Bitter cold is gripping large parts of the South once again this weekend, creating hazardous conditions for millions in a region not accustomed to freezing temperatures.

On Saturday morning, it was 5 degrees in Louisville, Ky., 9 degrees in Nashville, 20 degrees in Little Rock, Ark., and 21 degrees in Atlanta. Several states were under wind chill advisories and other freeze warnings as frigid temperatures were expected to continue into Sunday.

The extreme cold, which followed days of subfreezing temperatures earlier in the week, was not limited to the South, with single-digit temperatures reported from the Northern Plains to New England.

But for states that do not typically experience prolonged periods of ice and bitter wind chills, the past week has been particularly harsh. In Tennessee, where severe winter weather began last Sunday and the cold snap has lingered for days, health authorities have confirmed at least 19 weather-related deaths. And problems at water utilities had authorities advising thousands of residents to boil their water before drinking it. Water issues also affected many parts of Arkansas, where the National Guard assisted communities in delivering potable water.

In the Nashville area, the heavy snowfall that fell earlier this week — as much as eight inches — had turned into thick sheets of ice on many streets and sidewalks by Friday. Schools were closed for the entire week, and residents were encouraged to stay off the roads.

On Saturday morning, Beverly Burton, 64, walked several blocks to the grocery store for food, staying off slick sidewalks and walking in the street with a small cart. She was bundled in a long tan coat, red hat, gloves and a plaid scarf.

“I’m ready for it to be over,” Ms. Burton said. Talking about winter storms, she added that “we get them, but we don’t get them like this.”

More than 700 residents sheltered at Nashville’s two homeless shelters, along with about 300 to 375 more at the city’s overflow shelter that opens during freezing temperatures.

One shelter, Room in the Inn, said that some religious organizations that typically would transport people to the shelter had to cancel because of icy roads.

“It’s the snow and the ice that, in the South, it shuts us down,” said Rachel Hester, Room in the Inn’s director. “We become paralyzed. We don’t have the infrastructure.”

Tony Stokes, 58, has been at one of the shelters all week. Last Sunday, he said, he initially tried to spend the night under an overpass but woke up shivering and surrounded by snowflakes. “I just laid there, and it got a little too chilly for me,” said Mr. Stokes, who has been unable to afford housing since moving from Georgia a year ago. “You think you can tough it out.”

Metro Nashville staff members made welfare checks on senior and disabled residents by phone instead of in person because of road conditions, according to the city’s social services officials.

Sam Siple, an official with Nashville Rescue Mission, a nonprofit shelter, said demand for services has been especially high.

Icy roads have meant fewer volunteers, and staff members have been stretched thin with more people to prepare for. Some workers have had to stay overnight, he said. “It has been an intense week,” Mr. Siple said.

The freezing weather comes just months after much of the South experienced a brutal summer of unrelenting heat and humidity, and weeks after scientists concluded that 2023 was the planet’s hottest year on record. As the world warms, cold spells can still occur on occasion, though they are becoming less frequent and less severe in many places. And even though much of the United States is currently experiencing icier-than-normal conditions, Earth as a whole has been warmer than average this month because of unusually high temperatures in other parts of the globe.

On Saturday, the National Weather Service warned of a weekend filled with Arctic air that will “dominate the eastern two-thirds of the country.”

In the Mid-Atlantic and Eastern regions — specifically parts of West Virginia, Virginia, Maryland and Pennsylvania — winter storm warnings were in effect on Saturday morning, with heavy snow and slippery conditions expected.

Farther south, below-freezing temperatures were forecast to spread to much of the Gulf Coast region except southern Texas and the southern half of the Florida Peninsula. The cold air was also expected to continue to trigger more lake-effect snow in the Great Lakes region on Saturday.

In Knoxville, Tenn., which is under a wind chill advisory until Sunday morning, Erin Read, the executive director of the Knoxville-Knox County Office of Housing Stability, was bracing for another weekend of dangerously cold air.

Warming centers in Knoxville have sheltered over 270 people so far, Ms. Read said, adding that the city received two years’ worth of snow in one week.

When the warming centers initially opened last week, they exceeded their capacity of 125 people on the second day, Ms. Read said. There are four centers open now, and they are still over capacity. But they have made space.

“The bright spot is that we’ve been able to shelter everyone who wants to be inside,” Ms. Read said. “No one has been turned away.”

Raymond Zhong contributed reporting.

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