Natural Disasters

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Dangerous Air Quality in California

Several years ago my mom sent me four giant boxes of N95 respirator masks. This was during the “swine flu” pandemic in 2009. I never wore them (but don’t tell her). Frankly, I thought I would look silly and believed any benefit was minor. Finally, after sitting in the far corner of a cabinet for years, there is a better use for them. Health officials are advising N95 respirator masks be worn in areas affected by the horrific fire outbreak this week.

Hospitals in Southern California have reported an uptick in patients with breathing problems, and are advising that people limit time spent outside, keep windows closed, and use air conditioners inside.

Santa Rosa, where devastating fires broke out in October, had the same air quality issues and recommendations:

The blazes create smoke waves — pulses of pollution containing everything from charred plastic residue to soot to other small particles that lodge deep in the lungs. They can trigger short-term ailments, such as coughing; worsen chronic diseases, such as asthma; and lead to long-term damage, including cancer.

The effect of the fires in Northern California’s wine country, which destroyed thousands of homes and killed 43 people, went well beyond the burn zone. The smoke choked the San Francisco Bay Area, home to 7 million people in nine counties, for days…

Even for healthy people, it can make breathing a miserable, chest-heaving experience. For the elderly, the young and the frail, the pollution can be disabling or deadly.

Health officials have advised that people in fire areas take precaution, even when smoke and ash can’t be seen or smelled.

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Smoke Effects from the California Wildfires

The fires in California are heartbreaking and terrifying. Because I think there are enough hellscape fire photos already circulating, here is a smoke free photo of Ventura harbor on better days, plus a pelican. 

In addition to the completely unsettling feeling of not knowing if and when and where the winds will shift the fires to, there are a number of health effects that come from inhaling all that smoke. Wildfire smoke is a mixture of particles from burning vegetation, burning building materials, and anything else that’s burning.  According to the CDC, “wildfire smoke can make anyone sick. Even someone who is healthy can get sick if there is enough smoke in the air.” Inhalation can have immediate health effects, including coughing, asthma, chest pain, headaches, and more. People who are more likely to experience health effects include older adults, pregnant women, children, and people with preexisting respiratory and heart conditions.

So what can you do, besides sigh loudly in despair every few minutes? Limit your time spent outside, and keep your windows and doors closed. Other CDC recommendations:

Do not add to indoor pollution. When smoke levels are high, do not use anything that burns, such as candles and fireplaces. Do not vacuum, because vacuuming stirs up particles already inside your home. Do not smoke tobacco or other products, because smoking puts even more pollution into the air.

Run an air conditioner if you have one, but keep the fresh-air intake closed and the filter clean to prevent outdoor smoke from getting inside.

Do not rely on dust masks for protection. Paper “comfort” or “dust” masks commonly found at hardware stores trap large particles, such as sawdust. These masks will not protect your lungs from smoke. An “N95” mask, properly worn, will offer some protection. If you decide to keep a mask on hand, see the Respirator Fact Sheet provided by CDC’s National Institute for Occupational Safety and Health.

Also, keep an eye on your pets for breathing trouble. And remember that even if the air outside looks clear, it’s unlikely to be free from harmful particles.

More resources:

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Is the Water Safe to Drink?

That’s the question many in Puerto Rico still have. Safe drinking water is more widely available now, but less so for those in more remote mountainous areas. From the Miami Herald:

Although government officials say they’ve distributed water purification tablets and bottled water throughout the island, by late October there were still places where residents said the help hadn’t arrived.

The mountainous area outside Utuado in central Puerto Rico was one of those places. Gambo Rodríguez and his family said they hadn’t gotten any bottled water or purification tablets from the government and couldn’t afford to buy their own.

Leptospirosis, a bacterial disease spread through contact with contaminated water, is a concern. There have been at least 18 confirmed cases, and are likely more that haven’t been accounted for in remote areas.

In the town of Humacao on the eastern edge of the island, local officials were still concerned about getting clean drinking water to the surrounding area in late October.

“I have 58,000 inhabitants and only one truck to take water to the upper areas,” said Ramon Díaz, the assistant director of the local emergency management center. Díaz was meeting with a water and sanitation expert from the nonprofit Oxfam, which was trying to identify the nearby areas in most desperate need of water purification systems.

