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Six people have been taken to hospital and up to 10 vehicles have been damaged after a crash in east Kent.
Emergency teams were called to the crash scene on the A20 at Capel-le-Ferne just before 1320 BST.
Two cars and two lorries, believed to be foreign-registered, were involved in the main crash, police said.
Initial reports said 30 vehicles were involved, but Kent Fire Service said many people stopped at the scene and conditions were extremely foggy.
A spokeswoman said: "Lots of vehicles had stopped and there was quite a lot of fog - it might not have been initially clear as to who was involved in the collision."
Young child
The injured included a 38-year-old man with head, chest and facial injuries, who was airlifted to the Royal London Hospital, a spokesman for the South East Coast Ambulance (Secamb) said.
A 29-year-old woman with arm, leg and suspected pelvic injuries was taken to the William Harvey Hospital in Ashford, and a young child from their vehicle was taken to hospital as a precaution.
Meanwhile, a man, aged 30, who was travelling in a van, was taken to the Queen Elizabeth Queen Mother Hospital in Margate with an arm injury.
And a woman in her late 20s and a child who were travelling in a camper van were taken to the William Harvey Hospital with minor cuts and bruises, the Secamb spokesman said.
Minor incidents were reported in the tailback but there were no serious injuries.
Two trapped
Both the coastbound A20 and M20 were closed until 1950 BST and drivers were advised to avoid the area.
On Tuesday evening police were diverting traffic around the crash via slip roads and reported no significant tailbacks in the area.
Three fire engines from Folkestone, Dover and Ashford were sent to the scene and crews used hydraulic cutting equipment to free a man and a woman.
Officers said no further persons were trapped in vehicles at the scene, near the Roundhill Tunnels.
Paramedics and air ambulance crews were present alongside police and fire teams.
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