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“There is no infrastructure in the region that can withstand a Category 5,” Prime Minister Andrew Holness said. “The question now is the speed of recovery. That’s the challenge.”

The storm is expected to make landfall on Tuesday and slice diagonally across the island. Shortly after, it is expected to hit Cuba.

Melissa is the fifth most intense Atlantic basin hurricane on record by pressure, and the strongest such hurricane to make landfall since , according to hurricane specialist and storm surge expert Michael Lowry.

It is "a worst-case scenario unfolding for Jamaica,” he said.

Landslides, fallen trees and numerous power outages were reported ahead of the storm, with officials in Jamaica cautioning that the cleanup and damage assessment would be slow. The storm is expected to enter near St. Elizabeth parish in the south and exit around St. Ann parish in the north, forecasters said.

“Total structural failure is possible near the path of Melissa’s center,” the U.S. ��ɫtv Hurricane Center in Miami.

A life-threatening storm surge of up to 13 feet (4 meters) is expected across southern Jamaica, with officials concerned about the impact on some hospitals along the coastline. Health Minister Christopher Tufton said some patients were relocated from the ground floor to the second floor, "and (we) hope that will suffice for any surge that will take place.”

The storm already was blamed for seven deaths in the Caribbean, including three in Jamaica, three in Haiti and one in the Dominican Republic, where another person remains missing.

Jamaica braces for catastrophic damage

On Tuesday morning, Melissa was centered about 50 miles (80 kilometers) south-southeast of Negril, Jamaica, and about 260 miles (420 kilometers) southwest of Guantánamo, Cuba. The system had maximum sustained winds of 180 mph (280 kph) and was moving north-northeast at 7 mph (11 kph), according to the U.S. ��ɫtv Hurricane Center in Miami.

“We will get through it together,” said Evan Thompson, principal director at Jamaica’s meteorological service.

Colin Bogle, a Mercy Corps advisor based near Kingston, said most families are sheltering in place despite the government ordering evacuations in flood-prone communities.

“Many have never experienced anything like this before, and the uncertainty is frightening,” he said. “There is profound fear of losing homes and livelihoods, of injury, and of displacement.”

Necephor Mghendi, the international Red Cross’ regional head of delegation for the English- and Dutch-speaking Caribbean, said that an estimated 1.5 million people in the storm’s path will be affected, but many others may be as well.

“The entire population may feel the impact one way or the other,” he said by video link from Port-of-Spain, Trinidad and Tobago.

U.N. agencies and dozens of nonprofits had food, medicine and other essential supplies prepositioned as they awaited a distribution rush after the storm.

Matthew Samuda, Jamaica’s water and environment minister, said he had more than 50 generators available to deploy after the storm, but warned people to set aside clean water and use it sparingly.

“Every drop will count,” he said.

Melissa takes aim at Cuba

Melissa also was expected to make landfall in eastern Cuba late Tuesday as a powerful hurricane.

A hurricane warning was in effect for Granma, Santiago de Cuba, Guantánamo and Holguin provinces, while a tropical storm warning was in effect for Las Tunas. Up to 20 inches (51 centimeters) of rain were forecast for parts of Cuba, along with a significant storm surge along the coast.

Cuban officials said Monday that they were evacuating more than 600,000 people from the region, including Santiago, the island’s second-largest city.

Melissa also has drenched the southern regions of Haiti and the Dominican Republic, with a tropical storm warning still in effect for Haiti.

The hurricane was forecast to turn northeast after Cuba and strike the southeast Bahamas by Wednesday evening.

A hurricane warning was in effect for the southeastern and central Bahamas, and a tropical storm warning was issued for the Turks and Caicos Islands.

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Coto reported from San Juan, Puerto Rico. Geir Moulson in Berlin contributed.