“Which ones should we prioritize?” water expert Andrea Chaves Arana asked, listing off the names of several places.

“All of them, because they don’t have water,” Díaz responded.

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When Death Lurks in the Water

Two people have died from flesh-eating bacteria (necrotizing fasciitis) believed to be caused by the Hurricane Harvey floodwaters. A 31 year old man who was working on recovery projects in the area and a 77 year old woman who contracted an infection when cleaning debris have died.  From CNN:

Necrotizing fasciitis spreads quickly, destroying the body’s soft tissue, and can become lethal within a very short time, according to the Centers for Disease Control and Prevention. However, treatment with antibiotics can prevent death if diagnosed quickly. In some cases, surgery is needed to prevent the spread of this infection, which can be caused by more than one type of bacteria.
“The bacteria that caused necrotizing fasciitis are not strange or unique bacteria,” said Dr. David Persse, public health authority for the city of Houston. He explained these bacteria can live in swimming pools or natural bodies of water, and the flood waters, contaminated by sewage and fecal matter, just “happened to have more” bacteria than other bodies of water.
Meanwhile in Puerto Rico, where many people still don’t have access to clean water over a month after Hurricane Maria, an outbreak of leptospirosis is feared. Puerto Rico has reported at least 76 cases of suspected and confirmed leptospirosis, including a handful of deaths, reports Dr. Carmen Deseda, the state epidemiologist for Puerto Rico. On average, 60 cases are usually reported in a whole year. From the Huffington Post:
Leptospirosis is spread through the urine of infected animals, including rats, pigs, dogs and horses. When a person comes into contact with water, mud or soil that has been contaminated by an infected animal’s urine, the bacteria can enter the body through open abrasions or mucous membranes in the eyes, nose and mouth, according to the U.S. Centers for Disease Control and Prevention. The current conditions in Puerto Rico are ripe for this type of infection…leptospirosis can be treated early on by using antibiotics. If left untreated, in some strains of the disease, patients may hemorrhage in the lungs or experience kidney failure and die.
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Snapshots of Despair and Resiliency in Puerto Rico

Over a week ago, Hurricane Maria made landfall as a Category 4 hurricane in Puerto Rico. Maria was the strongest hurricane to make landfall in Puerto Rico since 1928. Only a week before, Hurricane Irma, a Category 5 hurricane, skirted past Puerto Rico lashing it with rain and wind, and leaving millions without power. The situation is now nothing short of dire.  PBS has a good list of places to donate.

From the LA Times:

The scale of the devastation is mind-boggling. The main island of Puerto Rico is about 500 square miles smaller than Los Angeles County, and about a third of the population. At this moment, relatively few of those people have sufficient shelter, access to potable water, or food, or even the ability to travel to find supplies. One mayor warned that “hysteria is beginning to spread.”

People are stranded in high-rises, and few have power for air conditioning to counter the tropical heat and humidity. Those relying on medicines that must be refrigerated (about 14% of the islanders suffer from diabetes; insulin must be refrigerated to maintain its potency) or treatment systems requiring electricity are particularly vulnerable. Local officials report there are still parts of the island from which they have not received damage and casualty reports.

From The Washington Post:

But the scope of the devastation is so broad, and the relief effort so concentrated in San Juan, that many people from outside the capital say they have received little to no help.

“Nothing, nothing, nothing,” said 58-year-old retiree Angel Luis Rodriguez. “I’ve lost everything, and no one has shown up to see if anyone lives here.”

From The New York Times:

For the sick and the elderly, heat can be deadly. Without sufficient power, X-ray machines, CT scans, and machines for cardiac catheterization do not function, and generators are not powerful enough to make them work. Only one in five operating rooms is functioning. Diesel is hard to find. And with a shortage of fresh water, another concern looms: a possible public health crisis because of unsanitary conditions.

The potential for a public health crisis is a big concern, he said. Rats and decomposing animals can spread disease, the doctor added. Without running water, people are probably not washing their hands or boiling water often enough, or cooking their food well enough. This could lead to gastrointestinal outbreaks.

“This is like in war: You work with what you have,” said Dr. Carlos Gómez-Marcial, the emergency room director.