In parts of US and Canada, temperatures were forecast to fall below -20F, with wind chill making it feel more like -90F on January 5.
In Canada, high winds have knocked out power for tens of thousands of residents in Nova Scotia.
Thousands of snow ploughs are clearing roads across the East Coast.
On January 5, the National Weather Service (NWS) predicted dangerously low temperatures moving into the weekend as frigid air lingering over the North Pole prowls towards the US mid-Atlantic region.
In Massachusetts, residents of Boston, which received over 1ft of snowfall, were clearing the streets with shovels.
It comes just days after a phenomenon described as a “bomb cyclone” brought heavy snowfall to a wide area along the East Coast, as well as hurricane-force winds.
Giant waves caused by the storm saw freezing floodwaters inundate parts of the New England coast.
According to reports, the extreme weather has so far been linked to up to 19 deaths in the US and two more in Canada.
Four deaths were reported in traffic accidents in North and South Carolina. Further fatalities occurred in Wisconsin, Kentucky and Texas.
In Philadelphia, a car was unable to stop at a railway line at the bottom of a steep hill and was hit by a commuter train, killing a passenger in the vehicle.
In Virginia, a girl was fatally struck by a car while sledging, and a 75-year-old man was killed after being hit by a snow plough.
In Perth Amboy, New Jersey, where the temperature averaged 20F on January 4, a 13-year-old girl died and 35 others suffered carbon-monoxide poisoning in an apartment building. Seven of those treated were first responders.
The extreme weather caused travel chaos and led to the cancellation of thousands of flights on January 4 and 5.
Most flights have since resumed at airports in New York and Boston.
Experts say the so-called bomb cyclone storm drew moisture and strength from as far south as the Caribbean Sea.
New Hampshire’s Mount Washington, which boasts of having the “world’s worst weather”, was forecast to experience a wind chill temperature as low as -90F on January 5.
Law enforcement in Indiana issued a joke warrant for the arrest of the heroine in Disney movie Frozen, blaming her for the cold snap.
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