MISSOULA, Mont. – The new downtown Missoula library was teeming with people who typically spent a Saturday afternoon hiking, biking, or otherwise enjoying Montana’s abundant outdoor recreation. One look at the soupy haze that covers the city and it was clear why.
“We’re definitely trying to stay out of the smoke,” said Charlie Booher as his children picked books from the piles.
Smoke from the forest fires that burn through bone-dry forests and grasslands to the west has affected air quality from California to the east coast this week. Polluting smoke was strongest in the northwest, including Montana, where Missoula, Helena, Great Falls and other cities were among the top 10 places with worst air quality last week, according to AirNow.
The smoke and relentless heat that pours down the state have caused people to seek refuge in libraries, cinemas, museums, and other interior settings. In areas with low Covid-19 vaccination rates, where people have largely avoided masks and physical distancing, health officials fear Covid outbreaks will occur.
Add to that concern the surge in the highly transmissible Delta variant of the coronavirus, and research suggests that Covid cases and deaths increase during times of intense wildfire smoke.
Missoula County has the highest vaccination rate in Montana at 60%, but Whitney Kors was still aware of the risks when she took her family to the library to get out of the smoke.
“My daughter and I are still masked because she hasn’t been vaccinated,” said Kors.
She said her family will continue to distance themselves from others until her daughter, who is under 12, is eligible for her admission. However, health officials fear that not everyone looking for smoke-free indoor activities this summer will take the same precautions if they are not vaccinated.
Up north in Flathead County, Joe Russell, the county’s health officer, said he has seen about a 50% increase in Covid cases in the past two weeks, mostly from unvaccinated people contracting the virus at events.
“These are activities that are specific to an event or setting and take place indoors,” he explained.
Russell said his team are closely examining new clusters to see if people have walked in to escape heat and smoke. About 6 out of 10 counties eligible for Covid vaccines have not received these, and Russell fears that these large clusters could get worse as more people gather indoors.
The dangers of the pandemic appear to have subsided in people’s minds as they congregate in indoor public spaces, many of which dropped masking and physical distancing requirements earlier this year.
In Yellowstone County’s and Billings, Montana’s largest city, the pandemic is still being felt in hospitals that have treated younger, sicker patients than they did earlier in the pandemic. There too, Covid deaths increased in early July.
Yellowstone County’s Health Officer John Felton hoped the summer would be time to increase the county’s vaccination rate by 50% before cold weather sends people indoors and increases the risk of unvaccinated people transmitting Covid.
“But this year has been so hot, so dry and with so much smoke that we fear we will climb a little earlier,” he said.
Across Montana, about 48% of the eligible population are fully vaccinated, but Magdalena Scott of the State Department of Public Health and Human Services said county rates are between about 23% and 60%. She said that this means case numbers, hospital admissions and deaths are likely to vary more widely than last summer, when vaccines were not yet available. “We’re worried it’s going to be a long smoking season for sure,” said Scott.
There are also fears that forest fire smoke could increase the transmission of Covid not only from driving people indoors, but also from susceptibility to the coronavirus.
Particulate matter in forest fire smoke, known as PM 2.5, is so small that it bypasses the body’s natural defenses, builds up in the bloodstream, inflames the lungs, and weakens the immune system, according to the Centers for Disease Control and Prevention.
PM 2.5 from urban air pollution and forest fire smoke is increasingly being linked to susceptibility to respiratory infections in general, but researchers have been trying to investigate the same possible association with coronavirus, a respiratory virus, since last summer.
Daniel Kiser is a researcher at the Desert Research Institute in Reno, Nevada. He was working on a recently published paper on an increase in Covid cases in Reno during the forest fire season.
“We found that the rate of positive tests increased by about 18% during the period most affected by forest fire smoke,” said Kiser.
Other studies have also shown a link between the rise in particulate matter levels and deaths from Covid-19. Sultan Ayoub Meo of King Saud University in Saudi Arabia led a team of researchers that examined 10 California counties where particulate matter levels rose 220-fold on average at the height of the forest fire season last year.
“We found that Covid-19 cases and deaths rose 57% and 148%, respectively,” Meo said.
Meo said his team is now studying infection rates in partially and fully vaccinated people during forest fire smoke incidents.
University of Montana researcher Erin Landguth also extends her earlier study, which shows that intense forest fire seasons in Montana were followed by bad flu seasons months later in the fall and winter.
“If you compare bad fire seasons with non-bad fire seasons, you would expect that there would be flu seasons three to five times worse,” said Landguth.
Landguth is taking particulate matter measurements in the western United States to investigate whether the same relationship applies not only to the flu, but also to Covid and other respiratory diseases in a larger area.
As evidence of Covid cases and deaths during forest fires continues to emerge, more studies are needed. But we know, said Landguth, we know enough to be concerned and to advise people to protect themselves.
Back in Missoula, Sarah Coefield, the county’s air quality specialist, said the best thing people can do is get vaccinated, especially when venturing into public spaces to escape heat and smoke. You can also create a clean air room at home.
With about 2.5 million acres already burned in the US this year and the drought worsening in the west, Coefield said, “There’s no forecast that suggests it will end anytime soon – and it will not get any easier in the further course. “
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health topics. Together with Policy Analysis and Polling, KHN is one of the three major operational programs of the KFF (Kaiser Family Foundation). KFF is a non-profit foundation that provides the country with information on health issues.
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