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It is difficult to understand COVID-19 from the symptoms of smoke inhalation – and the flu season is coming

A cyclist on a street: A cyclist rides on the 1st Street Bridge in Los Angeles under a smoky sky.  (Gary Coronado / Los Angeles Times)

© Contributed by The LA Times
A cyclist rides on the 1st Street Bridge in Los Angeles under a smoky sky. (Gary Coronado / Los Angeles Times)

Patients enter Dr. Melissa Marshall̵

7;s clinics in Northern California with treacherous symptoms. They have trouble breathing. May even be harmful by inhalation. They have a cough and a sore throat is definitely present.

A real case of COVID-19? Not so fast. This is a country of forest fires.

Up and down the West Coast, hospitals and health facilities report an influx of patients with problems most likely related to smoke inhalation. As fires rage largely uncontrollably amid dry heat and strong winds, smoke and ash settle in cities hundreds of miles away, turning the sky orange or gray and making it difficult to breathe normally.

But that, Marshall said, is only part of the challenge. Devices that are already attached for testing consumables and personal protective equipment should first rule out COVID-19 in these patients, as many of the symptoms they have are the same as those caused by the virus.

“Obviously there is an overlap of symptoms,” said Marshall, CEO of CommuniCare, a collection of six clinics in Yolo County that treats mostly underinsured and uninsured patients. “Every time someone comes in with even some of these symptoms, we ask ourselves, ‘Is it COVID?’ “After all, clinically, I still want to rule out the virus. “

The protocol is to treat the symptoms, regardless of their cause, while recommending that the patient be quarantined until the results of the virus test return, she said.

This is a scene that takes place in many hospitals. Administrators and physicians adapted to the ability of COVID-19 to spread rapidly and devastate simply will not take the risk of recognizing symptoms that may result from the virus.

“We have seen an increase in the number of patients attending the emergency department with respiratory distress,” said Dr. Nanet Mickiewicz, president and CEO of the Dominican hospital in Santa Cruz. “Because this can also be a symptom of COVID-19, we treat these patients as we would any coronavirus subject until we are able to rule them out through the screening process.” During treatment, symptoms that are more COVID-19-specific, such as fever, will become apparent.

For workers in the Dominican edition quickly moved to the top of the list. The cities of Santa Cruz and San Mateo bore the brunt of the CZU Lightning Complex fires, which burned more than 86,000 acres. Numerous tents set up outside the building serve as an extension of her waiting room. They are also used to fulfill what has come to be understood as an essential role: separating those with symptoms of COVID-19 from those without.

New patients arrive at two NorthBay Healthcare hospitals in Solano County with COVID-19-like symptoms that may actually be from inhaling smoke.

The NorthBay adoption process “requires anyone with COVID characteristics to be treated as [a] a patient under investigation for COVID, which means they are separated, screened and managed by staff in special PPE, ”said spokesman Steve Huddleston. In the two hospitals, which have so far examined nearly 200 cases of COVID-19, the protocol is well established.

Although the West Coast is now the most dangerous time of year for forest fires – usually September to December – another complication for healthcare providers is on the horizon: the flu season.

The southern hemisphere, whose flu trends during the summer months usually predict what lies ahead for the United States, has had very little of the disease this year, likely due to limited travel, social distancing and face masks. But it’s too early to be sure what will lead to the flu season in the United States.

“You can start seeing some cases of flu in late October,” Marshall said, “and the reality is that it will have a number of characteristics that can also be symptomatic of COVID.” And nothing changes: you have to turn it off just to eliminate the risk. “

Mark Kreidler writes for Kaiser Health News, a non-profit news service covering health issues. This is an editorially independent program of the Kaiser Family Foundation and is not affiliated with Kaiser Permanente.

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