The US Coast Guard and Britain's Royal Navy airlifted survivors and ferried in emergency supplies Wednesday as the death toll from Hurricane Dorian's devastating rampage through the Bahamas rose to 20.

The United Nations said 70,000 people on Grand Bahama and Abaco island -- virtually the entire population -- were in "immediate need" of aid while the government confirmed the grim new victim count, which was expected to rise further.

"At this point we are starting to get a more vivid picture of the loss of life, at least in Abaco, and the loss of life in Grand Bahama," Health Minister Duane Sands said, quoted by local and US media.

"So, the toll has risen to just 20 persons... in Abaco and Grand Bahama thus far. But bear in mind that search and rescue exercises, exploration of homes that were flooded, is just now starting."

Shelter, safe drinking water, food and medicine were urgently needed for some 50,000 people on Grand Bahama and between 15,000 and 20,000 on Abaco, UN emergency relief coordinator Mark Lowcock said after a meeting with Bahamian Prime Minister Hubert Minnis.

"Speed is of the essence," Red Cross official Stephen McAndrew said of rescue operations on the two northernmost islands in the Bahamas archipelago which were pummeled by one of the strongest Atlantic storms on record.

People on Grand Bahama island were using jet skis and boats to pluck victims from homes flooded and pulverized by heavy rain and lashing winds from the monster storm.

US Coast Guard and Royal Navy helicopters were conducting medical evacuations, aerial assessments to help coordinate relief efforts, and reconnaissance flights to assess damage.

US President Donald Trump spoke by telephone to the Bahamian leader and pledged US assistance, the White House said.

"A big section of the Bahamas was hit like few people have seen before," Trump said. "They need a big hand."

Minnis called Dorian "one of the greatest national crises in our country's history," lamenting the severe flooding and widespread damage to the country's infrastructure.

He said additional police were being sent to Abaco to prevent possible looting.

Aerial footage showed scenes of catastrophic damage in Abaco with hundreds of homes missing roofs, cars submerged or overturned, widespread flooding and boats reduced to matchwood.

The international airport in Freeport, the largest city on Grand Bahama island, was severely damaged and its runways unusable, complicating relief efforts.

- 'Lucky in Florida' -

As rescue efforts ramped up, Dorian remained a strong Category 2 hurricane threatening the US east coast states of Georgia and South and North Carolina but leaving Florida largely unscathed.

"We got lucky in Florida, very, very lucky indeed," Trump said.

The Miami-based National Hurricane Center predicted the Carolinas could be hit with dangerous storm surge of up to eight feet (2.4 meters) and six to 12 inches of rain.

"We are very well prepared," Trump said.

Larry Lewis, who runs Paradise Water Sports in Freeport, said most of the flood waters had receded but some roads remained impassable.

"Everybody is trying to do their best," Lewis told AFP by telephone.

He said very few stores were open. "I saw a lot of people scrapping for something to eat," he said.

Roberto Smith, who was born in Abaco but now lives in Florida, said he was worried about his family.

"I spoke to my dad on the night of the hurricane, on Sunday night, and his roof blew up," Smith told AFP. "I haven't spoken to him since then. I am really worried. I can't even eat."

"The island is devastated," he added. "There is no power, no running water, no electricity."

- 'Truly shocking' -

The US Coast Guard said it had rescued 61 people including 19 injured patients from the Marsh Harbour clinic on Abaco island who were flown to Nassau on Tuesday.

USAID, the US relief agency, said meanwhile it was airlifting supplies such as plastic sheeting for shelter, hygiene kits and water from Miami.

A British landing ship, the RFA Mounts Bay, launched boats carrying supplies for Marsh Harbour on Abaco and Britain's Department for International Development said it had deployed a team of three humanitarian experts.

"The clock is now ticking to get help to those in need," British International Development Secretary Alok Sharma said.

The Bahamas, a former British colony, gained its independence in 1973 and is a member of the Commonwealth.

Dorian, which dumped as much as 30 inches of rain on the islands, was downgraded Tuesday morning to a Category 2 hurricane on the five-level wind scale.

At 5:00 pm (2100 GMT), Dorian was packing winds of 110 miles (175 kilometers) and located 150 miles (245 kilometers) south of Charleston, South Carolina.

It was moving in a north-northwest direction at eight mph.

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