Pulmonary & Lung Health

Wildfires, Extreme Heat, Unhealthy Air During a Pandemic

Posted on Aug 20, 2020 in Pulmonary & Lung Health, Scroll Images

An Integrated Network Continues to Serve Northern California Communities

SACRAMENTO, Calif. –Wildfires fueled by high temperatures and winds are spreading across Northern California. Firefighters are battling to stop the blazes, which have forced thousands of people out of their homes. And to top it off, smoke from the fires is causing extremely unhealthy air quality in many areas, compounding respiratory issues concerns–especially for people with COVID-19.

Sutter’s round-the-clock emergency management system is monitoring the progress of the fires and the impact the heavy smoke is having on some of our care sites. Sutter has a long-standing commitment to the health and safety of the communities we serve, especially in times of natural disasters. During these unprecedented times, our integrated network is able to quickly move and redirect resources to those most in need. And despite the many challenges we’re all facing right now, Sutter hospitals and the vast majority of our clinics are open and stand ready to care for patients.

“I want to thank the thousands of firefighters and additional emergency personnel who are responding to these blazes and patients with medical conditions triggered by them—especially the physicians, nurses and staff across Sutter’s integrated network,” said Sarah Krevans, Sutter Health’s president and CEO. “Our teams have been on the front lines caring for patients since the very beginning of the COVID-19 pandemic and now they are simultaneously helping support their communities during these fires.”

December 11, 2017 – Fire crews, using controlled burns, create a barrier in the foothills of Carpinteria, California, in the hopes of containing the Thomas fire in Southern California.

“We are deeply saddened by the devastation the firestorms are waging on our communities and we are committed to supporting wildfire victims and evacuees,” said William Isenberg, MD, Phd, Sutter Health’s chief quality and safety officer. “Sutter Health team members also live in these communities and we know many of their homes and families have been impacted by the fires, so we are activating employee resources like emergency financial assistance.”

Resources to Help You Access Care

Although some care sites may be experiencing temporary closures due to evacuation orders, air quality concerns or COVID-19, listed here, care team members at those care sites are available to determine which available options work best to help patient access care during the closures:

  • Video visits with a care provider
  • Obtaining in-person care at another Sutter facility
  • Rescheduling services once it is safe to do so

In partnership with clinicians and care sites across our network, Sutter’s Mental Health & Addiction Care team is also available to assist with your mental wellness. Even if you are not directly affected by the wildfires across Northern California, just hearing about them may trigger memories from a past event, leading to fear, anxiety or other strong emotions. If you or a loved one needs help, please contact your primary care physician or access the emergency resources found here.

How to Stay Safe from Double Whammy of Smoke and COVID-19

Posted on Aug 20, 2020 in Pulmonary & Lung Health, Scroll Images

With wildfire smoke settling in every Northern California community, and with COVID-19 still a major health concern, Dr. William Isenberg, Sutter Health’s Chief Quality & Safety Officer, has two words of advice on the best way to avoid the associated health risks: Stay inside.

“With COVID-19, we have sheltered in place and limited our public interactions, and with the smoke in the air, sheltering in place is even more important,” Dr. Isenberg says. “Stay home, close the windows and doors, try not to let the outside air in. Those are the optimal recommendations to keep everyone safe during this unprecedented combination of a deadly pandemic and wildfire smoke, not to mention the heat of summer.”

Especially at risk of lung issues from the smoke are children, the elderly, those with underlying respiratory and heart issues, and pregnant women. “Inhalation of this wildfire smoke can cause premature labor,” he said. But he reiterated that prolonged exposure to all this smoke can cause queasiness and heart attacks to even those who are not high risk.

Dr. Isenberg offers the following precautions during this time of poor air:

  • Stay indoors as much as possible, limiting opening of doors and windows.
  • Use air conditioning in your homes and vehicles, if you have it. Malls, if open, are great places for people without their own air conditioning at home.
  • Do not run fans that move smoky outdoor air inside, such as whole-house fans. If your home is equipped with an automated venting system, make sure you turn it off.
  • Keep wellhydrated. Dr. Isenberg recommends drinking a minimum of 8 ounces of water eight to 10 times daily.  
  • Use your maintenance puffers/inhalers if you have asthma, emphysema or other respiratory diseases, and carry your rescue puffer/inhaler with you if you leave your home.
  • When out in public, make sure you wear your cloth or surgical mask. While these won’t protect you from the small smoke particles, they do help in controlling the coronavirus.

