Ep. 49: When Wildfires and a Pandemic Collide

Welcome to The Undark Podcast, which will deliver — once a month from September to May — a feature-length exploration of a single topic at the intersection of science and society. In this episode, join environment and health reporter Eilís O’Neill and podcast host Lydia Chain as they hear from the people who are battling simultaneous catastrophes: hazardous wildfire smoke and the coronavirus pandemic.

Below is the full transcript of the podcast, lightly edited for clarity. You can also subscribe to The Undark Podcast at Apple Podcasts, TuneIn, or Spotify.

Eilís O’Neill: The first year Kena Hudson remembers it being really smoky in the Bay Area was 2018.

Kena Hudson: I remember walking to get like a coffee and just the ash coming down and people had the N95 masks out and I was like, that’s weird.

Eilís O’Neill: Hudson has been living in the San Francisco Bay Area since 2002. She says it didn’t used to get smoky in the summer, but now it’s pretty bad every year.

Kena Hudson: I’m from Oklahoma and we have a tornado season; we call it the fifth season. And so it was like, “Wow, we’re going to have a fifth season here in California.”

Eilís O’Neill: The smoke season. Hudson says the thing that makes the smoke hardest for her and her family is that her younger son has asthma.

Kena Hudson: There were some times when he was coughing and rushed to the hospital. And then there were two incidences actually where he had to be hospitalized for about a night or two, which were really terrifying.

I feel a little traumatized by the things I’ve been through with him, you know, staying in the hospital or being told that he might need to be intubated. That ages you.

Lydia Chain: This is the Undark Podcast. I’m Lydia Chain. Record wildfires raged across the West this summer and early fall. Those fires burned forests and homes. They killed more than 30 people. And they inundated cities with smoke. Smoke blanketed the Bay Area for weeks. Parts of Oregon saw hazardous air quality in early September. And western Washington breathed smoke from eastern Washington, Oregon, and even California.

The smoke would have been a public health crisis on its own. But, this year, it arrived in the middle of another crisis: a respiratory pandemic. Eilís O’Neill has the story.

Eilís O’Neill: Kena Hudson says the summer of 2019 felt apocalyptic.

Kena Hudson: My husband was traveling and I was at home with the boys and it was just very like the end of the world feeling. I mean, it was just, the smoke was so bad. The ash.

Eilís O’Neill: Hudson wanted an air purifier so her asthmatic son could sleep comfortably and safely.

Kena Hudson: I remember calling all over the Bay Area and then there was this one store that had one left. I remember pleading with him, saying, you know, “I have — at the time — like a 6-year-old with asthma. Like, I really need it.” And they had thrown pity on me and agreed to save it.

Eilís O’Neill: It took Hudson 10 minutes to drive over.

Kena Hudson: I remember leaving the kids at home and running to the Cole hardware store … and coming home and plugging it in and like putting towels around the doors and windows and just thinking like, “We’re kind of like trapped in here. You know, the air’s not safe to breathe.”

Eilís O’Neill: Hudson’s younger son is 7 years old now.

Clark Lorie: My name’s Clark. My nickname’s Clark. My first name’s Clarence.

I like to swim and my favorite food’s orange chicken. And I love to read.

Eilís O’Neill: But what Clark does not love is when it’s smoky outside.

Clark Lorie: I just don’t really like it. And I sneeze and cough a lot. I’m really allergic to dust.

Eilís O’Neill on tape: Does it make it harder to breathe?

Clark Lorie: Sometimes.

Kena Hudson: What do you use? What do we do? You want to show her these?

Clark Lorie: Yeah, this one is to open the air. And this one is the medicine.

Eilís O’Neill: As smoky summers became the new normal all up and down the West Coast, cities like Seattle and San Francisco tried to put better systems in place — so that, even if the summer felt apocalyptic, at least their most vulnerable residents were somewhat protected from the smoke.

But they didn’t plan on dealing with a smoke wave in the middle of a pandemic — which has made the situation more dangerous, and all their planning harder and sometimes completely moot. This year, cities scrambled to try to protect residents from smoke.

Dan Jaffe is an environmental chemistry professor at the University of Washington in Bothell.

