At least three women are dead after a Greyhound bus carrying 33 people collided with a four-wheel drive towing a caravan on the Bruce Highway in north Queensland.
The crash occurred on a stretch of the Bruce Highway about 8 kilometres north of the town of Gumlu, between Bowen and Townsville, at around 11am on Sunday.
Four men remained in hospital in Townsville on Sunday night, two of them in a critical condition and two stable.
Queensland Police Superintendent Graeme Paine said the car was travelling south and the bus was driving north. All the fatalities and injured passengers were onboard the bus.
Describing the crash as "very significant", Superintendent Paine said one person had been airlifted from the scene.
He said it was not clear what caused the collision, which occurred in a 100kph zone.
"It's a crash involving a significant impact," he told reporters.
"We haven't determined any factors that have contributed to the crash at this stage, but certainly a crash of this nature involving this many people is a very significant and very tragic incident for us."
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A number of specialists are on scene collecting forensic evidence that will be assessed against any witness statements, Superintendent Paine said.
Anyone with information about the accident, such as dashcam footage, should contact police.
"A crash like this is very, very confronting," Superintendent Paine said.
"The first responders and the community members on scene at the time have done a very significant job in trying to help those who were injured and safeguard the scene, and try and assist those with medical attention."
Greyhound Australia CEO Dan Smith said staff at the company were "heartbroken" about the deaths of the three passengers aboard its service GX402, travelling from Brisbane to Townsville.
"This is a tragic incident and our deepest sympathies go out to those involved and their families and friends," Mr Smith said.
"We are working closely with authorities to assist them with their investigation in understanding the course of events that have led to this accident. We are also providing support to members of our team impacted by this tragedy.
"We will provide further updates as more information becomes available and ask that you respect the privacy of those involved at this extremely difficult time."
Additional staff mobilised to care for patients
Images from the scene show a badly damaged bus with a crushed front cabin on the highway, surrounded by police officers and ambulance workers.
Paramedics assessed 27 people at the scene — of those, seven had life-threatening injuries, according to Queensland Ambulance.
They were transferred to Townsville University Hospital after initial treatment at the Ayr Health Service, according to Townsville Health and Hospital Service acting Chief Medical Officer Dr Jason Yates.
On Sunday night, four people remained at the hospital, Dr Yates said.
Two men, aged 24 and 23, were in a critical condition, while a 27-year-old man and a 51-year-old man were in a stable condition.
The Townsville Hospital and Health Service's health incident management team has been meeting to assess the clinical needs of the injured bus patients.
"We have created capacity across our critical care units, including intensive care and emergency, as well as in theatres and inpatient units," said the service's chief medical officer, Dr Jason Yates.
Dr Yates said additional staff had been mobilised to care for the patients.
Members of the community have been asked to stay away from the hospital, unless their matter is serious, as staff treat the injured.
"Staff at both hospitals are currently busy managing patients from the crash," the Townsville Hospital and Health Service said in a social media post.
Bruce Highway closed in both directions
The Bruce Highway has been closed in both directions, while delays have also hit Queensland Rail services due to the proximity of the crash to rail lines.
A Queensland Rail spokeswoman said the North Coast line between Bobawaba and Gumlu would remain closed for emergency services to respond to the crash.
The northbound Spirit of Queensland is being held at Proserpine and the southbound Spirit of Queensland is being held at Townsville.
In a post on social media, Queensland Premier Steven Miles thanked community members and first responders who provided help, adding he was "shocked and saddened" by Sunday's events.
"Our thoughts are with their loved ones and all those impacted by this tragedy," he said.
"Queenslanders are sending you strength."
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