Ian is likely Florida’s deadliest hurricane since 1935. Most victims drowned.

FORT MYERS BEACH, Fla. – The water was rising quickly, so the women ran to the top floor of the vacation house they’d rented for Nishelle Harris-Miles’s 40th birthday and huddled together on a bed.

But Hurricane Ian’s storm surge gushed through the floor, lifting the mattress higher and higher until the four were smashed against the ceiling. Then the roof collapsed, lodging a nail into the neck of the woman they affectionately called Nene.

“Nene died right there with us,” said Chanel Maston, 48, sobbing as she recounted the ordeal. “She took her last breaths with us.”

As stories of death emerged from the destruction in southwest Florida, President Joe Biden, Florida Gov. Ron DeSantis and local authorities have clashed over Ian’s casualty toll. Lee County Sheriff Carmine Marceno told “Good Morning America” that deaths could range into the hundreds. Biden warned Ian could be the “deadliest hurricane in Florida’s history.” The governor has downplayed deaths in daily briefings, saying the tropical cyclone’s numbers won’t come near the 1928 hurricane that killed a record 2,500.

Yet already Ian is shaping up to be the deadliest storm to pound Florida since 1935. State authorities have documented 72 deaths thus far – slightly under Hurricane Irma’s toll in 2017, according to the National Hurricane Center. County sheriffs have reported dozens more, pushing the total to at least 103. That makes Ian more fatal than Hurricane Andrew in 1992.

Ian’s storm surge has claimed the most lives, according to the Florida Medical Examiners Commission, which is tallying direct and indirect deaths. Slightly more than half of Ian’s victims drowned, the latest data shows, underscoring what experts call a frequently overlooked reality: Water usually kills more people than wind.

Storm surge as high as 18 feet blasted through homes, trapping some people inside while sweeping others into brownish rivers. One woman was found tangled below her house in wires. Many of those who drowned were elderly.

“I don’t want to scare people, but they need to understand: The leading cause of death is going to be drowning,” said W. Craig Fugate, former head of the Federal Emergency Management Agency and Florida’s Division of Emergency Management. “Storm surge doesn’t sound inherently deadly unless you understand it.”

One week after landfall, rescue teams continue to wade through wrecked communities – often with only a vague idea of who might be buried in the rubble. Lee County Manager Roger Desjarlais admitted Monday at a news conference that officials do not know how many people they are searching for. First-responders are relying on cadaver dogs.

“We don’t have anything,” Virginia Task Force 2 leader Brian Sullivan said Tuesday as his team scoured Red Coconut RV Park in Fort Myers Beach, the storm’s ground zero. “The sheriff’s office was trying to work to compile a missing persons list. We haven’t received any information regarding that area.”

Counting the dead is an imprecise science – there is still no certain tally from Hurricane Katrina, for instance – and throughout the years, officials have debated what qualifies as a storm death. Hurricane Maria’s toll was initially in the dozens, with officials including only drownings and blunt force trauma. But an analysis of excess deaths later pushed the total into the thousands. Many elderly people died in Puerto Rico as the island’s blackout continued for months and medical care was hard to reach.

DeSantis at first indicated that indirect deaths might not be counted.

“For example, in Charlotte County, they recorded a suicide during the storm,” he said the day after the storm. “They also had somebody pass away from a heart attack because you don’t have access to emergency services.”

But the agency tasked with cataloguing the deaths, the Florida Medical Examiners Commission, adheres to a broader definition.

“We include motor vehicle accidents if someone is trying to evacuate and they hydroplane,” spokeswoman Gretl Plessinger said. “If someone had a heart attack when medical services were down. … If there was any suspicion it was related to a hurricane, that’s a storm death.”

Water – storm surge, rainfall, inland flooding and surf – directly cause 90% of tropical cyclone deaths in the United States, according to the National Hurricane Center. The top indirect killers: car wrecks, carbon monoxide poisoning, electrocution and heat. And the lethal danger persists after the skies have cleared, said Jay Barnes, a hurricane historian in North Carolina.

“Deaths often occur during cleanup,” he said. “Everything from carbon monoxide poisoning and chain saw victims to people falling off roofs.”

Many Americans underestimate the power of hurricane torrents, disaster experts say. They tend to picture powerful gusts and falling trees – perhaps because the nation’s best-known categorizing scale measures wind. Some in harm’s way choose to hunker down at home. Critics have slammed Lee County authorities for not ordering Fort Myers Beach residents to evacuate more swiftly.

”There’s a saying in the industry that you run from water and hide from wind,” said John Renne, director of the Center for Urban and Environmental Solutions at Florida Atlantic University in Boca Raton. “We need to do a much better job of conveying the risk in storm-surge areas.”

Mitch Pacyna, 74, a resident of Fort Myers Beach, had weathered 27 years of tropical storms. His social life was so packed, Pacyna’s friends jokingly referred to him as “the mayor.”

On Facebook, he documented the storm’s approach, noting that the forecast had suggested Ian would veer toward Tampa. When county officials ordered his barrier island to empty before the hurricane struck, Pacyna opted to stay behind.

“Oh my God … wrong decision,” he lamented in a video as water swept his street. Soon enough, the tide crashed into the home he shared with his partner, Mary, and wiped away the bar he’d built in his garage.

Pacyna’s last post: “WE’RE TERRIFIED.”

His family announced his death the next day.

”Everyone loved him,” said Scott Safford, co-owner of the Sea Gypsy Inn, a lemon-yellow hotel that once stood near Pacyna’s home. Now it doesn’t exist.

For rescue crews, the search for victims is stymied by a lack of information on who stayed behind and where the storm surge might have carried them.

The Red Coconut RV Park, once a beachfront oasis, was crushed into pieces of roof, walls and knickknacks. Dozens of members of Virginia Task Force 2, one of the urban search and rescue teams deployed to Florida, dug through the debris Tuesday as three cadaver dogs detected a possible human scent. They found only household items, including an errant refrigerator filled with beer.

”It’s just total destruction,” said Sullivan, the team’s leader.

There was little left of the vacation house that Nishelle Harris-Miles’s friends and family had booked for her birthday.

The women from Dayton, Ohio, had heard Ian was barreling toward Tampa Bay and figured the airline or rental owner would cancel on them if the storm posed a real threat to Fort Myers Beach.

They’d arrived the Tuesday before Ian struck and tried to make the most of it: dancing indoors, snapping silly photos, singing “Happy Birthday.”

”We were smashed against the ceiling,” Maston said of what came next. “We were fighting the ceiling, and there was water everywhere. Next thing you know, the roof went down, and we went with it.”

They were stranded in the debris for 14 hours, she estimated. Eventually, someone heard their cries, built a makeshift plank and pulled them out. A rescuer who descended from a helicopter confirmed what Maston already knew: Nene was dead.

”We didn’t want to leave her behind,” she said.

Nene was the mother of two sons and two daughters. A home health aide who cared about her patients. A tourist who’d saved up for that trip.

”We could never have imagined,” Maston said. “I saw bodies hanging out of windows. I’d never seen stuff like this – only on TV.”

She wept.

”We didn’t know,” she said. “We just didn’t know.”