Jamaicans have started to take shelter from Hurricane Melissa as the category 5 storm neared the coast amid warnings of catastrophic flooding, landslides and extensive infrastructure damage.

The slow-moving giant, the strongest hurricane to hit Jamaica since records began in 1851, is set to make landfall early on Tuesday and to linger over the island.

The storm is expected to slice diagonally across the island, entering near the parish of St Elizabeth parish in the south and exiting around the parish of St Ann in the north, forecasters said.

Late on Monday, the storm lay about 150 miles (240km) south-west of Kingston and about 330 miles (530km) south-west of Guantánamo, Cuba, with maximum sustained winds of 175 mph (280km/h). It was moving north-northeast at 2mph (4km/h), according to the US National Hurricane Centre in Miami.

Some parts of eastern Jamaica could receive up to a metre (40in) of rain while western Haiti could get 40cm (16in), the US National Hurricane Center said. “Catastrophic flash flooding and numerous landslides are likely.”

The parish of St Elizabeth has already lost power as ferocious winds brought down power lines. The parish also bore the brunt of Hurricane Beryl, which caused historic levels of destruction in St Vincent and the Grenadines, Grenada and Jamaica last year. Some people say they have only recently completed work on their properties after Beryl.

Hours before the storm, the government said it had done all it could to prepare as it warned of catastrophic damage.

“There is no infrastructure in the region that can withstand a Category 5,” prime minister Andrew Holness said. “The question now is the speed of recovery. That’s the challenge.”

A life-threatening storm surge of up to 4 metres (13ft) is expected across southern Jamaica, with officials concerned about the impact on some hospitals along the coastline. Health minister Christopher Tufton said some patients were relocated from the ground floor to the second floor, “and [we] hope that will suffice for any surge that will take place”.

The storm has already been blamed for seven deaths in the Caribbean, including three in Jamaica, three in Haiti and one in the Dominican Republic, where another person remains missing.

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The director of the Meteorological Service of Jamaica, Evan Thompson, has warned that no part of the island is likely be spared Melissa’s deadly combination of rapid intensification and snail-paced advance.

“If it continues as projected in terms of the turn toward the island, we should therefore on Tuesday look for the hurricane-force winds starting to impact southern coastal areas and then gradually spreading as the system moves closer to the coastline,” he said.

He said the rapid strengthening of the hurricane was notable: “That is something that would not always happen, and this is usually indicative of the kind of warm waters that we’re experiencing that we believe is somewhat related to climate change.”

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Desrick Kenton, who lives in Portland on the north-east coast, said the rattling of his zinc roof persuaded him to head to a shelter. Asked why he thought some people were refusing to move, he said: “The spirit of God has to touch some of the people before they move. But I tell them despite the fact you may have a concrete structure it doesn’t matter, if you are living in a low-lying area, sort out yourself and move out to the best shelter.”

Leslie Burton, a farmer who also lives in Portland, has been without power. “Some of the little things in my refrigerator I have to dispose of and my neighbours are in the same problem,” he said, adding that he was concerned about his animals.

“I tried to put some zinc [coverings] over them but the breeze blew them away,” he said. He said he had to find a way to protect them, because they are his livelihood. “I do all the preparations even for my house but now I just have to hope for the best,” he said.

Maria Douglas, a shop owner in Portland, is also without electricity. “My ice-cream is melting. I have to be giving them away as well as drinks. The meat is still frozen but I’m not sure how long those will last, so it’s gonna be a big loss. We didn’t expect the electricity to go off so early otherwise we could have been better organised.”

Ava Brown, an author and publisher who owns the Black River film festival, is in St Elizabeth, which is expected to be one of the worst-affected areas. She said that despite taking every possible precaution, she was scared. “I am a single mom so I had one of my neighbours help me to batten down my windows. We had to move certain things away from the house.,” she said. “I’m really scared. It’s scary because, for example, you worry about how to ration the food.”

Jason Henzell, the chair of Jakes hotel in Treasure Beach, a popular tourist destination, said he decided to leave his St Elizabeth home and relocate his family to Kingston as he saw the effects of the storm.

Henzell said that despite his efforts to “lead by example” and encourage other residents to leave the area and seek shelter elsewhere, some have chosen to remain.

“Jamaicans are very deep in their faith. And I don’t say that as a means of mockery. I mean it with a tremendous amount of sincerity and respect. So, as a people, we (tend) to think that we can pray something away. And for the most part, we have been spared. So there is a feeling as though the Lord is going to protect us. He’s going to take [the hurricane] into a different direction. And that faith and belief has saved us on many occasions. But you know … at some point, the luck is going to run out, the blessings are going to run out. And I just, I hope and pray this is not that day, but it is looking like it is that day.”

Category 5 is the highest on the Saffir-Simpson scale with sustained winds exceeding 157mph (250km/h). The chief meteorologist at AccuWeather, Jonathan Porter, said Melissa would be the strongest hurricane in recorded history to hit Jamaica directly.

He said critical infrastructure including the island’s main international airport and power plants was located along the coast in Kingston, where the storm surge was expected.

“This can become a true humanitarian crisis very quickly, and there is likely going to be the need for a lot of international support,” he said.

One of the main concerns for Jamaican officials is getting people in low-lying and flood-prone areas on the coast and elsewhere into almost 900 shelters.

Holness announced late on Sunday that he had signed a compulsory evacuation order for several communities along the south coast, which will empower the country’s Office of Disaster Preparedness and Emergency Management to remove people from high-risk areas after some refused to leave.

Residents in Port Royal, a small fishing village in Kingston, said at the weekend they did not want to move because they would not feel safe in shelters where their belongings could be stolen and women could be at risk.

A Port Royal resident awaits the arrival of Hurricane Melissa. Photograph: Octavio Jones/Reuters

Before a 1692 earthquake submerged most of Port Royal, it was one of the biggest cities in the Caribbean. Today it is considered one of the communities most vulnerable to hurricanes and is on the compulsory evacuation list.

Minister Tufton said people who refused to move risked putting more pressure on already vulnerable healthcare services.

“The concerns are more with the people who are not evacuating,” he said. “But generally, we do have some vulnerabilities in some of our institutions. We have about three hospitals that are close to the coast – Falmouth, Black River and Hanover. They are right on the shoreline, on the coastline. So those could see some flooding if a surge is high enough.”