The winter storm that has ravaged much of America has coincided with 57 deaths thus far, and that count could continue to tick upward.

It is being called a “once in a lifetime blizzard,” stretching from the Great Lakes near Canada down to the Rio Grande along the Mexican border, according to NBC News. Overall, deaths have been recorded in 12 states, either directly or indirectly related to inclement weather.

Buffalo, New York, has been hit particularly hard. At least 27 people have died in Erie County since the start of the storm. The medical examiner’s office in Erie County said that some died due to heart problems while shoveling or snow blowing, according to NBC News.

Roads in many areas remain impassable. As of Monday morning, Erie county officials began lifting a county-wide ban on driving in some areas, but the ban remains in effect for nine cities and towns, including the entire city of Buffalo.

“It’s a generational storm that, unfortunately, we haven’t begun to really assess its full toll,” said Erie County Executive Mark Poloncarz.

A “band of heavy lake effect snow” in the Buffalo area on Monday morning produced 2 to 3 inches of hourly snowfall, the National Weather Service reported.

The lake effect occurs when cold air passes over the unfrozen and warmer lake water, transferring moisture and warmth to the lower parts of the atmosphere. The air then rises to form clouds, ultimately causing intense snowfall, according to NBC News.

Jackson, Mississippi, has been struggling to return pressure to its water system following the storm and has issued a citywide boil water notice, CNN reported.

The City asked residents to refrain from reporting pressure loss, as it said it’s “well aware of the system pressure issues.” Even if the pressure is restored, Jackson is expected to be under a boil water notice until further notice.

In Texas, with temperatures rising and expected to reach into the 70s as early as Thursday, frozen pipes are at risk of starting to thaw and then flood, according to WFAA. The outlet suggested that if the water coming through the faucet is only a trickle, it might indicate a frozen pipe.

The news outlet suggested using a hair dryer or heating pad to thaw the pipes, adding that keeping the faucets open and running helps the frozen pipes thaw faster.