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Difficult to convey COVID from the symptoms of smoke inhalation — the flu season is approaching: LAist

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On September 13, 2020, the sun set in the smoke of a wildfire in Los Angeles, California. (Mariotama / Getty Images)

Mark Kreidler California Healthline

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Patients are reported to Dr. Melissa Marshall’s community clinic in Northern California. They have difficulty breathing. It may hurt to inhale. They are coughing and the sore throat is definitely there.

COVID-19 straight case? Not so fast. This is a country of wildfire.

Above and below the west coast, hospitals and healthcare facilities report an influx of patients with the most likely problems associated with smoke inhalation. As the fire gets fierce Mainly out of control Smoke and ash swirl in the coastal areas in dry heat and strong winds San Francisco And cities and towns hundreds of miles inland also turn the sky orange or gray, making even normal breathing difficult.

But that’s only part of the challenge, Marshall said. Facilities already fixed for test supplies and personal protective equipment should first exclude COVID-19 for these patients. This is because many of the symptoms they show are the same as those caused by the virus.

“Clearly, the symptoms overlap,” said Marshall, CEO of CommuniCare, a group of six clinics in Yolo County near Sacramento, treating most under- and uninsured patients. Said that. “Whenever someone comes with even some of these symptoms, we ask ourselves,” Is it COVID? ” After all, clinically speaking, I still want to rule out the virus. “

The protocol is to treat the condition, whatever the cause, and recommends quarantining the patient until the virus test results are returned, she said.

It is a scene that is unfolding in many hospitals. Administrators and physicians are familiar with the rapid spread of COVID-19 and its ability to cause havoc, and will not miss an opportunity to recognize the symptoms that may arise from the virus.

Dr. Nanette Mikievich, President and Chief Executive Officer of Dominican Hospital in Santa Cruz, said: “This may be a symptom of COVID-19, so we treat these patients the same as those under investigation for coronavirus until they can be ruled out in the screening process.” During the test, fever As you can see, the symptoms peculiar to COVID-19 become clear.

For Dominica workers, the problem quickly moved to the top of the list. Santa Cruz County and San Mateo County were hit by a fire at the CZU Lightning Complex as of September 10. Burnt Over 86,000 acres have destroyed 1,100 buildings and threatened more than 7,600 other buildings. Almost a month after them I startedThe fire was contained about 84%, but thousands of people continued to evacuate.

Dominican, a hospital at Dignity Health, “is open, safe and provides care,” said Mickiewicz. Multiple tents built outside the building serve as an extension of the ER waiting room. They are also used to perform what has come to be understood as an important role: distinguish between those with and without symptoms of COVID-19.

At two North Bay Healthcare-operated Solano County hospitals, some wildfire routes have prompted authorities to review evacuation procedures, spokesman Steve Huddleston said. They eventually avoided the need to evacuate the patient, and new patients arrived with symptoms like COVID that could actually have been due to smoke inhalation.

Huddleston said the North Bay intake process was “anyone with COVID characteristics, [a] Patients under investigation for COVID. That is, patients are separated, screened, and managed by staff in a special PPE. Protocols have been established in two hospitals that have handled nearly 200 COVID cases so far.

California hospitals are mostly unsiege, but usually deal with multiple issues that can only be encountered sporadically. Adventist Health St. Helena Hospital in Napa County Evacuated On the night of August 1, when the fire was approaching, 51 patients moved to 10 other facilities, depending on their needs and bed space. After 10 days of closure, the hospital Can be resumed Since the evacuation order was lifted, the fire was contained at some distance.

Wildfires also make personal sacrifices to health care workers. CommuniCare’s Marshall lost his family’s home in the winter countryside, planting 20 acres of olive trees and other plants surrounding them. August 19 fire It swept Solano County.

“They called it a’fireball’,” Marshall said. The confluence of the three fires went out of control and thousands of acres were destroyed. She returned to work as her family safely accounted for it and her friend arranged a temporary housing. “Our clinic interacts with a very vulnerable population,” she said, and “this is an important time for them.”

She pondered how her family would be rebuilt, but the CEO faced another imminent crisis: a shortage of clinics. Last month, CommuniCare reached 19 COVID test kits on hand and “literally relied on a veterinary friend to strengthen them,” said the doctor, due to a lack of cotton swabs. Meanwhile, the clinic’s COVID test results took nearly two weeks to be returned from an overwhelming external lab, making contact tracking almost useless.

According to Marshall, these situations have been resolved, at least temporarily. However, although the west coast is the most dangerous time of the year for wildfires, it is generally September to DecemberAnother problem for healthcare providers is on the horizon. It’s the flu season.

In the Southern Hemisphere, influenza trends in the summer months predict future developments in the United States, but this year the disease is due to travel restrictions, long social distances, and face masks. Is rarely occurring. But it’s too early to see what the US flu season is all about.

“Several cases of influenza may be seen in late October,” Marshall said. “In reality, it will bring many features that can be a symptom of COVID, and nothing has changed, just to eliminate the risk.”


Kaiser Health News (KHN) is a national health policy news service. It’s an editorial independent program Henry J. Kaiser Family Foundation It has nothing to do with Kaiser Permanente.

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