Dan Jaffe: These very small particles which are the major ingredients in smoke are the ones that we’re able to inhale. They get deep into our lungs and the ones that cause the greatest health effects. And these are the ones that EPA regulates.

Eilís O’Neill: Jaffe’s research suggests that Hudson is right: Summer air pollution is getting worse in the western United States.

Dan Jaffe: We’ve actually made fantastic success here in the United States in cleaning up our air. It’s one of the great environmental success stories. … But, in the West, … this region is — we’re seeing this increase in fires and the increasing in smoke. And what that’s doing is offsetting the otherwise gains that we’ve made in the United States. There’s this big red bull’s eye centered on the western United States where the air quality gains have been offset, and we’re actually getting worse because of wildfires.

Eilís O’Neill: In 2018, Jaffe published a study looking at exactly how much worse the air pollution is getting.

Dan Jaffe: Think of the seven worst days a year. We’re seeing a statistically significant increase in the concentrations of those seven worst days a year. The seven worst days are getting worse.

We are seeing these effects now. They’re very clearly linked to climate change.

Eilís O’Neill: That’s because, with climate change, summers in the West are getting hotter, drier, and longer, making forests more likely to burn.

Cora Sack is a pulmonologist at the University of Washington in Seattle.

She researches the health effects of air pollution, and she works with patients with lung problems, many of whom work outside and can’t get out of summer wildfire smoke.

Cora Sack: They have an increased at least burden of symptoms when it’s smoky days, and we strategize about ways that they can help reduce that.

Eilís O’Neill: Sack says the negative effects of chronic air pollution are well-known, but research on the health impacts of short-term smoke exposure is still emerging.

There are some studies that show acute effects, and researchers are just beginning to look at the long-term effects of either one-time smoke exposures or repeated exposure to wildfire smoke, summer after summer after summer.

Cora Sack: The kind of more emerging research we’re seeing is those acute exposures being linked to cardiovascular disease and then potentially this link with people who are exposed repeatedly to this high wildfire smoke have worse outcomes down the road.

Eilís O’Neill: Sack says wildfire smoke is particularly bad for people with chronic heart disease and respiratory problems like asthma, people like Clark Lorie. And it’s also very dangerous for the elderly, the very young, and pregnant people.

Cora Sack: In susceptible people, it can lead to problems with their lungs. In particular, people who have chronic lung disease can get exacerbations of that disease.

Eilís O’Neill: In 2019, Seattle’s mayor Jenny Durkan recognized that smoke season was here to stay and the city government would need to plan for that.

So, with great fanfare, she unrolled a plan to protect people from the smoke by opening up public buildings, like community centers and event spaces, as smoke shelters.

Jenny Durkan from press conference: If this is the new normal, how do we equip our city so that people living in this city have somewhere safe to be when the smoke levels are high? So one of the things we’re doing is looking at our community centers to see how do we upgrade our HVAC systems so that we actually are screening out the worst of the smoke and toxins? And we’ve done that, and we’ve done that here in Rainier Beach Community Center.

Eilís O’Neill: 2019 was the smoke year that wasn’t in Seattle. For the first time in several years, the city wasn’t enveloped by smoke that summer.

But smoke did plague the Bay Area, and city officials bolstered existing resources to protect people from the smoke. Like Seattle, they made a plan to open public buildings as smoke shelters to try to give residents a place to get some relief.

Then, in 2020, the fire season broke all over the West Coast in the middle of a global pandemic.

Andrew Kornblatt: Right now, looking outside, the sky is blue, but you definitely see a yellowy orange haze in it.

Eilís O’Neill: Andrew Kornblatt lives in Berkeley. Like Clark Lorie, he has asthma.

Andrew Kornblatt: It’s like looking through a miasma of smog. It’s been worse than this. Right now in Berkeley, when you’re breathing in without a mask, for me who has asthma, it feels tight; it feels dense. It feels a little smoky and ash-ridden. But there were days where if I breathe in the air, it burned my larynx and it would burn my lungs. It felt unsafe.

Eilís O’Neill: It’s that layering of disaster upon disaster for people with pre-existing respiratory conditions that experts like Cora Sack were worried about.

