A fast-strengthening Nor’easter pushed ashore this weekend, sending pounding surf and heavy rain into low-lying coastal communities and prompting officials to ready hospitals, nursing homes and emergency shelters for possible evacuations. The National Weather Service warned of life-threatening coastal flooding and sustained high winds, as storm surge coincided with astronomical high tides along parts of the Southeast and Mid-Atlantic coasts.

In Charleston, South Carolina, where NBC’s Jesse Kirsch reported on conditions from the storm zone, volunteers sandbagged storefronts and crews shored up dunes as public officials issued a mix of mandatory and voluntary evacuation orders for barrier islands and flood-prone neighborhoods. Local emergency managers urged residents dependent on electricity-dependent medical devices or regular dialysis to make contingency plans, as prolonged outages and flooded roads could cut off access to routine care.

“We are preparing for the full range of public‑health impacts: power loss at medical facilities, contamination of drinking-water sources, and preventable interruptions to chronic care,” said a hospital spokesperson in Charleston. The hospital said staff were relocating several patients on ground-floor wards and coordinating with regional partners to accept transfers if necessary.

FEMA said it had pre-positioned personnel and relief supplies along the storm track and was working with state emergency operations centers. “Our priority is to support local authorities in protecting the most vulnerable — older adults, people with disabilities, those without reliable transportation — and ensure continuity of care,” an agency official said.

Public-health experts cautioned that the storm’s immediate physical dangers could have longer-term consequences. Flooding commonly leads to mold, contaminated wells and wastewater backups that increase the risk of respiratory and gastrointestinal illness, particularly in aging housing stock and communities with limited resources to rebuild. Evacuations and sheltering can be medically complex when large numbers include people with chronic illnesses, limited English proficiency, or undocumented status, all of which can create barriers to accessing aid.

“These events expose persistent inequities in how communities prepare for and recover from extreme weather,” said a public-health professional familiar with coastal resilience planning. “Emergency plans must account for transportation, language access, and the need to maintain critical treatments like dialysis and oxygen therapy.”

Local officials noted that rural counties and lower-income neighborhoods are at elevated risk because of older infrastructure, fewer health-care providers and less redundancy in power and transport networks. Earlier this year, federal audits highlighted gaps in emergency medical transport and surge capacity in many coastal regions — vulnerabilities that are tested during storms.

The storm is also reviving policy debates about long-term investments in climate adaptation. State and local leaders said they need increased funding for sea walls, elevated critical infrastructure and grid hardening, along with targeted assistance to retrofit low-income housing. Advocates pressed for streamlined federal support to help community health centers and nursing homes upgrade backup power and evacuation plans.

As the Nor’easter moves north, officials emphasized preparedness: avoid driving through flooded streets, register medically dependent residents with local emergency services, and heed evacuation orders. For many communities, the test will not end when the wind subsides; recovery will hinge on whether relief efforts prioritize the households and health services that are most at risk.