Dozens in intensive care units with 'thunderstorm asthma', more deaths predicted

Julia Medew, Neelima Choahan, Richard Willingham

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Two people have died and at least 30, including two children, are in intensive care after an extraordinary outbreak of "thunderstorm asthma" hit Melbourne.

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Two people, including 20-year-old law student Hope Carnevali, have died and at least 30, including two children, are in intensive care after an extraordinary epidemic of 'thunderstorm asthma' in Victoria on Monday night. Vision courtesy Seven News Melbourne.

Twenty-year-old law student Hope Carnevali died on the front lawn of her home after she and her family waited more than 30 minutes for an ambulance.

Omar Moujalled, a popular high-school student from Greenvale in Melbourne's north, also did not make it to hospital. The 18-year-old died at a doctor's surgery just days out from his Year 12 graduation.

A spokesman for Ambulance Victoria said it was aware of two cases "where patients with respiratory symptoms were unable to be revived by paramedic crews".

He said in one case it took the ambulance 31 minutes to arrive and in the other, the other ambulance arrived within 15 minutes - but was still too late.

"Our thoughts are with the families of those patients. We will carry out a full clinical review into these cases," he said.

Health Minister Jill Hennessy has ordered a review, after hospitals were inundated with more than 1000 people seeking help.

Manaia McElhaney had to be revived twice on the way to hospital. Photo: Justin McManus

The breakout of "thunderstorm asthma" on Monday night has been described as having put more of a strain on the ambulance service and emergency departments than a mass casualty terror attack.

On Tuesday, paramedics told Fairfax Media that they feared more deaths occurred during the catastrophe which contributed to 1900 calls for ambulances in five hours – six times ordinary demand.

One intensive care paramedic, who did not want to be named, said ambulances had taken more than an hour to reach several urgent "code one" lights and sirens cases during Monday night, and that he'd heard of "numerous deaths".

"It sounds like a lot more than two people died," he said.

Most hospital emergency departments reported double the usual number of patients during the night, prompting many to enact emergency plans and to set up makeshift emergency treatment spaces.

Some ran short on oxygen and Ventolin before the Health Department sent out additional supplies on Tuesday morning.

Jaxon Dowal had never had asthma until storms hit Melbourne on Monday evening. Photo: Justin McManus

Head of the Alfred Hospital's allergy and asthma department, Mark Hew, said his hospital saw the same number of patients with respiratory distress in one night as they would expect in six months.

He said more deaths could occur given about 1 in 10 people have asthma, which kills about 300 people in Australia each year.

Manaia McElhaney nearly died twice in the ambulance on the way to hospital. Photo: Justin McManus

Associate Professor Hew said "thunderstorm asthma" events, which are caused by strong winds stirring up pollen and other irritants in the air, tend to happen every five to 10 years.

"It is a big wake up call for people with asthma in the community ... If they have been prescribed a 'preventer' they should be taking it ... and they should make sure their action plan is up to date so they know what to do in an emergency," he said.

Victim Palli Zamani with his mother Rayann Zamani. Photo: Justin McManus

Health Minister Jill Hennessy described the event as a "great challenge" for authorities and said private hospitals, including the Cabrini in Malvern, had been opened to public patients to help meet demand.

"There will no doubt be a full review of what occurred last night and what the clinical outcomes were," she said.

The shocking turn of events has devastated Omar's family and close-knit school community. Photo: Supplied.

"No doubt there will be lessons to learn, there always are in these cases. But every part of our emergency management surge occurred correctly."

State health commander Paul Holman said in his 40 years as a paramedic he had never seen anything like it. He said the majority of the patients were so sick they needed to be taken to hospital, rather than being treated at the scene, and at one stage there were 190 people waiting for assistance.

Hope Carnevali, 20, died on her front lawn waiting for an ambulance. Photo: Facebook/hope.marsh.5

"Every ambulance and ambulance manager was recalled," he said.

"It was an unprecedented night ... I have never seen the computer dispatch of Melbourne look like it. It was what we call a sea of red."

Shadow Health Minister Mary Wooldridge said the government had some serious questions to address including what type of ambulance call out codes applied to people calling for urgent help.

"How long were these patients waiting after calling for an ambulance, and what classification was given, were they code 1 or classified as less urgent," Ms Wooldridge said.

"It is unacceptable for people to be waiting for an ambulance."

By the numbers

Two people died, 20-year-old Hope Carnevali and 18-year-old Omar Moujalled

At least 30 people in intensive care

1900 calls to Ambulance Victoria in five hours

Royal Children's Hospital: 500 children taken to emergency, normally 300 in a day

Royal Melbourne Hospital's Emergency Department: a record number of 335 patients in 24 hours, more than 215 people with thunderstorm asthma.

Northern Hospital: 383 patients, normally 170.

Western Health: at 1am Tuesday morning, 230 patients across the two emergency departments of Footscray and Sunshine Hospital.

St Vincent's: 216 in 24 hours to 2am. Normal day is 120.

Monash: 512 emergency patients overnight across its three emergency departments, compared with an average of 250.

Austin Health: 197 patients overnight, compared to an average of about 50. About 75 per cent had respiratory problems.

The Alfred Emergency Department: 110 more patients than an average Tuesday night

Sandringham Hospital Emergency Department: 90 more patients over an average Tuesday night

Frankston Hospital: 260 patients in 24 hours, normally 200.

University Hospital Geelong: 108 people arrived at the Emergency Department between 6pm and midnight., normally 200 people in a day.

Eastern Health: On Monday, 147 people arrived at Angliss Hospital's emergency department, 211 people arrived at Maroondah Hospital's emergency department.

Box Hill: On Monday, 230 patients presented to Box Hill Hospital's emergency department.