Air Now also has information about how to protect yourself from wildfire smoke, along with a chart that pinpoints the Air Quality Index of your town.

For further information, listen to this podcast from Capital Public Radio, which features an interview with Vanessa Walker, D.O., a Sutter Health pulmonologist.  

COVID-19 and Wildfire Smoke: Doctor Answers Masking Questions

Posted on Aug 20, 2020 in Pulmonary & Lung Health, Scroll Images

OAKLAND, Calif. –Wildfire season is suddenly upon us and thick smoke from multiple wildfires around Northern California, coupled with hot weather and the COVID-19 pandemic, has led to some confusion about masks: when to wear them and what type is best.

Now Ronn Berrol, M.D., medical director for Alta Bates Summit Medical Center’s emergency department in Oakland, offers tips to help you and your loved ones stay healthy in the Q & A below and in this KTVU interview.

Q: It’s so hot and smoky out! Do I need to wear a mask?

A: Yes! It’s important that everyone who can medically do so continues to wear a mask when they are in public to help reduce the spread of COVID-19. Between the heat, the smoky air and COVID-19, the virus still poses a significant risk.

Q: Does it matter what type of mask I wear? Will a homemade mask protect me or do I need an N95 mask?

A: With respect to COVID-19, for most people it’s probably more important that you wear a mask whenever you are in public than the type of mask you wear. This is because the COVID-19 virus is transmitted to others by droplets that people produce when they exhale—and especially when they cough, laugh, sing or speak loudly. By wearing a mask, you help protect the people around you.

If you have a lung condition such as asthma, emphysema or COPD (Chronic obstructive pulmonary disease), that makes you more susceptible to wildfire smoke, the type of mask you wear becomes more important. This is because tiny particulates and chemicals in the smoke can cause inflammation or difficulty breathing. And homemade cloth masks or surgical masks are not very effective at filtering out harmful particulates and chemicals from the smoky air. To filter out these particulates, an N95 mask is preferred. However, N95 masks can be more difficult to breathe through and lead to more overheating when it’s hot out.* So my advice is to stay indoors, keep doors and windows closed and use air conditioning and an air purifier, if you have them. I also recommend changing your home’s air filter and running the air conditioner in your car on recirculate so you’re not pulling outside air in.

Q: What else can I do to protect myself from the heat and the smoke?

A: It’s always a good idea to keep hydrated –when you are well-hydrated, your body can better respond to infectious challenges and the mucous membranes in your nose and lungs are better able to protect your body from environmental insults like smoke particulates. If you have asthma, emphysema or other respiratory illness, use your maintenance inhalers as directed by your doctor and be sure to carry your rescue inhaler with you if you do have to leave your home. Contact your doctor if you experience symptoms such as asthma, difficulty breathing or chest pain.

Read more about wildfire smoke and its effect on lung health here.

Read more about Sutter’s respiratory care clinics here.

*Important note: Some N95 masks have valves in them that vent exhaled breath without any filtration. Though they may be helpful to filter out wildfire particulates, these vented N95 masks will not provide protection for nearby individuals in the event the wearer has COVID-19.

Air Quality + COVID-19. What Does This Combo Mean for Our Lung Health?

Posted on Aug 20, 2020 in Pulmonary & Lung Health, Scroll Images

SAN FRANCISCO – Wildfires burning across Northern California coupled with extreme heat and dryness has the air quality in the unhealthy range. All of this is sparking concerns for people with respiratory issues, especially those with COVID-19. Dr. Vinayak Jha, a pulmonologist affiliated with Sutter’s California Pacific Medical Center, says the best way to protect ourselves from the virus and poor air quality is to stay indoors and wear a mask or face covering when outside.

Jha says elderly people, children and individuals with respiratory illnesses are particularly susceptible to elevated air pollution levels. With smoky air blanketing much of the Bay Area and the Sacramento and Central Valley regions, these at-risk populations should take extra precautions to avoid exposure.

Know before you go: View a list of Sutter Health facilities temporarily closed due to the effects of wildfires in Northern California.

Signs Wildfire Smoke May Be Affecting You

Breathing in wildfire smoke can have both immediate and long-term health impacts. In the short term, wildfire smoke can irritate the eyes and airways, causing coughing, a dry scratchy throat and irritated sinuses. Elevated particulate matter in the air can also trigger wheezing in those who suffer from asthma, emphysema or COPD (Chronic obstructive pulmonary disease).

