How many people are missing or unaccounted for isn’t clear.

The soared to 215 people on Thursday as more victims were found, making Helene the deadliest hurricane to hit the mainland U.S. since in 2005.

Roughly half the victims were in North Carolina, while dozens more were killed in South Carolina and Georgia. Each road presents a new challenge for rescuers Along the Cane River in western North Carolina’s , rescuers from the Pensacola Volunteer Fire Department were cutting their way through trees at the top of a valley nearly a week after a wall of chocolate-milk colored water swept through for hours. Pensacola, which sits a few miles from Mount Mitchell, the highest point east of the Mississippi River, lost an untold number of people, said Mark Harrison, chief medical officer for the department.

“We’re starting to do recovery,” he said Thursday. “We’ve got the most critical pe.