Fire and COVID rage all around me. Can’t we do better?

This has been anything but a normal year, but when I first saw the lightning

This has been anything but a normal year, but when I first saw the lightning strikes, I thought, even for 2020, this is crazy. Waking me from sleep in my San Francisco home, forks of lightning lit up the pitch-black sky at a terrifying frequency and with deafening roars. It was beautiful. It was ominous. In all, there were almost 7,000 lightning strikes on that mid-August day, streaking across the urban landscape.

The following morning, we joked of the coming apocalypse, but little did we imagine that two weeks later we would literally find ourselves in a fiery, hellish landscape, obscuring the beauty of California behind smoke and fire, and leaving millions of people struggling with the health consequences of breathing these toxic fumes. 

Coupled with climate change, heat waves and forest overgrowth, the lightning storms were the catalyst to the worst wildfire season the West Coast has seen in decades. Lives and property have been lost directly to the out-of-control fires; here in the Bay Area, the resulting smoke and ash has blanketed everything. Walking outside is like stepping into a crowded cigarette-smoke filled bar where they are barbecuing and have coincidentally also just launched fireworks. There are days where every breath leaves an ashy taste in the mouth and eyes watering.

Even the hospital smells like smoke

When the air quality is deemed “hazardous” to overall health, we are left with few options but to stay indoors and search online for any air-filters in stock while obsessively checking the local air quality index online. Going out to buy groceries is an exercise in holding your breath. 

The most striking experience though, was the day the skies turned red. By now, you have likely seen photos of the orange-red hue projected by the smoke filtering out the blue of the sky, but the pictures do not do it justice. It was dark, eerie, and disconcerting. Comparisons were made to Mars, but seeing ash rain down under a crimson sky, a post-apocalyptic landscape seems more appropriate. 

Fires on Sept. 14, 2020, near Camp Nelson, California.
Fires on Sept. 14, 2020, near Camp Nelson, California.

I am a hospital-based internal medicine doctor who has already been dealing with the terror that is the COVID-19 pandemic. This wildfire season has certainly not helped. Not only are the respiratory problems from COVID-19 patients exacerbated by the poor air quality, but patients with other kinds of lung issues, such as asthma, emphysema and COPD (chronic inflammatory lung disease) are also flooding the hospital with acute flare-ups and low oxygen levels. And despite having the best air filters that can be produced, there are days when even the hospital hallways smelled like a bonfire.  

Wildfires, blackouts, anger: California shows us the future of climate change

If even a hospital is not immune to infiltrating smoke, how could those struggling with chronic health conditions in their own homes stand a chance? Even more tragic are the displaced and homeless people who have no shelter from this poisonous miasma. Not only can toxic air exposure worsen existing conditions, prolonged and intense exposure can cause chronic lung diseases. These days, I use N95 respirators when seeing my COVID-19 patients, and find that I would like that same intense level of masking when I go outside to my ash-covered car (which I had washed off just 24 hours before). 

Gloomy 2020 feels like end times 

It can be difficult to know what to do when it seems the outdoors is toxic and the indoors full of contagious disease. First, of course, make sure you listen to local news about evacuation zones. If you are able to travel to somewhere with better air quality, do so but balance that with the risk of having too many people in one household during this pandemic. Stay indoors, and if available, use air purifiers. Avoid burning or adding more air pollution inside. Measures of air quality index can be found on the internet., one such site, has become a staple on my internet browser. 

The Backstory: Covering the record-setting wildfires that have wracked Western states

As the wildfires rage through California, Oregon, and Washington, and the COVID-19 pandemic surges throughout the 50 states, it truly can feel like the end times. But I see glimmers of hope in the doom and gloom that is 2020. America seems ready to take on challenges that have been smoldering unaddressed — among them forest management, climate change, and homeless health and resources. If we can wear our masks, socially distance and make it past this year, I hope we will take the lessons we learn, apply them in 2021, and never let such calamities get out of control again.   

Dr. Thomas Ken Lew is an assistant clinical professor of medicine at the Stanford University School of Medicine and an attending physician of Hospital Medicine at Stanford Health Care —ValleyCare. Follow him on Twitter: @ThomasLewMD 

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This article originally appeared on USA TODAY: COVID-19 and wildfires create health hazards inside and out: Doctor

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