Areas east and southeast of Buffalo, in northern New York state, could receive a year's accumulation of snow or even more in just two days, Erie County executive Mark Poloncarz told reporters.
The deadly storm may see as much as another three feet (90 centimeters) of snowfall tomorrow, which could prompt a federal disaster declaration, Poloncarz said.
US media reported two other deaths in the states of New Hampshire and Michigan.
Temperatures will remain below normal from the Midwest to the East Coast until the weekend, with all 50 states recording below freezing temperatures yesterday, the National Weather Service said.
The National Guard was called in to assist military Humvee vehicles after New York's transportation department worked through the night to rescue stranded motorists and take people to shelters.
"Many communities are still in a very difficult, sometimes paralyzed situation," Poloncarz said.
Three of those who died suffered heart attacks while shoveling snow and another person died while using a snowplow.
County spokesman Peter Anderson said runways at Buffalo Niagara International Airport were open, but that "a lot of flights" were being canceled because people cannot get to the airport.
Dave Zaff, a meteorologist from the National Weather Service, said areas east and southeast of Buffalo city received upwards of five feet (1.5 meters) of snow.
"That is somewhat of an extreme event," he told AFP. "From a forecast standpoint, it will be historic.
"The impact alone when you have hundreds of thousands of people stranded, roads closed everywhere, you start to get fatalities," he said. "It becomes a very memorable event that people will never forget."
And New York-based rock band Interpol was among those trapped in the snowstorm outside Buffalo overnight, forcing them to cancel a concert across the Canadian border in Toronto.
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