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Governors from North Carolina to Connecticut declared states of emergency and Delaware ordered mandatory evacuations for coastal communities as Hurricane Sandy lumbered north from the Caribbean, where it left nearly 60 dead, to threaten the eastern U.S. with sheets of rain, high winds and heavy snow.

Officials warned millions in coastal areas to get out of the way of the massive storm.

Sandy was expected to affect up to 60 million people when it meets two other powerful winter storms. Experts said it didn't matter how strong the storm was when it hit land: The rare hybrid that follows will cause havoc over 1,300 kilometres from the East Coast to the Great Lakes.

President Barack Obama was monitoring the storm and working with state and locals governments to make sure they get the resources needed to prepare, administration officials said.

Craig Fugate, director of the Federal Emergency Management Agency, said the storm was a threat to the region's interior, not just coastal areas: "This is a very large area," he said.

New Jersey Gov. Chris Christie declared a state of emergency Saturday as hundreds of coastal residents started moving inland and the state was set to close its casinos. New York's governor was considering shutting down the subways to avoid flooding and half a dozen states warned residents to prepare for several days of lost power.

Sandy was at Category 1 strength, packing 120 kph winds, about 418 kilometres southeast of Cape Hatteras, North Carolina, and moving northeast at 16 kph as of 8 a.m. Sunday, according to the National Hurricane Center in Miami. It was about 636 kilometres south of New York City.

The storm was expected to continue moving parallel to the Southeast coast most of the day and approach the coast of the mid-Atlantic states by Monday night, before reaching southern New England later in the week.

The storm forced the presidential campaign to juggle schedules. Romney scrapped plans to campaign Sunday in the swing state of Virginia and switched his schedule for the day to Ohio. First lady Michelle Obama cancelled an appearance in New Hampshire for Tuesday, and Obama moved a planned Monday departure for Florida to Sunday night to beat the storm.

In Ship Bottom, just north of Atlantic City, Alice and Giovanni Stockton-Rossini spent Saturday packing clothing in the back yard of their home, a few hundred yards (meters) from the ocean on Long Beach Island. Their neighbourhood was under a voluntary evacuation order, but they didn't need to be forced.

"It's really frightening," Alice Stockton-Rossi said. "But you know how many times they tell you, 'This is it, it's really coming and it's really the big one' and then it turns out not to be? I'm afraid people will tune it out because of all the false alarms before, and the one time you need to take it seriously, you won't. This one might be the one."

What makes the storm so dangerous and unusual is that it is coming at the tail end of hurricane season and the beginning of winter storm season, "so it's kind of taking something from both," said Jeff Masters, director of the private service Weather Underground.

Masters said the storm could be bigger than the worst East Coast storm on record, the 1938 New England hurricane known as the Long Island Express, which killed nearly 800 people. Experts said to expect high winds over 1,300 kilometres and up to 60 centimetres of snow as far inland as West Virginia.

The storm was so big, and the convergence of the three storms so rare, that "we just can't pinpoint who is going to get the worst of it," said Rick Knabb, director of the National Hurricane Center in Miami.

Officials are particularly worried about the possibility of subway flooding in New York City, said Uccellini.

New York Gov. Andrew Cuomo told the Metropolitan Transportation Authority to prepare to shut the city's subways, buses and suburban trains by Sunday, but delayed making a final decision. The city shut the subways down before last year's Hurricane Irene, and a Columbia University study predicted that an Irene surge just 30 centimetres higher would have paralyzed lower Manhattan.

As the storm swirled away toward the U.S. East Coast, officials in the Caribbean reported that the hurricane cost at least 58 lives in addition to destroying or badly damaging thousands of homes.

While Jamaica, Cuba and the Bahamas took direct hits from the storm, the majority of deaths and most extensive damage was in impoverished Haiti. The country's ramshackle housing and denuded hillsides are especially vulnerable to flooding when rains come.

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Breed reported from Raleigh, North Carolina. Contributing to this report were AP Science Writer Seth Borenstein in Washington; Emery Dalesio in Kill Devil Hills, North Carolina.; Glenn Adams in Augusta, Maine; Randall Chase in Lewes, Delaware; Rodrique Ngowi in Boston; Ron Todt in Philadelphia and Nancy Benac in Washington.