Preparation is key for those living under threat of prolonged wildfire smoke, experts say

A pair of medical experts say preparing ahead of time for the possibility of prolonged, thick wildfire smoke is critical to both physical and mental health.

Air quality warnings remain in place for much of Canada, in particular in B.C., as wildfires burn all over North America. 

After the record-breaking wildfire seasons of 2017 and 2018 in B.C.'s Interior, and a bout of choking wildfire smoke over the South Coast in 2020, British Columbians have become used to smoky summer skies. 

Smoke has caused air quality to plummet to dangerously unhealthy levels dozens of times over the past 20 years, especially in B.C.'s Interior.

Courtney Howard, an emergency room physician in Yellowknife, said that during the 2014 wildfires in the Northwest Territories, asthma patients were showing up at the emergency room needing more medicine than usual.

"I was in the emergency department and it was a morning shift, and every patient I saw for about the first half of the shift had asthma," she told Angela Sterritt on CBC's The Early Edition. 

Wildfire smoke can exacerbate chronic health conditions, including asthma, chronic obstructive pulmonary disease (COPD), heart disease and diabetes, and it can also affect both the physical and mental health of those who do not suffer from chronic illness. 

Provincial Health Officer Dr. Bonnie Henry says eye irritation, runny nose, sore throat and mild coughs are normal in the presence of smoke, and can be managed at home. 

But anyone experiencing shortness of breath, chest pain, dizziness, severe cough or heart palpitations should seek medical attention.

According to Howard and Sonia Bola, an asthma and COPD educator in Vancouver, planning ahead for wildfire smoke is key for everyone, even if they don't suffer from chronic conditions. 

"Last year, in early September, when Vancouver had something like the worst air quality in the world, I was hearing that people were needing to take time off work, particularly for those people who had to go into the office," Bola said. 

"Action plans can prevent [emergency room] visits and allow people to act quickly by taking a little bit more of their anti-inflammatory medications, inhalers or bronchodilator inhalers. They allow people to still go to work, still do activities, and they are really important," Bola added.

Howard said primary care practitioners should start treating wildfire season like cold and flu season and prescribe inhalers ahead of time. 

Avoiding the outdoors and closing windows during periods of heavy smoke are advised for anyone living in smoky conditions. But if that goes on for too long, Howard said it can have a negative impact on mental health. 

Howard interviewed people in Yellowknife after the 2014 wildfire season to find out how the smoke had affected them.

She found that the people who prepared ahead of time by making sure their homes were safe, or lived in communities that had created clean air shelters for people to exercise and socialize in, were in better shape psychologically.

"They had a completely different tone to their interviews. They sounded empowered. They sounded proud."

Those who weren't prepared, she said, were anxious and irritable, because they were unable to exercise and felt disconnected from the outdoors.

Additionally, the smoke gave people a greater understanding of how climate change was affecting their lives.

Howard said it's important to plan to exercise and spend time in nature on days where smoke has lifted.

"We're going to see more summers like this, maybe even worse summers, and we need to prepare for that. And that's going to feel good, to actually align our actions with what's required right now," Howard said. 

"Action feels better than anxiety."