Tropical Storm Isaias, raking a path through the Caribbean, dealt Puerto Rico another blow on Thursday, as heavy winds and rain caused damage and flooding.

Although flooding was widespread, the worst impacts were felt on the west and southwest portions of the island, said Direct Relief staff member Luis David Rodriguez.

Puerto Rico, still badly affected by 2017’s Hurricane Maria, has been dealing with a series of earthquakes that have roiled the island since late December of last year. Seismic activity has also been concentrated in the southern part of the island.

And more recently, Puerto Rico has been confronting a drought that has compromised running water access to many, along with a recent spike in Covid-19 cases.

Right now, “a lot of the rivers are overflowing,” Rodriguez said. “Two weeks ago, we were in a drought, and now we have to open the dams.”

An official with the Puerto Rico Electrical Power Authority told the news outlet Primera Hora that nearly 450,000 customers were left without electricity in various parts of the island.

Some health centers throughout Puerto Rico lost power, and some closed their doors due to widespread concerns about the extreme levels of flooding, Rodriguez said.

Still, “other than the loss of power, I think most of them were pretty prepared,” he said, naming a generator and PPE among requests from health centers on the island.

Direct Relief is stationing 14 hurricane prep packs on the island this week and next to be ready for future storms, but Rodriguez explained that Isaias had appeared particularly early. “This is super weird,” he said.

Isaias is a vast storm system with tropical-storm-force winds extending more than 300 miles from its center, USA Today reported. From Puerto Rico, it has made landfall in the Dominican Republic and may gain strength as it moves toward Florida.

In an advisory, the National Hurricane Center announced “a risk of impacts from winds, heavy rainfall, and storm surge along portions of the U.S. east coast beginning this weekend in Florida and spreading northward to the Carolinas and southern mid-Atlantic states early next week.”

However, the center said, it is too soon to determine the path or magnitude of the storm when it reaches the mainland.

Direct Relief has been in contact with partners in Puerto Rico and the Virgin Islands, and is working to meet requests from Puerto Rican health care providers. The organization will continue to monitor the situation and respond as needed.