Contact your provider if you experience any of the following symptoms:
• Repeated coughing
• Shortness of breath or difficulty breathing
• Wheezing
• Chest tightness or pain
• Palpitations
• Nausea or unusual fatigue
• Lightheadedness

What happens when a virulent virus is added to the mix? In a recent article by the San Francisco Chronicle, Jha explains that people are already concerned about catching the COVID-19 virus and becoming ill. And the situation becomes more complicated when smoke from wildfires is combined with the unusually high temperatures we’ve experienced in Northern California. This trifecta is not ideal for those with respiratory conditions.

Jha says the early science is revealing. “There are growing reports out of China, Europe and the U.S. that the more air pollution there is, the more COVID deaths and cases there are. There’s some reason for concern that wildfire smoke, besides being bad for people in general, may affect people’s susceptibility to getting the virus, too.”

Recovering from COVID-19? Living with a respiratory illness? Here’s what you should do if wildfire smoke becomes a problem.

As this fire seasons heats up, Jha recommends COVID-19 patients keep in close contact with their health care providers and avoid exerting themselves, especially if they are at the beginning of the illness.

“Continue to socially distance, and continue to wear a mask in public,” says Jha. He encourages people to check the Air Quality Index (here), check their own home air purifying system to make sure the filters are clean, and have a plan in case you need to leave the area.

Pulmonary Care

In the Sutter Health network, pulmonary specialists have deep expertise in treating acute and chronic lung conditions, including asthma, bronchiolitis, emphysema and pneumonia. They offer treatment for interstitial lung disease, advanced COPD, pulmonary nodules and pulmonary hypertension.

In light of COVID-19, Sutter Bay Medical Foundation stood up respiratory care clinics (RCCs) to prepare for increased patient demand. These exam experiences keep potentially contagious people distanced from those that aren’t, while allowing all who need in-person care to receive it.

Read more about Sutter’s respiratory care clinics here.

Sutter Health is committed to your health and safety. If you need care, make an appointment today. Our care teams are ready to serve you, either in person or by Video Visit.

Learn more about getting care during COVID-19 here.

Wildfire Smoke and COVID-19: What to Know and How to Prepare

Posted on Aug 2, 2020 in Pulmonary & Lung Health, Scroll Images

SAN FRANCISCO – For people who experienced breathing and respiratory problems brought on by previous years’ wildfire smoke, a San Francisco health expert cautions that these individuals should be extra vigilant with their health while COVID-19 is among us.

In an article by the San Francisco Chronicle, Vinayak Jha, M.D., a pulmonologist affiliated with Sutter’s California Pacific Medical Center (CPMC), says that people are already concerned about catching the virus and becoming ill. Having respiratory problems combined with air pollution from wildfires is not an ideal situation.

“There are growing reports out of China, Europe and the U.S. that the more air pollution there is, the more COVID deaths and cases there are,” says Jha. “There’s some reason for concern that wildfire smoke, besides being bad for people in general, may affect people’s susceptibility to getting the virus.”

Jha says breathing in wildfire smoke can cause shortness of breath, coughing and sore throat, and that having the coronavirus may worsen symptoms.

Recovering from COVID-19? Living with a respiratory illness? Here’s what you should do if wildfire smoke becomes a problem.

As the fire seasons heats up, Jha says COVID-19 patients should keep in close contact with their health care provider and avoid exerting themselves, especially if they are at the beginning of the illness.

“Continue to socially distance, and continue to wear a mask in public,” says Jha. He encourages people to have precautions in place now, before the wildfire season hits: know how to check the Air Quality Index, check your own home air purifying system to make sure the filters are clean, and have a plan in case you need to leave the area.

Pulmonary Care

In the Sutter Health network, pulmonary specialists have deep expertise in treating acute and chronic lung conditions, including asthma, bronchiolitis, emphysema and pneumonia. They offer treatment for interstitial lung disease, advanced COPD (Chronic obstructive pulmonary disease), pulmonary nodules and pulmonary hypertension.

In light of COVID-19, Sutter Bay Medical Foundation stood up respiratory care clinics (RCCs) to prepare for increased patient demand. These exam experiences keep potentially contagious people distanced from those that aren’t, while allowing all who need in-person care to receive it.

Read more about Sutter’s respiratory care clinics here.