Cora Sack: The biggest concern is really the people who are at risk from wildfire smoke are also those people who are going to be at risk from Covid infection. So, people with chronic lung conditions or heart conditions, the elderly, or people who are immunocompromised, pregnant women…

Eilís O’Neill: Exposure to air pollution can lead to inflammation in the lungs and cardiovascular system. And it can alter immune responses, perhaps weakening the immune system. There’s some evidence that air pollution could lead to more, and worse, cases of Covid-19.

And the historical evidence on this front is worrisome. One study in Montana showed an increase in influenza cases following bad seasons of wildfire smoke.

Cora Sack: Wildfire smoke has really been associated with an increase in severity and number of respiratory infections, which does certainly give us pause for a time when there’s a pandemic.

Eilís O’Neill: So, because of the pandemic, the wildfire smoke that rolled across the American West this year was expected to be even more dangerous for health than it is in normal years. But the pandemic also made it much harder to protect people from the smoke.

Cora Sack: A lot of the things we tell people to do when there’s wildfire smoke to protect them … will put them potentially at greater risk of Covid infections.

Eilís O’Neill: Sack says, in normal years, public health officials tell people to go to clean air shelters — places like libraries and community centers with air conditioning and HVAC systems — to get relief from the smoky air.

Cora Sack: Those are going to be harder to maintain when we want social distancing.

Eilís O’Neill: And then there’s the issue of masks.

Cora Sack: The cloth masks which help prevent a lot of your risk of transmission of Covid do not protect against the size of smoke particles that we most worry about for health effects.

Eilís O’Neill: …even if people do feel like they smell less smoke when they’re wearing a cloth mask. The masks that do protect against smoke particles are N95s. In past years, Sack recommended that her most vulnerable patients stock up on those. But, this year, …

Cora Sack: They just aren’t available right now, because of supply demands for health care professionals.

Eilís O’Neill: Andrew Kornblatt says staying safe from wildfire smoke and from Covid-19 has been a challenge this summer — because it means just staying in his house all day. And that’s not exactly comfortable.

Andrew Kornblatt: Our house doesn’t have air conditioning. So, to cool it on hot days, we would open the windows, put fans in the windows and drag in the cool air, push out the hot air to cool down the house for the next hot day.

Eilís O’Neill: But, of course, you can’t do that when it’s smoky outside.

Andrew Kornblatt: So … you rely on other elements, such as ice packs, putting up air filters. We have two of them that we set up in our small bungalow, just trying to make the air breathable and so I’m not coughing all the time. But we also have two dogs. And when it gets up to 90 in the house, they’re overheating.

Eilís O’Neill: Kornblatt says it’s not just hard for his dogs; it’s hard for him.

Andrew Kornblatt: It’s very taxing on your mental state. You feel trapped; your house becomes a sweltering swamp — because, again, you can’t get the good air flow in, and, no matter how many fans you put in, it’s still not fresh air. And, at a certain point, you think to yourself is this discomfort worth it?

Eilís O’Neill: So, one evening in early September, Kornblatt and his wife finally relented and opened up the windows.

Andrew Kornblatt: The house did cool down, but now all our stuff smells like smoke.

Eilís O’Neill: The preponderance of homes without air conditioning isn’t just a problem in the Bay Area. The pulmonologist Cora Sack says that’s true in Seattle as well.

Cora Sack: A lot of people in Seattle don’t have air conditioning. So it sometimes makes it harder to stay indoors and shut windows and try to create a safe space.

Eilís O’Neill: In non-pandemic years, Kornblatt says, he and his wife had a coping mechanism on hot, smoky days: They got out of their house.

Andrew Kornblatt: Coffee shops, anywhere where there is AC and where we can beat the heat. Definitely, we would go see like a matinee or definitely we would go to, say, like a museum — and just somewhere the air is filtered and it’s cool. … We would find any place that we could get out of the house and find a way to have breathable air and not be a sweaty, overheated mess.

Eilís O’Neill: But, this year, because of Covid, those places are all closed, or feel dangerous themselves.

Andrew Kornblatt: This year, we were even considering going to a hotel for a couple of nights that was pet-friendly, so we could take the dogs, go somewhere that had AC even just for a night to get relief from it. The more you think about that, the more you’re like, “That’s not sustainable for us, let alone all the other people who are dealing with this mess.”

