By Nouran Salahieh and Holly Yan, CNN
(CNN) - Newly homeless Floridians are struggling to restart their lives while rescuers scramble to find any remaining signs of life among the wreckage of Hurricane Ian.
In some cases, emergency workers are juggling both unimaginable tasks.
"Some of the guys on Pine Island, they lost everything, but they're doing what they can," said emergency physician Dr. Ben Abo, who was preparing to join first responders on a rescue mission Sunday near decimated Sanibel Island and Pine Island.
"It brings tears to my eye to see how hard they're working."
But because Hurricane Ian washed out Sanibel Island's lone road to mainland Florida, "we're helicoptering in and doing our grid search," Abo said.
More than 1,100 people have been rescued from inundated parts of southwest and central Florida since Ian crashed into the state last week, Gov. Ron DeSantis' office said.
But as the search for survivors continues, rescuers are also finding more bodies. Officials say Ian killed at least 74 people in Florida and four more in North Carolina.
Those lucky enough to survive face an arduous road to recovery. About 812,000 homes, businesses and other customers in Florida still did not have power as of early Sunday afternoon, according to PowerOutage.us. Nearly 21,000 remained in the dark in North Carolina, and roughly 8,000 customers in Virginia had no electricity.
'Anybody who lives near water' should get flood insurance, FEMA chief says
Hurricane Ian could be the most expensive storm in Florida's history, devastating communities from the state's western coast to inland cities like Orlando.
While Florida has more flood insurance policies than any other state, only about 13% of homes there have flood insurance, and only 18% who live in the counties that had mandatory or voluntary evacuation orders in place ahead of Ian, according to an analysis by actuarial firm Milliman.
On Sunday, the head of the Federal Emergency Management Agency said Americans don't have to live in a flood zone to benefit from flood insurance.
"I think anybody who lives near water should certainly purchase flood insurance because it's your No. 1 tool to help protect your family and your home after the storm," FEMA Administrator Deanne Criswell said.
"If you live near water or where it rains, it can certainly flood, and we have seen that (with) multiple storms this year."
She said FEMA is in the process of updating its flood zone maps. "While in certain areas we require flood insurance, everybody has the ability to purchase flood insurance," Criswell said
"It is certainly in your best defense to help protect your property in the aftermath of any of these storms."
Parts of Florida are now 'unrecognizable'
But the most severe lashing took place in southwestern coastal cities like Fort Myers and Naples, where some neighborhoods were annihilated.
"We're flying and we're operating in areas that are unrecognizable," US Coast Guard Rear Adm. Brendan McPherson 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."
Many of the Ian-related deaths have been reported in southwestern Florida's Lee County, which includes Fort Myers and Sanibel Island, where at least 42 people died.
'Unfortunately, people did get complacent'
Local officials are facing criticism about whether mandatory evacuations in Lee County should have been issued sooner.
Officials there did not order evacuations until less than 24 hours before the storm made landfall, and a day after several neighboring counties issued their orders.
DeSantis defended the timing of Lee County's orders, saying they were given as soon as the storm's projected path shifted south, putting the area in Ian's crosshairs.
"As soon as we saw the model shift northeast, we did exactly what we could to encourage people to" evacuate, Lee County Commissioner Kevin Ruane said Sunday.
"I'm just disappointed that so many people didn't go to shelters, because they're open."
Ruane called the reporting about a possible delay in issuing a mandatory evacuation "inaccurate." He said the county did what it was supposed to do, without providing any evidence that the reporting was inaccurate.
"I think the most important thing that most people need to understand is we opened up 15 shelters. During Irma there were 60,000 people in our shelters. There's 4,000 people in the shelters right now," Ruane said Sunday.
"Unfortunately, people did get complacent ... As far as I'm concerned, the shelters were open, they had the ability, they had all day Tuesday, they had a good part of Wednesday as the storm was coming down -- they had the ability to (go to a shelter)."
