Category Archives: Public Health

Smoke from California fires may have killed more than 1,000 people

SAN JOSE, CALIFORNIA – AUGUST 19: Smoke blankets the area from local fires in San Jose, Calif., on Wednesday, August 19, 2020. (Nhat V. Meyer/Bay Area News Group)

Vallejo Times-Herald, by Paul Rogers, September 25, 2020

Heavy smoke from wildfires that choked much of California in recent weeks was more than an annoyance.

It was deadly. And it almost certainly killed more people than the flames from the massive fires themselves, health experts say.

Between Aug. 1 and Sept. 10, the historically bad concentrations of wildfire smoke were responsible for at least 1,200 and possibly up to 3,000 deaths in California that otherwise would not have occurred, according to an estimate by researchers at Stanford University. Those fatalities were among people 65 and older, most of whom were living with pre-existing medical conditions such as heart disease, diabetes and respiratory ailments.

By comparison, through Wednesday, 26 people have died directly in wildfires this year statewide.

“Clean air is much more important than we realize,” said Marshall Burke, an associate professor of earth system science at Stanford who calculated the impacts. “When you look at it on a population level, you can see very clearly that breathing clean air has huge public health benefits, and breathing dirty air has disastrous consequences.”

Decades of medical research has shown that soot is among the most dangerous types of air pollution. Known as “PM 2.5,” for particulate matter that is smaller than 2.5 microns, the microscopic soot particles are so small that it would take 30 or more to span the width of a human hair.

Generated by diesel trucks, power plants, fireplaces and other sources, the tiny particles can travel deep into the lungs, even entering the bloodstream, when people breathe them in high concentrations.

In mild levels they cause itchy eyes and sore throats, coughing and a tight feeling in the chest. In more severe instances, they can trigger asthma attacks, heart attacks, strokes or respiratory failure, particularly in the elderly, infants and people with heart and lung problems.

Smoke levels broke all-time records in California. The Bay Area Air Quality Management District called 30 “Spare the Air” days in a row from Aug. 18 to Sept. 16. Soot levels exceeded federal health standards for 19 days. Air quality was even worse in the Sierra, the Sacramento Valley and parts of Southern California, where it reached 10 to 15 times the federal health standard. On Sept. 9, smoke turned the air across Northern California an apocalyptic orange.

Burke and Sam Heft-Neal, a research scholar at Stanford’s Center on Food Security and the Environment, looked at a study published last year that used Medicare data to show that when levels of particulate pollution increased around the United States, the death rate of people 65 and older also increased, as did emergency room visits.

That study, by researchers at the University of Illinois and Georgia State University, found that for each day particulate air pollution increased by about 10% over typical levels — or 1 microgram per cubic meter — there was an increase in deaths and emergency room visits among people over 65 during the next three days.

California has roughly 6 million people older than 65. The Stanford researchers compared air pollution readings during California’s fires with increased death rates and emergency room rates from the previous study. They concluded at least 1,200 “excess deaths” occurred from Aug. 1 to Sept. 10 in California, along with about 4,800 extra emergency room visits.

“These are hidden deaths,” Burke said. “These are people who were probably already sick but for whom air pollution made them even sicker.”

Burke noted Stanford’s analysis doesn’t include young children or people under 65 with serious respiratory or heart conditions.

Other researchers say they generally support Stanford’s conclusions.

“It makes total sense,” said Dr. John Balmes, a professor of medicine at UC San Francisco and a member of the California Air Resources Board. “It should give us pause.”

In recent days, Bay Area air has cleared. But there is still at least another month of fire season.

Balmes and other experts say it’s important when people can smell smoke outdoors that they go inside and close doors and windows. On very smoky days, towels, masking tape or painter’s tape can block leaks. Air purifiers and wearing N95 or KN95 masks also can help.

“I don’t want to panic people who are healthy and without pre-existing disease, but we should reduce exposure as much as possible,” Balmes said. “You should stay indoors and not be outside any more than you have to be. Exercising outdoors when the air quality is bad is particularly problematic.”

The big unanswered question is whether exposure to thick wildfire smoke has long-term effects on healthy people. A study published this summer by the University of Montana found that of 95 people who lived in the small town of Seeley Lake near Missoula — where wildfire smoke choked the area for 49 days in 2017 — roughly one-third had compromised lung function two years later.

Other studies of wildland firefighters are ongoing. But the public and media often pay more attention to flames than smoke, because we’ve evolved that way, said Dr. Anthony Harris, medical director at WorkCare, a health care company based in Anaheim.

“Those things that are immediate we see and are alarmed by,” he said of the flames. “But studies show that fear only lasts for about two weeks in terms of behavior modification. So the notion that I might have a poor outcome in 15 years because of the smoke I am inhaling today just doesn’t cause a rise in the awareness of people.”

Public health experts urge police to stop using tear gas during coronavirus pandemic

Doctors say the gas can damage the respiratory system and aggravate COVID-19 symptoms or aid spread of the disease

OAKLAND, CA – JUNE 1: Protesters run away as police shoot tear gas and flash grenades to disperse the crowd on Broadway near the Oakland Police Department during the fourth day of protests over George Floyd’s death by the Minneapolis police in Oakland, Calif., on Monday, June 1, 2020. (Ray Chavez/Bay Area News Group)
Vallejo Times-Herald, By Emily DeRuy, June 2, 2020

Public health experts are calling on police to stop using tear gas on people protesting the death of George Floyd.

An online petition started at the University of Washington and created with Peter Chin-Hong, an infectious disease specialist at UCSF, opposes the use of tear gas, suggesting it could “increase risk for COVID-19 by making the respiratory tract more susceptible to infection, exacerbating existing inflammation, and inducing coughing.”

