What you should learn about this harmful combo for Californians

The coronavirus pandemic is already stressful for most Californians. Add in forest fires and the situation is worse.

Smoke from huge forest fires is once again choking the Bay Area and creating unhealthy air quality. Given this year’s fire season, how will smoke affect people suffering from or recovering from COVID-19 or people with chronic lung disease?

“It is worrying because we have no other problem to deal with,” said Dr. Vinayak Jha, a San Francisco pulmonologist affiliated with Sutter Health’s California Pacific Medical Center.

“People are already worried about catching the virus and getting sick. Having breathing problems and other problems and then having a natural disaster or multiple fires during the fire season is not comfortable, ”he said.

In July, Governor Gavin Newsom pointed out the additional challenges that forest fire evacuations bring to California during the pandemic, particularly in shelters and fire camps.

According to the Centers for Disease Control and Prevention, those who are particularly vulnerable to forest fire smoke are: 65 years and older, teenagers 18 and younger, people with chronic health problems, and those who are pregnant, work outdoors, or have low incomes. Some of them overlap with groups that are also susceptible to COVID-19.

Early indications of risks

While there are still no definitive answers on the effects of forest fire smoke on COVID-19 patients, experts can use research on smoking and air pollution to draw preliminary conclusions.

“Wildfire smoke is like tobacco smoke without nicotine,” said Dr. John Balmes, professor of medicine at UCSF and environmental health science at UC Berkeley. “It is a plant material that, when burned, produces carbon particles with unpleasant hydrocarbons that are toxic.”

As an example, he took the 2018 Camp Fire. This flame caused fine dust, known as PM2.5 particles, to migrate from the northern part of the Central Valley down into the Bay Area. A thick haze blanketed the area for weeks, closing schools and shops, with northern California’s air quality rated as the worst in the world for several days.

“Fine particles are small enough to penetrate the deep lungs and can cause inflammation,” he said. “The acute effects of forest fire smoke on the lungs of firefighters have been investigated and there is evidence of inflammation. … The closer you are to the fire, the greater the risk of ignition. “

PhD student Joao Carreira walks through Sproul Plaza wearing a respirator at UC Berkeley on Friday, November 16, 2018. The place was largely deserted after university officials canceled classes on Friday due to unhealthy air conditions, which continued to keep the Bay Area with heavy smoke from campfires in Butte County.Paul Chinn / The Chronicle 2018

Jha said forest fires and air pollution from vehicles and factories have some of the same PM2.5 particles.

“There are increasing reports from China, Europe and the US that the more air pollution, the more COVID deaths and cases,” Jha said. “So there is cause for concern that forest fire smoke is not only bad for people in general, but can also affect people’s susceptibility to contracting the virus.”

Inhaling forest fire smoke can cause shortness of breath, coughing, and sore throat. So the coronavirus could “definitely make your symptoms worse,” Jha said.

One thing that Dr. Monica Minguillon, pulmonologist at Kaiser Permanente Santa Rosa Medical Center, was particularly concerned about the long-term effects of COVID-19, especially in severe cases and in the hospital.

“One of the things we see … is that it can take a long time to recover,” she said. “It will be months and years before we know the long-term consequences. Anyone recovering from chronic lung disease needs to be on high alert during the forest fire season. “

Tips for dealing with forest fire smoke

So what should people recovering from COVID-19 or living with other respiratory illnesses do when forest fire smoke becomes a problem?

All experts agree that unless there are mandatory evacuations, it is best to stay indoors with the windows closed – a step that is made easier as most people are already seeking refuge in the pandemic.

But that also means keeping your home as clean and pollutant-free as possible. Balmes said installing a high quality air filter in the HVAC system with a Minimum Efficiency Report Value (MERV) of 13 or higher that filters out the particulates that can get into the deep lungs.

For those without a ventilation system, Balmes recommends a portable HEPA filter air purifier that is certified by the California Air Resources Board and can cost anywhere from $ 200 to $ 1,000.

Poor San Francisco air quality during the 2018 forest fires. The EPA recently declined to raise standards for particulate matter before experts believe this will be a bad fire season in California.Russell Yip / The Chronicle

An air purifier cleans a room, so people might want to consider additional air purifiers for rooms where they spend most of their time. If an air purifier is too expensive to buy, experts can make a DIY version with a box fan and air filter.

Jha said COVID-19 patients should be in close contact with their doctor and not exert themselves, especially at the onset of the disease.

How to Track Air Quality

Experts also recommend checking current air quality conditions regularly on the Federal Air Quality Index and the Bay Area Spare the Air website. The Chronicle’s Air Quality Tracker also shows the current fire-emitted particulate matter in the Bay Area and state.

For more information on air quality and forest fire smoke, visit AirNow.gov. For more resources, see the CDC Forest Fire Smoke and Coronavirus website.

If you have to leave home when forest fire smoke is in the air and you have a pre-existing medical condition or have recovered from COVID-19, an N95 respirator is the best protection against smoke and coronavirus. As these are needed by health care workers, they are in short supply.

Experts say fabric covers and surgical masks don’t protect against forest fire smoke, but Balmes said that most healthy people don’t need a specific type of mask.

Two UC Berkeley students walk through Sproul Plaza wearing respirators on November 16, 2018. The site was largely deserted after university officials canceled classes due to unhealthy air conditions due to the heavy smoke from the Butte County’s campfire.

Paul Chinn / The Chronicle 2018

Jha said it was important to stay vigilant in the pandemic and be as prepared as possible for wildfire.

“Keep yourself socially aloof and wear a mask in public,” he said. “Take precautions: know how to check the air quality index, check your own home system, and have a plan in case you need to leave the area.”

The Chronicle’s Fire Map and Tracker provides information on forest fires currently burning in California.

Kellie Hwang is a contributor to the San Francisco Chronicle. Email: kellie.hwang@sfchronicle.com Twitter: @KellieHwang