Eilís O’Neill: Many more people have been stuck in their un-airconditioned houses and apartments this year than in normal years. Cora Sack says people who have homes but don’t have air conditioning can do a couple of things to stay safe in the smoke.

Cora Sack: Whatever people can do to make a clean room inside their house, and there are economical ways to do that. Best case scenario we’d want people to have a HEPA air filter, which helps purify air and takes away those really small wildfire smoke particles. But you can even make cheap versions of those with a box fan and filter on top.

Eilís O’Neill: Sack says people should also monitor local air quality and also just listen to their bodies.

Cora Sack: So, if they go outside and then they are experiencing irritation of their eyes or coughing, then listen and stop doing as much activity.

Eilís O’Neill: But, she says, cities would still need public clean air shelters. They would just need to be careful about what they put in place ahead of time.

Cora Sack: Reimagining what clean air shelters could look like and putting in policies to ensure, you know, people who may really need those public air places, like people who are homeless or have underlying health conditions, that they can have somewhere safe to go and putting in safe policies that maintain social distancing and ensuring that public spaces have the correct type of air filters to remove particulates from wildfire smoke. There’s also some possible evidence that some of these air purifiers, may remove some of the SARS-CoV-2 virus.

Eilís O’Neill: That reimagining that Cora Sack says would have been needed? That was difficult this year. Seattle officials had moved on from their 2019 smoke preparedness plan to 2020 problems: the pandemic, protests that filled the streets and often shut down the main freeway that runs through town, violence against those protestors, a six-block “autonomous zone” for a month or so. In short, their hands were full.

Shirlee Tan is with the public health agency for Seattle and King County. She says the agency was stretched thin this year, and wildfire smoke wasn’t their top priority.

Shirlee Tan: Covid is probably our biggest priority, and then the heat could come in actually above Covid if we had an extreme heat event, and wildfire smoke would be after that, given that we have limited resources this year, and people resources.

Eilís O’Neill: In August, before any wildfire smoke had hit Seattle, Tan said there was no plan to open any smoke shelters this year. Then, in the midst of a terrible smoke wave in mid-September, the city did end up opening one smoke shelter with room for one hundred people.

That’s less than 2 percent of how many people the city could shelter last year.

In the Bay Area, Kena Hudson did let her kids go outside a bit on days that the smoke wasn’t as bad.

Kena Hudson: When there’s ash falling, like it’s like snowflakes, I won’t let them go outside then.

Clark Lorie: Yeah

Kena Hudson: But we haven’t had ash. It’s mostly just been smoke the last few weeks.

Clark Lorie: Yeah

Eilís O’Neill: The morning I spoke with Kena Hudson and Clark Lorie, they’d gone to the park behind their house.

Clark Lorie: We might get a gate to go behind our house to the park. We played pig. It’s basically like horse. With a basketball.

Eilís O’Neill: San Francisco had many more weeks of smoke than Seattle. A heat wave led the city to open several public buildings as respite shelters from the heat and the smoke. Unlike Seattle’s 24-hour smoke shelter, these were only open during the day.

Mary Ellen Carroll is the director of San Francisco’s Department of Emergency Management.

Mary Ellen Carroll: We had less respite — relief centers open, but, generally speaking, people do not go to them. People really prefer to stay close to home. And in particular, what we found is that people will only go to places that they’re familiar with. So like if it’s the library that I normally go to, and I know the staff there, or the senior center where I go to have lunch, I might go there. And so we had a particular challenge this year because those places are not open.

Eilís O’Neill: Carroll says only 20 to 25 people used San Francisco’s smoke respite shelters over the five days they were open.

From the beginning of the pandemic, the city had rented hotel rooms for sheltering homeless people, and those hotel rooms provided some shelter from the smoke as well. For those living without any shelter, the city offered N95 masks. For those who have homes, the EPA says the keys to improving indoor air quality are air purifiers, HEPA vacuum cleaners, and window air-conditioning units.

But not everyone has the resources to buy those, and they can also sell out fast when wildfire smoke arrives. Some agencies in Washington state have distributed box fans with filters attached to them to families living in low-income neighborhoods. But Carroll says San Francisco has no programs to provide anything in the way of filters or air purifiers to residents.

