Within a half-hour, the hospital, Adventist Health Feather River, sent out an alert across its loudspeakers that warned of the impending emergency, kicking off a fevered scramble to evacuate the hospital’s patients and staff before the flames subsumed the town. Patients, including many on gurneys or in wheelchairs, were loaded in waiting ambulances, police cars, even some nurses' vehicles as the staff worked to evacuate, Loney said. Within a few hours of the hospital’s evacuation, many of the buildings on its campus were destroyed, with a makeshift medical station set up on a nearby helipad left eerily untouched.

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The story was not unique. Residents across the area, in Butte County about 90 miles north of state capital Sacramento, described fleeing a catastrophic fire that grew with incredible speed and turned a sunny day into an end-of-days scene of flames, smoke, sparks and wide destruction.

And the Camp Fire, named for a nearby creek, was not yet done. A state emergency, it had burned at least 90,000 acres, more than 140 square miles, and was only 5 percent contained by Friday night. Officials warned about hot, dry and windy “red flag” conditions persisting on and off through Monday.

Butte County Sheriff Kory L. Honea told reporters at a news conference Friday evening that officials had found nine people who had been killed by the fire: Four were found dead in their cars in Paradise, down from the five officials had spoken about earlier; three outside of houses; and two others, one inside a home, and another near a car.

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It had injured an undisclosed number of residents as well as three firefighters. And Honea’s deputies were still looking into some 35 reports of missing people.

“This event was the worst-case scenario," Honea said. “It’s the event that we have feared for a long time."

Hundreds of miles south in Ventura County, still reeling from a mass shooting that left 12 people dead, more wildfires had broken out, causing the evacuation of 100,000 people in Thousand Oaks, Malibu and other areas. The Woolsey Fire had burned some 35,000 acres, officials said, while the nearby Hill Fire had burned through 6,000.

But of all the areas struck by fires in the state so far, Paradise had fared the worst. Its main commercial street transformed into a smoking runway of destruction. Officials said that 6,453 homes and 260 businesses had been destroyed, making the fire the most destructive in California’s history. The previous record holder, the Tubbs Fire in the state’s wine country, was just one year ago.

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Stories of hope did emerge from the frightening swirl of chaos and devastation. The Adventist Health Feather River was eventually evacuated in its entirety, Loney said, calling it one of the most “horrific but also amazing things,” she’d ever seen. Patients had been funneled out of the hospital through the emergency room with attention to the level of care they required. There were people who had recently been in surgery, she said. Newborns thrust back into the hands of their mothers. Patients with breathing or feeding tubes.

But getting out of the hospital was just the beginning of the evacuation. The two-lane road next to the hospital was choked with traffic, as the crush of cars fleeing the encroaching flames had slowed to a crawl.

Loney and other residents described a scene that made them question their chances of survival: flames that jumped on both sides of the road, transformers exploding atop ignited electrical poles as tree branches fell and thick plumes of smoke smothered out the sun and turned the air toxic.

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Street signs shimmered in the dancing orange light of the fire. Everything was engulfed. And the traffic was hardly moving.

“There were no traffic rules, everyone was just fending for themselves, cars bumping into each other,” Loney said, describing two people who exited their cars and started running. She called her brother, wondering if it was the last time she’d speak to him.

Others described similarly harrowing escapes. Marc Kessler, 55, a science teacher at a public middle school in Paradise, said the sky turned black soon after he arrived at work.

“It was raining black pieces of soot, coming down like a black snowstorm and starting fires everywhere,” he said in an interview. “Within minutes, the town was engulfed.”

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Teachers were told by emergency workers to forgo seat-belt laws as they piled 200 or so students into their personal vehicles. Bus drivers drove through flames to help out, he said. One of his students pointed out what they thought was the moon in the darkened sky.

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“I said, ‘That’s not the moon. That’s the sun,’ ” he recalled, his voice cracking. “There were times when you couldn’t see though the smoke.”

