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Blowing no smoke...Respiratory therapists like Hospital Corpsman 1st Class (Fleet Marine Force qualified) Omar Garcia-Argueta, assigned to NHB/NMRTC Bremerton Internal Medicine & Specialty Clinics continue to provide a variety of services to treat, evaluate and educate patients, everything from the ‘ABCs’ of Asthma, bronchitis and COPD (chronic obstructive pulmonary disease) to helping stop the spread of COVID-19. Respiratory therapy services have been in demand during the pandemic outbreak due to their ventilator expertise, including deploying on the hospital ship USNS Mercy (T-AH 19) to provide crucial assistance for those in need. Some of the services and support offered at Naval Hospital Bremerton include pulmonology function testing such as basic spirometry, lung diffusion and volumes Methacholine Challenge testing (test to rule out Asthma) and unattended sleep studies, along with coordinating breathing therapy with Continuous Positive Airway Pressure (CPAP), a common treatment for obstructive sleep apnea (official Navy photo by Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer).

BREMERTON, Wash.

Breathing a sigh of relief really isn’t up in smoke.

The current wildfire season is casting a smoky pale across much of the Puget Sound region, making the air quality unhealthy and potentially contributing to a host of associated health risks that mirror COVID-19 symptoms.

Many Pacific Northwest residents - like the rest of the country - have had respiratory and cardiovascular system ailments due to the ongoing pandemic outbreak for much of the year. There have been 77,545 cases and 1,953 fatalities as of Sept. 4, 2020, in Washington State alone due to COVID-19, with 1,064 cases and 10 deaths in Kitsap County.

As Naval Hospital Bremerton staff continue efforts to help stop the spread of COVID-19, there is awareness that prevailing winds have pushed wildfire smoke over populated areas which can cause coughing, wheezing, and difficulty breathing, along with aggravating other normal functions.

“Staff and patients should do their best to avoid prolonged exposure to the smoke due to the fact that it can irritate the eyes, nose, throat and lungs,” said Hospital Corpsman 1st Class (Fleet Marine Force qualified) Omar Garcia-Argueta, respiratory therapist assigned to Internal Medicine & Specialty Clinics.

State and country health advisory alerts on diminished air quality have been posted and shared to alert local populations, with NHB also taking a lead to assess those in need.

“The smoke can exasperate any existing underlying condition,” said Cmdr. Robert Uniszkiewicz, NHB/NMRTC Bremerton COVID-19 czar and public health emergency officer, acknowledging that there are similarities between COVID-19 and wildfire smoke. Both can wreak havoc on a person’s respiratory and immune systems.

The Washington State Emergency Management Division indicate those sensitive to wildfire smoke exposure include people with heart and lung disease, existing respiratory infection(s), diabetes, stroke survivor(s), infants, children, pregnant women, and people over 65 years of age.

If that list sounds the same as those most at risk from COVID-19, it’s because it is.

“Patients and staff who will most likely be impacted the most are those who have been diagnosed with cardio-respiratory diseases such as asthma, COPD (chronic obstructive pulmonary disease), pulmonary fibrosis or heart disease,” said Garcia-Argueta. “Asthma and COPD patients, in particular, should ensure that they are taking their maintenance medications as prescribed by their providers. Smoke may also impact pregnant women, the elderly population, and children. These patients and staff members should consult with their healthcare providers regarding specific precautions. According to the American Thoracic Society, inhaling smoke can cause inflammation of the airways and can make one more vulnerable to lung infections, such as COVID-19.”

“We realize that not everything is COVID-19 related, such as someone dealing with allergies, hay fever and the flu. But there are definitely those who are more vulnerable than others,” Uniszkiewicz added.

One effective strategy employed at NHB to ensure patients’ health care needs continue to be met during the pandemic is the Drive-Through Screening and Triage process, which follows Centers for Disease Control and Prevention (CDC) criteria.

Everyone—staff, patient, or visitor—who arrives on base goes through the same procedure. This is a best practice across the military health system and in the civilian network. The drive-through is a safe and efficient way to effectively assess patients on their current health and wellness.

Is it COVID-19 or wildfire smoke?

Some of what the COVID-19 screening process determines is if a person in the previous 24 hours has had such symptoms as fever, cough (not allergy related), sore throat, shortness of breath/difficulty breathing, and/or loss of smell or taste.

Wildfire smoke is capable of producing harmful health effects from minor symptoms such as eye, nose, and throat irritation or headaches, to more severe conditions like shortness of breath, dry cough, throat soreness, chest tightness, asthma attacks, and worsening existing chronic conditions.

NHB advocates that anyone experiencing these symptoms should seek medical attention. They should also continue to follow CDC guidelines for stopping the spread of COVID-19, such as, staying at least a fathom - 6 feet or 2 arms' length - from others; Washing hands often and disinfecting frequently touched surfaces at home; Avoiding touch your eyes, nose or mouth; and Covering coughs and sneezes with your elbow or tissue.

Garcia-Argueta attests that the best recourse for avoiding wildfire smoke is to stay indoors.

“In order to prevent prolonged exposure to the wildfire smoke, one should plan to stay indoors and have both their windows and doors closed. Patients and staff members should also avoid engaging in strenuous physical activity outside and should refrain from smoking,” Garcia-Argueta said.

If there’s a need to head out into the great outdoors, a face mask should be worn if around others.

“Our recommendation is to still wear cloth face coverings. There are going to be those who think the smoke is causing them to have trouble breathing with the air quality like it is, but they’re more susceptible to particles in the air due to being exposed to wildfire smoke,” explained Uniszkiewicz.

Garcia-Argueta also advocates American Thoracic Society basic steps for everyone to follow to stay safe, avoid smoke exposure and protect their lungs: stay indoors as much as possible; reduce strenuous activity; reduce other sources of indoor air pollution like vacuuming and frying meat; use central air conditioners or heater to filter the air; when traveling in a vehicle, keep the windows closed, run the air conditioner and set air to recirculate to reduce smoke.

Hot, dry conditions are in the forecast. Fire danger is high. The pandemic outbreak is also projected to keep lingering. Serious health effects are expected for some. To breathe a sigh of relief, patients and staff should continue to heed the advice from NHB to help them clear the air around them.

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