[Breaking news update, published at 8:09 a.m. ET]
Five deaths related to Michael have been reported in Virginia, the state's Department of Emergency Management said on Twitter on Friday morning.
That brings the total number of US deaths related to the storm to at least 11.
Federal Emergency Management Agency Administrator Brock Long said he expects the US death count to climb Friday and Saturday as searchers sift through debris.
[Previous story, published at 6:05 a.m. ET]
As Michael moves into the Atlantic, the days of misery are far from over in the coastal cities left devastated beyond recognition. There's no water, no power and emergency officials have no access to many towns from the Florida Panhandle to Virginia.
Michael, one of the most powerful hurricanes to hit the United States, left the East Coast early Friday morning. Yet, parts of Virginia are still seeing dangerous wind gusts, the National Hurricane Center said.
Aerial footage shows coastal cities in Florida completely wiped out. Residents are walking through piles of debris, some assessing the damage and others trying to get out and find food.
"This is not stuff that you just put back together overnight," Federal Emergency Management Agency Administrator Brock Long said Thursday. "It's unrealistic for people to think it's going to happen in the next day or two."
A psychiatric hospital in Florida remains isolated after downed trees blocked roads around Chattahoochee, Florida, and a tree caused a water line to break. The facility is running on power generators and helicopters have delivered food and water, the state's Department of Children and Families said.
• Where is Michael? As of 5 a.m. ET Friday, the storm is moving northeast across the Atlantic Ocean and was about 185 miles east-northeast of Norfolk, Virginia.
• Hundreds of thousands in the dark: At least 1.27 million customers in seven states are without power, including 495,000 in North Carolina.
• Victims identified: The dead include five people in Virginia; four people in Florida; a child in Georgia; and a man in North Carolina.
• Public health emergency declared in Georgia: The declaration will help ensure those who rely on Medicare and Medicaid have access to the care they need, Health and Human Services Secretary Alex Azar said.
6 dead, many missing
Sarah Radney saw trees falling down all around her grandparents' home when Hurricane Michael roared over Georgia. She was safe until a carport came crashing through the roof.
"It was just a freak accident, I never heard of anything like that," her father, Roy Radney said.
Sarah had just started the sixth grade and joined the drama club and the band. Her father says she loved playing the trumpet, acting and singing.
The 11-year-old girl and at least five others have been killed since Michael made landfall Wednesday and made its way northeast leaving a path of destruction, officials said.
A man who died when a tree fell on a home near Greensboro, Florida, has been identified as Steven Sweet, according to Lt. Anglie Hightower, Gadsden County Sheriff's Public Information Officer.
Three other people died in Gadsden County, Hightower said. Authorities did not discuss the circumstances of their deaths but their bodies have been taken to the medical examiner's office to determine the cause of death.
The sixth victim, a 38-year-old man,died when a large tree fell on his vehicle on Highway 64 east of Statesville, North Carolina, on Thursday, Iredell County Fire Marshall David Souther said.
Hundreds of people have been rescued from the debris and authorities fear the toll could climb higher as search-and-rescue efforts continue.
Signs of hope
Thousands of residents in the Florida Panhandle are slowly returning to their homes and discovering that everything or almost everything they owned has been reduced to rubble.
Linda Clarke gasped repeatedly at the sight of her once new home in Shell Point Beach -- now severely damaged.
"But you know what...it's just stuff, it's just stuff," she told her husband as they walked through their home. "It's just stuff we can replace."
There is not much left of what used to be the parish hall of St. Dominic Catholic Church in Panama City, Florida, but piles and piles of rubble. Despite the destruction, Rev. Luke Farabaugh and his congregation celebrated Mass on Thursday.
"Things, we can replace," he said, speaking on CNN's "Erin Burnett OutFront." "We've seen a lot of signs of hope ... I've been telling people ... to have hope."
"Hope is that even if the storm does come, even if I lose my car, my house, my family, even if I lose my life, blessed be God," he explained. "Our reward isn't just in this life but in the life to come. So we're just trying to give people hope at this point."
Flooding in the Carolinas and Virginia
The rapid-moving rainfall from Michael triggered flash floods in parts of Virginia and the Carolinas, including areas threatened by swollen rivers during Hurricane Florence.
Hundreds of residents were rescued on Thursday from cars, apartments and homes flooded by rushing water.
In Virginia, the Roanoke River jumped its banks and flooded several nearby homes and businesses. Cory Patirlo, who lives near the river, said the impact of Michael was unexpected. It was the first time he had nearly 2 feet of water in his home.
"It wasn't going to get this high, realistically. It never has," he he told CNN affiliate WDBJ.
"I'm gonna be sleeping in my van, with my dogs."
The water receded within hours in some areas and residents are beginning to cleanup on Friday. Others are expected to remain in shelters through the weekend as the rivers levels go down.
The impact of climate change on storms
Michael's strength may reflect the effect of climate change on storms. The planet has warmed significantly over the past several decades, causing changes in the environment.
Human-caused greenhouse gases in the atmosphere create an energy imbalance, with more than 90% of remaining heat trapped by the gases going into the oceans, according to the National Oceanographic and Atmospheric Administration.
While we might not get more storms in a warmer climate, most studies show storms will get stronger and produce more rain. Storm surge is worse now than it was 100 years ago, thanks to the rise in sea levels.
And unless we change the rate of greenhouse gas emissions, we should expect hurricanes to intensify more rapidly in the coming decades, the scientific research group Climate Central said.
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CORRECTION: An earlier version of this story gave the incorrect surname for storm victim Steven Sweet. It has been corrected.