(CNN) -- As hundreds of thousands of Texans struggle for heat and water for a fifth consecutive day, more potentially deadly storms are hitting parts of the South -- and slamming the mid-Atlantic and Northeast -- with snow and ice.
Winter weather alerts stretch from Texas -- where snow and ice still was accumulating in places Thursday morning -- to southern New England. Thursday's heaviest snow is expected from parts of Virginia to southern Pennsylvania, and dangerous stretches of ice in North Carolina and the Washington, DC, and Philadelphia areas, forecasters say.
At least 38 people have died nationwide from winter storms or frigid conditions since last week. And in Texas, communities are desperately seeking warmth and other necessities without electricity in freezing or near-freezing temperatures.
In the Texas city of Killeen, Angel Garcia has been rationing pre-filled oxygen cylinders for her 5-month-old preemie son at their home, unable to use a machine that converts room air because the home has been without power since Monday.
After running out of firewood, Garcia, her husband and two children have been staying warm by burning other things -- such as her daughter's toy blocks -- in the fireplace, she told CNN on Wednesday evening.
"A lot of people don't know the severity of what's going on. People are tearing down their fences to burn," Garcia said, between tears. "We started burning my daughter's little wooden blocks because it was just too cold."
More than 500,000 Texas homes and businesses still were without power Thursday morning, down from around 4.5 million earlier in the week, according to utility tracker PowerOutage.us.
Texas officials say a deep freeze starting Sunday crippled utilities' power generation, causing rolling blackouts or continuous outages. The issues affect a Texas-only grid that covers 90% of the state and is isolated form the rest of the country, so the grid cannot import power from elsewhere to make up for the shortage.
Days without power in freezing conditions have sent Texans scrambling for alternative heating, through generators, fireplaces, living in running cars, or sheltering in powered warming centers or businesses.
Millions of Texans also are facing water disruptions, with boil water notices, broken pipes and failing systems, state officials said. The cities of Austin and San Antonio issued boil water notices to their 2.5 million residents on Wednesday evening.
Difficult weather conditions across the country, meanwhile, have had serious implications for the coronavirus pandemic: Some shipments of Covid-19 vaccines have been delayed, and some clinics have had to cancel vaccine appointments.
Here's what the National Weather Service says to expect from Thursday's storm:
-- Snow across the mid-Atlantic states, with the heaviest -- about 6-12 inches -- possible from the Appalachians of Virginia and West Virginia to northern Maryland and southern Pennsylvania.
-- Snow also should hit the Northeast in the afternoon and night, with 3-6 inches possible from downstate New York to southern New England.
-- Dangerous ice accumulations -- up to three-quarters of an inch -- are possible from North Carolina's northern Piedmont region to southern Virginia, threatening extensive power line and tree damage and treacherous roads.
-- Up to a quarter-inch of ice also could accumulate around the Interstate 95 corridor from Washington, DC, to Philadelphia.
-- Heavy rain is expected in parts of the Southeast, and tornadoes and flash floods are possible.
Weather turns deadly
Continued severe weather means more days of risk for death and injuries.
The US Centers for Disease Control and Prevention warned doctors Wednesday to be aware of the increased hazard of carbon monoxide poisonings and deaths as storms sweep through the country.
Carbon monoxide is a tasteless, odorless gas that can build up when any type of fossil fuel is burned -- gasoline, coal or natural gas. Home heating systems are a common source, but the danger is especially high when people turn to unusual sources of heat or power during electricity outages.
From Saturday to Monday, four adults in Oregon died of carbon monoxide poisoning while trying to stay warm, according to the Clackamas County Sheriff's Office. One person appears to have ignited charcoal briquettes inside while three others were sheltering in recreational vehicles.
While Kentucky officials have responded to calls regarding carbon monoxide, state police reported Wednesday that a 25-year-old was found Friday dead as a result of hypothermia.
Texas has lost 16 residents to weather-related incidents, with causes including exposure to cold, carbon monoxide poisoning and vehicle wrecks. The rest of the toll is spread across Tennessee, Oregon, Kentucky, North Carolina, Louisiana, Ohio, Oklahoma and Arkansas.
Residents seek refuge in their cars
With little else available, many families are relying on their vehicles to make it through the cold.
In San Antonio, Jordan Orta and her 2-year-old son slept in her car Tuesday night because their powerless home was so cold, as outside temperatures dipped into the 20s. Her home was without power from Tuesday night until early Wednesday, after earlier outages.
Another Texan family, faced with a home with no electricity, opted to drive more than 200 miles through snow and ice, for shelter.
The normally two-and-a-half hour drive turned into a five- or six-hour trek, said Bryce Smith. He said the one thing that made the drive from Austin to Royce City possible was that he's from Iowa and knows how to drive in the snow.
"There are no plows here. There is no help at all. You go out here and it's just fresh snow and ice. There's no sand down," he said.
Sylvia Cerda Salinas, a Texas mother, told CNN's Don Lemon she is considering driving to Mexico to keep her family safe in a hotel. With another freeze expected, she is running out of options for three of her children whose insulin supplies are spoiling and her child on the autism spectrum, who has a compromised immune system.
"You either go to the shelter to get warm, or you stay home, stay cold, and stay away from the pandemic," Salinas said.
A long wait for the power to come back
Weather damage to utilities means many will be hunkering down for a while longer without power or water.
Winter storms in Kentucky have caused "physical damage to the infrastructure that transmits and delivers electricity to households" and some residents still might not have power by the end of the week, state officials said.
"We believe that we're going to make substantial headway through the end of this week in getting people their power back, but in some areas of eastern Kentucky it may take longer than through the end of the week," said Gov. Andy Beshear, who acknowledged it was tough news for residents.
With more snow and ice expected Thursday, Entergy, a power company for Arkansas, Louisiana, Mississippi and Texas, said about 40,000 of its customers in Louisiana were still without power Wednesday as a result of the winter storms, according to a statement from the company.
The weather has also knocked out water plants in many places, including Marlin, a town in central Texas with a population of more than 5,500 residents.
Speaking of residents' frustration, Marlin City Manager Cedric Davis said "They are cussing us, calling us names, saying they don't understand, they don't understand. We cried last night. We are giving it our all. People are so inhumane. They don't understand. I've never seen anything like it," the Waco Tribune-Herald reported.
Texas' power provider, the Electric Reliability Council of Texas (ERCOT), said Wednesday it was making progress in restoring power to the state's electric system and hoped local utilities may return to rotating outages instead of extended outages Thursday morning.
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