The two victims, both adults, were killed when the vehicle struck multiple pedestrians and a fireworks stand, police said.
Police believe the man driving the pickup truck had a medical emergency before the crash, according to Columbia County Police Assistant Chief Wilfredo Manlapaz.
At a news conference, Manlapaz said the truck, traveling north on the street, ran a red light and struck a bicyclist in the crosswalk before hitting the fireworks stand.
Both the cyclist and the booth worker were pronounced dead at the scene, he said. The truck driver and a passenger were taken to hospital.
No one else was injured in the incident, and police do not believe the crash was caused by exploding fireworks, Manlapaz said.
It is not known if anyone else was in the stands at the time of the crash.
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