The view of the Bay Bridge and East Bay from Bernal Heights Park is obscured as smoke from numerous wildfires chokes the Bay Area on Wednesday, Aug. 19, 2020. (Kevin N. Hume/S.F. Examiner)

Wildfires, extreme heat, COVID-19 present challenges to health care systems

The combined effects of the COVID-19 pandemic, crushing heat and the sudden, disastrous onset of wildfire season could intensify the current health care crisis in the Bay Area, according to a group of doctors from the University of California San Francisco.

On Thursday, there were wildfires burning in nearly every Bay Area county. The smoke from those fires, combined with the recent sweltering heat, have resulted in unhealthful air quality throughout the region.

On Wednesday, the Bay Area Air Quality Management District extended its “Spare the Air” alert though Sunday due to the heavy presence of wildfire smoke and particulate matter.

“We are in this perfect storm of a lot of uncertainty with not a lot of reassurance that things will get substantially better in the next few months,” said Dr. Jahan Fahimi, associate professor of emergency medicine and medical director of the UCSF Emergency Department.

During these periods of intense wildfire activity and sweltering heat, hospital emergency rooms typically see an increase of patients coming in complaining about new or worsened respiratory and cardiovascular illnesses and infections, Fahimi said. Many of the same people who are at particular risk during wildfire season — patients with asthma, COPD and heart or lung disease, for example — are also more vulnerable to contracting COVID-19 and, once infected, experiencing more severe symptoms.

While there isn’t a lot of research yet, it’s also possible that prolonged exposure to air pollution, including wildfire smoke, could increase people’s vulnerability to the virus, said Dr. Stephanie Christenson, UCSF assistant professor of medicine, division of pulmonary, critical care, allergy and sleep medicine.

“There is some data so far suggesting that there might be an association between air pollution and COVID-19,” Christenson said. “We think that it could affect your susceptibility (to the virus),” she said.

And with many health care workers and hospitals stretched dangerously thin, any increases in patients, especially those with acute illnesses that require long periods in intensive care units, could push some systems to the breaking point.

“The Bay Area and San Francisco in particular have been actually very good at responding to the pandemic,” Christenson said. “Are we going to throw a wrench in it because we’re having these issues?”

The issues — longer and more intense wildfire seasons and hotter temperatures, in particular — aren’t going away any time soon, said Dr. John Balmes, UCSF professor of medicine in the divisions of occupational and environmental medicine and pulmonary and critical care.

“It’s really become the new normal that we have these mega fires that foul our air and this is a particularly bad set of fires all around the Bay Area, due to the unusual lightning strikes,” Balmes said. “I just would point out that the big driver here, both for the tropical storm in August with lightning and the high heat and the wildfires as a result, is due to climate change, so we need to be working to mitigate climate change,” he said.

For the short term, however, the doctors advise people to stay at home as much as possible, avoid exercising or working outside if possible, seal up windows and use recirculated air conditioning systems or air purifiers if they can.

When out of the house, people should wear masks as usual, although the best masks for smoke — N95s with vents — are not as effective against the virus. Cloth masks, which can offer good protection from the virus, aren’t very effective when it comes to filtering out smoke, while surgical masks are good for preventing the wearer from transmitting the virus and are somewhat effective at keeping particulate matter out of the lungs, according to Balmes.

“We still want people to wear any kind of mask right now,” Christenson said.

By Kiley Russell Bay City News Foundation

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