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They were the first Melbourne hospitals to feel the brunt of a line of storm cells that swept in from western pasture lands carrying a load of allergenic ryegrass pollen, and took about one third of the 30 patients across the two cities admitted to intensive care with life-threatening respiratory reactions to the pollen. Across the board, the numbers are staggering: through Monday night and into Tuesday, nearly 10,000 people with respiratory distress, many of whom had never before suffered asthma, attended EDs and community health facilities in Melbourne and Geelong; 575 people were admitted. Between 6.30pm and midnight, 132 ambulances arrived at Footscray Hospital (normally it sees 40 ambulances in a 24-hour period). Over the two-day period of the asthma crisis, Western Health EDs saw more than 1200 patients about three times more than normal. Just before 7pm, Ambulance Victoria's executive director of emergency operations, Mick Stephenson, took a call from his Metropolitan West director to say there were no vehicles left to dispatch in the west, even for the most critical of cases. By 8pm, across the city, there were 150 jobs, 100 of them Code 1, pending. Of the nine people who lost their lives in the epidemic, it is believed that at least two died while waiting for an ambulance, including 20-year-old Hope Carnevali, who died on the front lawn of her home in Hoppers Crossing, about 30 kilometres south-west of Melbourne's CBD. Experts believe that, until November 21, 2016, the world's only known thunderstorm-associated asthma death was in the UK in 2002. Several Australian thunderstorm asthma events have been recorded over the years, always in spring when the pollen load is at its greatest, but newspaper archive searches reveal only a few small reports: 154 cases of asthma presenting at Melbourne hospitals in 1987, the first time the term "thunderstorm asthma" seems to have been used; two people requiring intubation and artificial ventilation in Wagga Wagga in 1997; more than 300 respiratory casesrequiring ambulances after a thunderstorm in Melbourne in November, 2010.

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