Sutter Health is committed to your health and safety. If you need care, make an appointment today. Our care teams are ready to serve you, either in person or by Video Visit.

Learn more about getting care during COVID-19 here.

Seven Months of Coronavirus. Here’s What We’ve Learned Treating COVID Patients.

Posted on Jul 24, 2020 in Pulmonary & Lung Health, Scroll Images

SAN FRANCISCO – The novel coronavirus has been with us since January 2020—and California is still in a continuation of the first wave. As the pandemic drags on, the medical community has acted as a sponge, absorbing knowledge of how the infection is best treated from each new case.

Vernon Giang, M.D., chief medical executive of California Pacific Medical Center (CPMC), part of the Sutter Health not-for-profit integrated network of care, shares four learnings CPMC clinicians have discovered since they began treating some of the nation’s first COVID-19 cases in March.

Constantly Refining the Approach to Treatment

COVID-19 symptoms differ based on the severity of disease. Fever, cough, and shortness of breath are more commonly reported among those who are hospitalized with COVID-19 than among those with milder cases of the disease.

“Early on, the thinking was to put patients with compromised lung function on a ventilator,” said Giang. “We’re managing patients much better now with high-flow oxygen. This is an incredible advance to keep patients surviving COVID-19 without bearing the risks of intubation.”

Additionally, Giang says, “Treatment of COVID patients has become more focused over the last few months because we’ve learned what drugs are effective against the disease.”

For instance, clinicians have learned that hydroxychloroquine or chloroquine isn’t effective against COVID-19. Rather, the anti-viral drug remdesivir is producing much stronger outcomes.

Increased & Faster Testing Means Early I.D. of Positive Patients

CPMC, like all hospitals in the Sutter network, test hospitalized patients for COVID-19, including those preparing for an upcoming surgical procedure.

“Testing is a very important part of controlling the spread of COVID-19. If we can get increased rapid testing down and make it widespread, we can help decrease the community spread of this virus. Testing in a hospital setting is important, too, as it enables staff to separate positive patients away from others, thus reducing exposure,” says Giang.

Sutter hospitals have also adopted cohorting, or grouping together, COVID positive patients on the same floor, which reduces the risk of spread and the need for additional PPE.

Clinical Progression Timeline

Giang shares that there is a strong correlation between patient infection rates and large public gatherings.

“We’re on a four- to six-week cycle,” he said. “People in early June were asking, ‘Why isn’t the death rate and hospitalizations rising?’ but we’ve learned it’s because the infection cycle takes time.”

An example of this timeline is when the country began opening over Memorial Day (May 22-25, 2020).
Giang explains that it took a couple of weeks after the holiday (COVID’s 2 to 14-day incubation period) for individuals to contract the virus and, in some cases, get sick enough that their symptoms required medical attention. In week’s three and four (or more), around mid-to-late June, we began seeing people hospitalized and pass away from the virus in increased numbers because the virus had taken its toll on their bodies.

Additionally, he confirms that patients with chronic diseases or conditions such as diabetes, heart disease and cancer, have a much greater chance of succumbing to COVID-19 because their bodies are already at a physical disadvantage, making it harder to fight off the disease.

Masking Works

According to Giang, we’ve learned there are significant portions of the population, particularly young people, who are asymptomatic or show no COVID-19 symptoms.

“What we’re seeing now is a surge in cases across the U.S. There are a number of reasons for this increase, including folks who are tired of being cooped up and returning to daily activities as if COVID didn’t exists. Some of it is from the fallout of people thinking they’re invincible and like it can’t happen to them.”

He continues, “We know that diligent masking works to help to slow the virus’ spread.”

Since March 2020, all Sutter hospitals, as well as Sutter outpatient and Walk-In Care facilities, have enacted 24-7 masking for all employees and patients. The Sutter network has also restricted visitors in these facilities.

“We’ve been able to effectively keep on top of community spread [within CPMC],” he said. “Now that we’re seeing a patient surge, we need to continue to be prudent about masking and how we connect and carry on about our everyday lives. Social Distancing and cleaning your hands frequently are also important. Things are opening up, but that doesn’t mean this virus is over.”

The Learning Never Stops

CPMC physicians, like those in teams across Sutter network, are constantly refining their approach to care in treating COVID-19 patients.

“A lot of people we’re seeing are recuperating. We’re learning everyday about how to be more effective with our treatment and we’re sending people home.”