The US Coast Guard made plans to evacuate people from Lee County's Pine Island on Sunday, according to the Lee County Sheriff's Office.
In addition to the 42 deaths in Lee County, Hurricane Ian also contributed to the deaths of 12 people in Charlotte County, eight in Collier County, five in Volusia County, three in Sarasota County and one each in Polk, Lake, Hendry and Manatee counties, officials said.
President Joe Biden continued to pledge federal support for Florida, saying Hurricane Ian is "likely to rank among the worst ... in the nation's history."
The President and first lady Jill Biden are set to travel to Puerto Rico Monday to survey damage from Hurricane Fiona, then head to Florida on Wednesday.
'The houses ... are all gone'
After Hurricane Ian finished its devastating crawl over Florida, residents tried to venture back to their damaged or destroyed homes and sifted through debris.
But residents from Sanibel and Captiva islands were cut off from mainland Florida after parts of a causeway were destroyed by the storm, leaving boats and helicopters as their only exit options.
Civilian volunteers rushed to help residents on Sanibel, where some homes were obliterated.
Andy Boyle was on Sanibel Island when the hurricane hit. He said he lost his home and two cars, but feels lucky to be alive.
"A lot of people have very expensive, well-built homes on Sanibel, and they felt with their multi-million dollar homes built like fortresses, they would be fine," he said.
Boyle was riding out the storm at home when the dining room roof collapsed. "That's when we started to get concerned," he said.
He described waving down National Guard aircraft the next day outside his house, and seeing the scenes of devastation around the island.
"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. When you go to the west end of the island, the old restaurants up there, they're all gone. The street going to Captiva is now a beach," Boyle said.
Residents were also evacuated from the Hidden River area of Sarasota County after a compromised levee threatened to flood homes, the sheriff's office said Saturday.
'We need everything'
Further complicating recovery is the lack of electricity and spotty communication in impacted areas.
It could take up to a week from Sunday before power is restored in storm-damaged counties, said Eric Silagy, president and CEO of Florida Power & Light Company.
And some customers may not be back on the grid for "weeks or months" because some buildings with structural damage will need safety inspections.
Around 65% of all power outages in Florida from the storm had been restored as of early Sunday, according to PowerOutage.us.
Florida is also working with Elon Musk and Starlink satellite to help restore communication in the state, according to DeSantis.
"They're positioning those Starlink satellites to provide good coverage in Southwest Florida and other affected areas," DeSantis said.
Emergency responders in Lee County will be among those receiving Starlink devices.
In Charlotte County, residents are "facing a tragedy" without homes, electricity or water supplies, sheriff's office spokesperson Claudette Smith said.
"We need everything. We need all hands on deck," Smith told CNN Friday. "The people who have come to our assistance have been tremendously helpful, but we do need everything."
Hurricane Ian may have caused as much as $47 billion in insured losses in Florida, according to an estimate from property analytics firm CoreLogic. That could make it the most expensive storm in the state's history.
Ian batters the Carolinas, contributing to 4 deaths
After pummeling Florida, Ian made its second landfall in the US near Georgetown, South Carolina, Friday afternoon as a Category 1 hurricane.
In North Carolina, the four storm-related deaths include a man who drowned when his truck went into a flooded swamp; two people who died in separate crashes; and a man who died of carbon monoxide poisoning after running a generator in a closed garage, according to Gov. Roy Cooper's office.
No deaths have been reported in South Carolina, Gov. Henry McMaster said Saturday.
The storm has flooded homes and submerged vehicles along South Carolina's shoreline. Two piers -- one in Pawleys Island and another in North Myrtle Beach -- partially collapsed as high winds pushed water even higher.
Edgar Stephens, who manages the Cherry Grove Pier in North Myrtle Beach, South Carolina, stood yards away as a 100-foot section from the pier's middle crashed into the ocean.
Stephens said the Cherry Grove Pier is a staple for community members and tourists alike.
"We're a destination," he said, "not just a fishing pier."
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