Other residents, like Mike Kirby, 62, made other plans after seeing the clogged roads. The lifelong Paradise resident had woken to the unnatural darkness outside at 8:30 a.m., and loaded up his trailer. He ended up parking in a cemetery in town — a “large area of green,” he said, where he felt he had room to move if he needed to, despite warnings from fire crews.

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“I was totally surrounded at one point,” he said. He spent the night there safely; the cemetery was relatively untouched.

The rest of the town, which has a large community of retirees, did not fare as well. People returning Friday arrived to find much of it destroyed.

Houses lay in ruins along the road, which was littered with the hulls of burned-out cars that had been ditched, and other debris. The strip of businesses downtown that included a Burger King, a Valero gas station, a Jack in the Box and small businesses had been reduced to charred ruins.

Nearby neighborhoods were wiped out as well. For every building that survived, there were dozens that did not. Mayor Jody Jones told reporters that about 80 percent of the homes in town had been burned. Officials said that they did not yet have a complete death count because of the hazards caused by the fire.

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In addition to Paradise, the nearby communities of Magalia, Pulga, Concow, Butte Valley and Butte Creek Canyon were also under evacuation orders. A total of 52,000 people had evacuated officials said; nearly 1,400 were in shelters.

The harrowing push to flee that so many residents described — one made even more tenuous because of the traffic — pointed to questions about whether more planning or infrastructure is needed in an era of catastrophic fires in the state.

Scott Lotter, a Paradise Town Council member, said it took him nearly two hours to go a half-mile as he evacuated with his wife, daughter and son-in-law, as well as a pet rabbit and two dogs.

In less than a year, California has seen its record for largest fire broken by the 282,000-acre Thomas Fire in Ventura and Santa Barbara counties in December. That record was shattered in July when the Mendocino Complex Fire claimed 460,000 acres. And five of the state’s 10 most destructive fires — measured by the number of buildings destroyed — have occurred in the past 10 years.

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Stephen Pyne, a wildfire expert at Arizona State University, said the destruction of the town of Paradise was a grim sign of the potency of modern wildfires in California.

“We’re seeing urban conflagrations, and that’s the real phase change in recent years,” he told Wired. “But what’s remarkable is the way they’re plowing over cities, which we thought was something that had been banished a century ago.”

Officials said Friday morning that an evacuation order had also been issued for Stirling City and Inskip, as the National Weather Service warned that strong winds and low humidity could create “critical fire weather.”

The fire started Thursday near Pulga, a small community surrounded by the Plumas National Forest, officials said. The first firefighters to arrive found 10 to 15 acres burning amid wind gusts of nearly 50 mph.

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Kessler, the teacher at Paradise Intermediate School, said more than 100 of the students were taken to Chico, where they were reunited with their family members. He read an email to The Washington Post from one of his students.

“The camp fire is horrible I wanna go home but there isn’t a home to go home to,” the email said, according to Kessler. “I can’t stop crying I’m having anxiety attacks.”

Rick Prinz, of Paradise, who has been the varsity football coach for Paradise High School for the past 20 years, said his players were all accounted for but were going through the same thing.

“A lot of kids lost their homes, and a lot of them are scattered around right now,” the 59-year-old told The Post. “I know three of my coaches lost their homes, and I know whole neighborhoods burned. I am assuming I lost my home.”

Officials said that schools in the county would be closed through Nov. 23. In Chico, a college town of about 93,000 about six miles from Paradise, officials had watched the blaze wearily.

The National Weather Service had predicted dangerous fire weather in California because of Santa Ana winds, which roar in from the east and accelerate down California’s north-to-south-oriented mountain slopes. Red-flag warnings for “critical fire weather conditions” were in effect not only for the Sacramento Valley but also through Central and Southern California. Gusts of 50 mph were expected in many locations.

About 23.4 million Californians were still under red-flag warnings early Friday, though the winds were expected to ease, giving emergency responders more advantageous conditions for battling the blaze.

Kessler said the fire felt like a battle.

“It felt like we were under attack with no warning,” he said.