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The New Normal: Smoke Apocalypse – Get Ready Now ~ An Interview with Sarah Coefield

…You need to remember that in the West even if your hills are green, somebody else’s are not, and wildfire smoke can travel really far.

Western water security depends on healthy forests – and so does our health.

It’s likely that this summer and fall (and spring and winter) will bring another round of catastrophic wildfires – the type that wildland fire fighters find almost impossible to stop.

We spoke with Sarah Coefield, of the Missoula City-County Health Department about what communities can do to get ready for the upcoming wildfire season.


What inspired you to do what you did last summer?

It actually goes back several years. My dad was the Air Quality Meteorologist for the Montana Department of Environmental Quality for 30 years. He was on the forefront of wildfire smoke response when wildfire smoke started being a thing 18 years ago.

When I started doing air quality work, he mentioned that he wanted to see people getting air purifiers so they have clean air to breathe. But then he retired. I took what he had said to heart. It had been kicking around for a while in my mind, how to make something like that possible in the health department where I work. But logistically it seemed out of reach.

Then a couple years ago, Amy Cilimburg from Climate Smart Missoula, which is a local nonprofit focusing on responding to climate change with solutions, had a program with funding called Summer Smart, and she wanted to focus on wildfire smoke. She came to me and said, ‘we want to help people with wildfire smoke, what can we do?’  My desire to fulfill this dream of getting clean air to people sprang to life. I had been struggling with how to work out details like the logistics, recipients, and financing. Amy listened and then went out and got a grant from local hospitals to launch a pilot project. We spent the winter before last summer working out the details. We teamed up with Missoula Aging Services and their Meals on Wheels program to identify shut-in, elderly Missoula residents with respiratory issues who would benefit from having an air purifier with HEPA filtration during the wildfire season.

Climate Smart Missoula took the lead and started to deliver air purifiers to Missoula residents. The main goal was to get the purifiers out there and then follow up with the recipients after the wildfire season. Did they like them? Did it help keep them out of the hospital? We hoped that this work would leverage more money and enlarge the program.

As you think back to last summer and ahead to this summer, what do you think it’s going to be like for the residents in and around Missoula?

Last year we were expecting a mild smoke year. We were told it was going to be a non-dramatic wildfire smoke year. But then we had a flash drought – the spigot basically turned off, we didn’t get any moisture starting in July, and everything dried out. We had a record-breaking wildfire season.

Hopefully, this year will not be as bad as what we had last year. But whatever smoke we do get is likely going to continue into the fall. Wildfire season is getting longer all the time.

Last year, even with the air purifier distribution pilot program in place, the stories were heartbreaking. In particular, one community, Seeley Lake, got incredibly smoky; we started seeing numbers that were literally off of our charts and beyond what our monitor could even measure. The Health Department put out a recommendation that people leave the valley and get away from the smoke. We knew, though, that not many people could or would leave their homes. I called Climate Smart Missoula and asked if we could redirect some of the filters that were going to Missoula residents up to Seeley Lake.

The Seeley Lake health clinic helped identify the neediest patients, the people most at risk, and Climate Smart Missoula donated 25 air purifiers to those patients. We then continued to build on the relationship we’d established with a vendor for the pilot project; buying more purifiers and placing them with people who quite desperately needed them, into elementary school classrooms and the Seeley Lake health clinic. As the smoke started hitting the rest of Missoula County, we started trying to get more purifiers for places like the Lolo School, which was being hit by smoke from the Lolo Peak Fire. It just escalated.

I can’t imagine that we would have been able to respond like we did if we hadn’t already had some processes in place. We were still flying by the seat of our pants; we weren’t ever planning on ratcheting it up like this. This was a public health emergency. The Health Department emptied and overdrew its public health emergency preparedness (PHEP) fund to in order to make these air purifier purchases. PHEP funds are more traditionally used to respond to flu outbreaks or other public health issues, and we emptied that account. Unfortunately, there is not a funding mechanism in place to treat smoke as an emergency beyond the small PHEP grant that we get from the state. The state didn’t have anything to give us. And they didn’t start planning to reach out to the feds until larger towns in Montana started being affected by smoke. I didn’t hear from the state that they had started thinking about looking for federal funds for the air quality emergency until the state capital got smoked out.

