Which is making you sick?

Dry cough. sore throat. Breathing difficulty.

These symptoms are common to both wildfire smoke exposure and COVID-19, a twin danger to bay area residents.

To protect your delicate lungs from both threats, health professionals should put high-risk individuals at home, closing windows, using air purifiers, and wearing special masks when they venture outdoors. We ask you to take special precautions such as.

“People should evacuate from the smoke of a forest fire in as bad a location as possible during poor air quality,” said Dr. John Balmes, professor of UCSF medicine in Occupational Environmental Medicine and Pulmonary and Emergency Medicine.

Although there are guidelines for social distance, it is important for high-risk people not to seek clean air in public facilities such as libraries, community centers and shopping malls.

Instead, they should try to create a cleaner air space at home. Use portable air cleaners with doors and windows closed in one or more rooms, if needed.

It’s too early to say that smoky air exacerbates the risk of getting COVID-19, but there are good reasons to be wary.

The reason is as follows. Previous studies have demonstrated that air pollution exacerbates diseases such as asthma and increases the risk of other viral respiratory diseases. It is also known that people who already have lung problems suffer COVID-19 disease more than healthy people when infected.

If you already have COVID-19, smoke can make recovery worse. High levels of air pollution are associated with acute respiratory distress syndrome, which can be fatal to COVID-19 patients.

“It just gave us another insult that could make the problem even worse,” said Dr. Stephanie Christenson, assistant professor of medicine for lung, emergency medicine, allergies, and sleep medicine at UCSF.

Q: How do the symptoms of wildfire smoke exposure differ from those of COVID-19?

A: They share many symptoms. However, COVID-19, unlike smoke exposure, can cause fever and chills, muscle and body pain, and diarrhea. Contact your healthcare provider if you have any of these symptoms. If symptoms such as dyspnea or chest pain worsen, call a 911 or go to the nearest emergency care facility for immediate medical attention.

Q: What is in the smoke that triggers illness, especially COVID-19?

A: Air pollution is a mixture of solid particles and gas particles. The first line of defense when we breathe are cilia, small hair-like structures that cover the airways and protect them from mucus and dirt.

Smoke and gas can damage the cilia and even kill them. In addition, the incidence of diseases such as cancer, heart disease, stroke, diabetes and asthma is high. All of these conditions also increase the risk of death in COVID-19 patients.

Air pollution can also cause dysregulation of the immune system that is needed to fend off viral pathogens.

Q: I have to go out. How can I stay safe?

A: Two factors affecting both COVID-19 and smoke risk: proximity and exposure time.

The closer you are to where you smoke, the more you smoke, the higher the risk. The longer you are exposed to smoke, the higher the risk of lung damage. You rarely get hurt by a short dash into the grocery store. But the people who work outdoors every day face greater problems.

The risk of becoming infected with the COVID-19 virus is also high if you are close to the infected person, for example within 6 feet, and will inhale many viral particles. At the hospital, if you are near 15 minutes or more, you may think of “exposure”.

“Whenever possible, people should avoid doing exercise outdoors. Individuals working outdoors are at particularly high risk of exposure to smoke from forest fires,” said UCSF Associate Professor of Emergency Medicine and UCSF Emergency Department. Said Dr. Jahan Fahimi, the dean of medicine.

Q: Can the mask help protect me from both COVID-19 and smoke?

A: Yes-but only N95 masks used in hospital settings. Regular cloth masks reduce COVID-19 infections, but they rarely protect you from the particulate matter of forest fire smoke.

The N95 mask removes viruses and all particles larger than 0.3 microns. The ash and soot size is about 2.5 microns.

Unfortunately, the N95 is hard-to-find because it’s reserved for healthcare professionals and first responders. More easily available is a mask made in China called K95. Some of these are very good, but have not been certified by US authorities.

However, these N95 masks were not designed for long-term use. After about 15 hours or about 6 removals, the mask loses its ability to protect the lungs. In addition, their usefulness is limited if they have a beard, if the beard is moist, or if the desorption is done about 5-6 times.

Surgical masks are only one-third of the N95, but they are better than cloth masks.

The effect of the cloth mask depends on the fabric used. “They do little about removing smoke from wildfires,” Balmes said.

“This is another reason to actually try to evacuate in place,” Christenson said. “Nothing is 100%.”