Thousands of people have poured onto streets from Walnut Creek to San Jose in demonstrations sparked by Floyd’s death and video of Minneapolis Police Officer Derek Chauvin kneeling on Floyd’s neck for nearly nine minutes. Those demonstrations have been met by tear gas, rubber bullets, batons and other measures from police.

While some health officials have worried the crowded demonstrations could spread COVID-19, the petition endorses the protests “as vital to the national public health and to the threatened health specifically of Black people in the United States.”

The document encourages protestors to wear face coverings and stay six feet apart if possible. It also calls on police to avoid arresting and holding protestors in confined spaces like jails and police vans, “which are some of the highest-risk areas for COVID-19 transmission.”

Santa Clara County is urging people who attend protests to get tested for the virus within a few days. The county has opened free testing sites available to anyone regardless of whether they have symptoms.

According to the Centers for Disease Control and Prevention, prolonged exposure to a large dose of riot control agent like tear gas can have serious consequences, including respiratory failure possibly resulting in death.

Echoing the petition, a UCLA professor of medicine and public health told LAist he was especially worried about the potential harm caused when law enforcement officers rely on the gas.

“During this time when we’re protesting police brutality, the use of tear gas is causing more harm in the way of spreading COVID,” the professor, David Eisenman, told the news outlet. “There is some culpability on the police for using this method, which increases the sneezing and increases the coughing and therefore increases the spread.”

Solano County on re-opening: guide and links to 8 new documents on County website

By Roger Straw, May 8, 2020

Late on Thursday evening, Solano County Public Health added 8 new links to COVID-19 information on the County website.

The detail is welcome, although late to be posted.  The detail is also somewhat confusing and open to interpretation.

I will detail here the new material.  I will leave the analysis and critique to others, or maybe to a later posting here.

Inventory of changes on County website as of 8am Friday May 8 (changes most likely posted sometime between 6 and 9pm on 5/7)

  1. The County’s main Coronavirus page at top, “NEW Solano County Public Health amends the shelter at home order, enabling low-risk businesses to reopen starting Friday, May 8, 2020 with specific social distancing practices. Click here for more information about the roadmap.”
    1. The link “amends the shelter at home order” goes to a 14-page PDF, “ORDER OF THE COUNTY PUBLIC HEALTH OFFICER No. 2020-07”.  The ORDER includes sections on Effective Date, Intent and Purpose, Guiding Principles for Resuming Activities, Prohibited Activities, Level of Risk (Low, Medium and High), Social Distancing, High-Risk Populations, General COVID-19 Business Precautions, and Enforcement.  It also includes Exhibit A – Previously Designated Essential Activities, Exhibit B – Low Risk Activity, Appendix A – Low Risk Activity – Golf Courses, Appendix B – Solano County Social Distancing Protocol (Updated May 5, 2020). Two additional pages are empty: Exhibit C – Medium Risk Activities and Exhibit D – High Risk Activities, both of which state, “Currently not permitted to be opened until the County Public Health Officer promulgates the necessary guidelines. Once issued, such guidelines will be inserted here.”
    2. The link “roadmap” goes to a web page, “Solano County COVID-19 Roadmap to Recovery”.   This page summarizes the May 8 re-opening of low-risk activities, stating that “low risk businesses can open starting May 8th, subject to specific social distancing practices.”  The summary at top begins with the following links:
      1. Another link to the Public Health Order (see above).
      2. A link to a similarly named but more detailed Roadmap to Recovery.  This is a 9-page PDF, revised May 7, 2020, that details Low Risk, Medium Risk and High Risk activities with color-coded guides to re-opening.  This document “outlines the criteria for reopening and the phases for lifting the stay at home order to guide critical decisions in support of the public’s health and well-being in the weeks and months ahead.”
      3. A link to a “press release about the amendment and roadmap.” The May 7, 2020 press release begins, “County Public Health Officer amends shelter-at-home order — low-risk businesses to reopen starting Friday subject to specific social distancing practices”.
        1. The press release announces “Starting May 8, 2020, low-risk businesses in Solano County may reopen providing they have implemented and maintain social distancing best practices for reducing the spread of COVID-19.” Acknowledging that enforcement will be near impossible, the document quotes Dr. Matyas, “Changes to lifting this order place a lot of responsibility on business owners, their staff and residents to make good decisions.”
        2. The press release states that “The FOX 40 News report and comments by Fairfield Councilwomen Moy are incorrect.”  That report (posted here on the Benicia Independent and subsequently removed), asserted that all Solano restaurants would be reopened by Friday, May 15.
        3. The press release announces the Supervisor meeting on May 12 when strategies for reopening medium-risk businesses will be considered, and links to “Details, including how to view and participate…included on the County’s website.” That link goes to a general page about Board of Supervisor meetings but with two new links:
          1. A bright red header box: “Solano County public meeting protocol in response to Coronavirus (COVID-19): CLICK HERE”. That page outlines how to access the live-streamed meeting, and how to submit public comments by email or phone.
          2. A link to Board Rules and Procedures, which goes to a 7 page PDF, the 2009 standing rules for Solano BOS meetings.

So yes, complicated.  I only hope this outline of the County’s new postings will help guide you to an understanding of the slow and careful openings that were passed by our Board of Supervisors on Tuesday May 5.  You, like me, might think it is still too soon to be opening these “low-risk” businesses.  And you, like me, might stay away from those businesses that do open.

Let’s all hope the County does NOT open “medium-risk” businesses when it considers the matter next Tuesday, May 12.  Consider attending or sending in your comment.  From the County press release: “The strategy for minimizing risk and the timeline for reopening of medium-risk businesses are still being reviewed and will be discussed further with the Solano County Board of Supervisors at their meeting on Tuesday, May 12, 2020, starting at 9 a.m.  Details, including how to view and participate, are included on the County’s website at”