Mary Ellen Carroll: The one Sunday that it was over a hundred degrees in San Francisco and we were at red air quality and we had zero bump on any of our emergency services, nothing at the hospitals, really no ill effect. … So, you know, people have been learning how to take care of themselves during this pandemic.

Eilís O’Neill: Even if there was no bump in how much people in San Francisco used emergency services, research suggests that this year’s smoke was very bad for people’s health.

Researchers at Stanford University estimated that the weeks of smoke in California might have caused more than one thousand additional deaths there, and quite possibly more than three thousand additional deaths there.

Researchers at the University of Washington estimated that about 120 additional deaths per week could be attributed to 2020’s smoke in their state.

Kena Hudson says she did her best this summer not to let her sons be exposed to too much smoke.

She bought both her sons a couple of kinds of masks, which Clark showed to me over Zoom.

Kena Hudson: Do you want to show her? What are the differences between the masks that you have?

Clark Lorie: Oh yeah, um, this mask is for the smoke, and this mask is for coronavirus.

Eilís O’Neill on tape: Do you have to wear both?

Clark Lorie: No.

Eilís O’Neill on tape: Do you wear them one at a time depending on whether it’s smoky or not?

Clark Lorie: Yeah.

Eilís O’Neill on tape: Show me the one for the smoke again.

Kena Hudson: How do you put it on?

Clark Lorie: Like this.

Kena Hudson: Just hold it to your face. It’s an N95.

Clark Lorie: N?

Kena Hudson: Yeah, like as in Nancy.

Clark Lorie: Oh. N95 like Nancy 95.

Kena Hudson: so when we went to go outside, we wear this one for the smoke. And then, if you have to go see people, we wear this one for the coronavirus.

Clark Lorie: This morning, I wore this one.

Lydia Chain: Eilís, thanks so much for bringing us this piece and for joining us on the show today.

Eilís O’Neill: Thanks for having me.

Lydia Chain: Is there anything that public health officials learned from dealing with smoke during a pandemic that they can use moving forward in non-pandemic years?

Eilís O’Neill: I think one of the big things learned is that retrofitting public buildings to serve as smoke shelters might not be the best or even the cheapest solution to protecting people from smoke. Even if there’s not a pandemic happening, obviously, it’s a big ask for people to come from wherever they are and go to a retrofitted public building and hang out there all day to breathe clean air.

And Mary Ellen Carroll with San Francisco’s department of emergency management actually told me people are very unlikely to do that, especially if those public buildings are outside of their neighborhood. And what that means is we really need to bring solutions to people where they are. And so that’s things like the Washington state program to provide filter fans for people in their homes and other solutions that have been named but haven’t really been tried anywhere like giving people HEPA filters for their homes.

Lydia Chain: We spend a lot of time in the story talking about how to protect people from smoke once it’s already here. What can be done to prevent it from becoming a crisis in the first place?

Eilís O’Neill: When people talk about protecting people from smoke they first talk about emergency management, so protecting people from smoke once it’s already here. And then forest management. And one of the big tools that forest managers have is prescribed burns. And that’s when a lot of fuel has built up in one part of the forest, so there’s a lot of underbrush and smaller dead trees that will burn and could lead to an out of control fire if it’s ignited in the summer when it’s really hot and dry. But if you set it on fire intentionally in the spring, that could be a smaller fire that would then kind of create its own natural fire break or be less likely to ignite under more dangerous conditions. And so that’s a tool that forest managers in the west are using more and more. It’s actually been used since time immemorial by Indigenous groups up and down the West coast. They would set fires.

But this year a lot of those prescribed burns were cancelled because of Covid-19. In the spring a lot less was known about how the novel coronavirus spreads and so forest managers kind of played it safe, cancelled the prescribed burns so that they wouldn’t be bringing workers together and into the woods. And as a result, this fire season there was a lot more fuel built up in forests. And then of course, the last piece is climate change which will require a lot of international coordination. It’s not something that state agencies can solve on their own, but is the biggest piece to how to make sure that the conditions do not continue to worsen in terms of how hot and dry and long summers in the west are.

Lydia Chain: Eilís O’Neill is an environment and health reporter based in Washington. Our theme music is by the Undark team and additional music in today’s episode came from Kevin MacLeod at Incompetech. I’m your host, Lydia Chain. See you next month.