Hurricane Matthew has brought havoc to northeastern Florida, with high winds and heavy rain leaving at least four people dead and more than a million people without power as the storm continues its destructive march up the coast toward Georgia and North Carolina.

The storm, which has already killed more than 800 people in Haiti, was downgraded on Friday to a Category 2 hurricane. But forecasters warned it could still bring winds of more than 100mph, some 15 inches of rain and a 9ft storm surge that would threaten flooding along hundreds of miles the south-east US coastline. Such flooding was reported in coastal Florida communities including Daytona Beach and St Augustine on Friday.

After making its way through the Caribbean, striking Cuba and the Bahamas, Matthew largely spared southern Florida, remaining some 100 miles from the shore as it passed Miami and Fort Lauderdale late on Thursday. The eye of the storm was expected to grind north, pounding the coast of Georgia on Friday night and South Carolina on Saturday, as well as parts of southern North Carolina, before turning back into the Atlantic.

The northern Florida city of Jacksonville, with a population of almost 1.6 million, was the largest metropolitan area in Matthew’s crosshairs. During Friday the storm moved parallel to the coast, with its centre staying between 25 and 40 miles from shore, according to the Weather Channel. It remained unclear when and where it might make landfall, but Florida Governor Rick Scott warned that “It could be the worst part of this is still to come.”

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Authorities have ordered some two million Floridians to evacuate their homes, while Governor Scott activated 3,500 members of the state’s National Guard. Patients from two waterfront hospitals and a nursing home close to Daytona Beach were moved to safer locations as thousands of people crammed into shelters and inland hotels.

President Barack Obama declared a state of emergency in Florida, Georgia and the Carolinas, meaning federal agencies will coordinate any relief efforts. On Friday, Mr Obama reiterated the advice of local officials for people to follow evacuation orders. “Do what they say. Do not be a holdout, because we can always replace property, but we can't replace lives,” he said.

On Thursday night, a 58-year-old woman died at her home in St Lucie County, Florida, following a heart attack. Emergency personnel were unable to reach her after cancelling operations due to the high winds. A second woman in her 60s was killed by a falling tree in Volusia County, while an 82-year-old man also died after falling unconscious with breathing difficulties while emergency services were unable to respond.