So, while Seeley Lake was experiencing the worst smoke they’ve ever seen, we had to find money on our own. The community wasn’t asking for money. It was just me calling state agencies asking for money, which didn’t have quite the same punch as if perhaps the residents had been making noise. The people in Seeley Lake don’t really complain. They’re fairly individualistic. It’s a wonderful community there. They take care of each other. The Seeley Lake Community Foundation bought air purifiers for the Seeley Lake Elementary School. Neighbors stepped up and bought each other air purifiers. They focused on helping each other.

What are the long-term solutions?

The long-term solution is preparation, and acknowledging there will be smoke. Try to encourage understanding and adaptation for what needs to happen; there is going to be smoke, let’s prepare for it.

Things like designing buildings with HVAC systems that are set up to handle wildfire smoke. We live in a fire-adapted ecosystem. Because of climate change and because of the fuel build-up that is out on those hills from 100 years of bad forestry practices, there’s no way we’re going to have a future without wildfire smoke. Our best solution is to plan for it, and expect it. Across the West, when you build a new building, plan for a system that can handle smoke. And for people who are not set up to have a new building, there are solutions that aren’t horribly expensive that can provide better air quality such as portable air purifiers that will clean a room and do an awesome job.

Another goal is to try to make it more affordable; get the medical community to buy in. Talk to medical providers about prescribing air purifiers with HEPA filtration to help people breathe better.

I know from a survey that the Montana Department of Public Health and Human Services did that there was a 2.3 times increase in emergency room visits by people from Missoula and Powell Counties with respiratory complaints this August as compared to 2016 when we didn’t have smoke. So, we know that there were a lot of people going to the emergency departments.

If the medical profession could recommend and prescribe a purifier to help their patients with heart conditions, asthma, COPD or any of these other myriad of lung and health conditions it could help them survive wildfire seasons. The health department sent out a message in August, 2017, asking physicians to prescribe purifiers because doctors had sent their patients to me asking for purifiers. I didn’t have them, and that was the worst thing. In the end, though, I found them all purifiers.

Thinking about communities across the West, what are the top three things that we all need to be doing?

First, preparation is key. In the health department, we’ve managed to get some grants and we’re purchasing more air purifiers that we can get out to either public buildings or daycares or schools. We’re building up a cache we can deploy. It’s a good idea to develop a relationship with a vendor – the WINIX company was great to work with last year.  They provided discounts for our bulk purchases and then extended that discount to all Missoula County residents during the wildfire season.

But at the same time we’re building up this cache, we also want to create a culture of smoke readiness, and encourage all folks and businesses and schools to take care of their air.

Second, pay attention to conditions. Understand that smoke is a serious health concern. If you’re getting messages from your health departments of “don’t go running in the smoke,” that’s keeping your best interests in mind.

Third – and most importantly – take care of each other. Pay attention to your body. Respect the health effects of smoke, and what it can mean for you, what it can mean to your neighbor.

While most folks recover from a smoke event after some time with clean air, there are some lingering health concerns after a wildfire smoke exposure; it affects your whole system. Smoke has an inflammatory response once it gets into your system. In addition to the more typical respiratory or cardiovascular symptoms you may expect while the smoke is present, smoke can affect your immune system’s ability to fight off infections. For example, you see increased hospitalizations for pneumonia during a smoke event.  Anecdotally, you tend to see a pretty wicked cold and flu season after a smoke event, because folks aren’t as able to fight off the infections as they would have been if they hadn’t been in the smoke. I know that physicians in town did see an uptick in kids coming in with exacerbated asthma after the smoke was gone. It just kind of dragged on for a while, and a lot of people were really affected by the smoke.

We’ve all known smoke is bad for a really long time. It feels like it’s not treated with the same sincerity as water quality. One of the things that I just couldn’t stop saying was if Seeley Lake’s water was poisoned we could find a way to get them water. But I couldn’t find a way to get them all air. Our air was poisoned and we couldn’t just get the residents clean air. The truth is, we can’t get everybody an air purifier, and it becomes a thing where folks need to prepare on their own. Look at it this way –  in the summer when it’s hot you buy a fan. In fire season, you have an air purifier because it’s going to be smoky. It’s the same idea; this should just be a standard appliance in your home.

Sarah Coefield has been an air quality specialist with the Missoula City-County Health Department (MCCHD) since 2010.  She is lead for smoke management and large projects in the air program and runs point during wildfire smoke episodes.  Prior to her work at MCCHD, Sarah completed master’s degrees in wildlife toxicology and environmental journalism at Michigan State University.  She is a native Montanan.

Photo Credit: Ellie Boldman-Hill Smith

April, 2018

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