Wildfire Smoke and COVID-19

Author: Robbie Edwards

Page Overview

This page covers the current research on how wildfire smoke impacts COVID-19 health outcomes. While reading, expect to learn about:

  • How wildfires contribute to air pollution

  • The health effects associated with PM 2.5, a key ingredient of wildfire smoke

  • The potential of wildfire smoke to lead to more serious COVID-19 infections, based on evidence from studies of air pollution

  • Some personal interventions to reduce exposure

  • Policy objectives for reducing the frequency and severity of wildfires by addressing climate change and forest management

Overview of COVID-19 and Wildfire Smoke

Video (5:44m)

A Historic Wildfire Season

In the summer and fall of 2020m many states along the West Coast faced a wildfire season of unprecedented scale, with California experiencing several of the most extensive wildfires in state history (Voiland 2020). In mid-September, the Portland metropolitan area recorded Air Quality Index values for PM 2.5 of well over 300, indicating air quality conditions that pose a threat to all individuals (EPA 2020).


Source: EPA AirNow

At the same time, states continued to grapple with the coronavirus pandemic, causing researchers and the public to wonder how the health consequences of these fires might compound those of the virus.

While the research isn't conclusive, there is good reason to believe that wildfire smoke can lead to worse outcomes for COVID-19 cases

The Main Ingredient: PM 2.5

A key pollutant in any discussion of wildfire smoke is particulate matter of less than 2.5 microns in thickness, or PM 2.5. It's important to understand this particulate matter in order to understand the effects of wildfire smoke.

Wildfires are unique compared to other sources of air pollution because they burn over an extremely wide area and an extremely wide range of materials, from grasses and foliage to housing. As a result of this, wildfire smoke is a heterogeneous mixture of all sorts of pollutants, including volatile organic compounds, nitrogen oxides, Carbon Monoxide, and particulate matter (PM) of varying sizes. The exact chemical makeup of smoke from a given event can vary dramatically based on a variety of conditions, but PM is almost always present in high concentrations (Kondo et al. 2019).

PM is itself a broad class of pollutants that come from many sources, but the PM in wildfire smoke is usually a product of organic carbon interacting with other chemicals in the atmosphere (Stephens et al. 2009). Particulate matter that is extremely small is an especially concerning class of pollutants that is very common in wildfire smoke. The documented respiratory health effects of particulate matter that is less than 2.5 microns thick (PM 2.5) include decreased immune response, decreased lung function, asthma and respiratory inflammation (Xing et al. 2016).

PM 2.5 is common in wildfire smoke and other forms of pollution such as vehicle emissions, but there is reason to suspect that exposure to wildfire smoke can be more damaging than exposure to sources that contain only or mostly PM 2.5. Research has estimated a 6% increase in asthma-related hospital admissions for each 10 micrograms per cubic meter increase in PM 2.5 from smoke on smoky days. This effect is higher than estimates for increases in typical PM 2.5 mixtures (Henderson 2020).

Image Source: U.S. Forest Service

Smoke from wildfires is a heterogeneous mix of substances that can be transported over long distances in the atmosphere.

Compared to the effects of exposure to air pollution and PM 2.5 generally, the health effects of wildfire smoke are not as well understood due to challenges in measuring exposure. However, population-based studies so far show associations between wildfire smoke and:

  • mortality from all causes

  • respiratory visits to emergency departments and hospitals

  • exacerbation of chronic obstructive pulmonary disease

Additionally, researchers still have yet to reach a consensus on the effects wildfire smoke might have on birth outcomes, mental health and, most importantly for the situation we are facing currently, respiratory infections (Reid et al. 2016).

COVID-19: Evidence from Air Pollution

The question is, does exposure to wildfire smoke amplify coronavirus? Currently, scientists have mixed evidence on whether or not wildfire smoke increases susceptibility to respiratory infections. However, researchers studying the effects of PM 2.5 have pointed out how exposure to the pollutant suppresses the immune system and reduces the capacity of macrophages in the body to deactivate pathogens, leading some to hypothesize that air pollution would be a significant factor amidst the pandemic. With respect to coronavirus, this has been borne out so far, with researchers showing varying levels of increase in relative risk of mortality for increases in total breathable particulate matter, and short term exposure possibly making infections more likely. Studies increasingly indicate that PM 2.5 is bad for coronavirus, likely due to its ability to compromise the immune system (Mehmood et al. 2020).

The effect of wildfire smoke on coronavirus morbidity has not been specifically studied yet, but given that smoke blanketed many parts of the West coast for an extended period during the pandemic it is reasonable to hypothesize that the increased ambient concentrations of PM 2.5 which resulted from the season's wildfires played some role in the severity of the pandemic.


Image Source: Dreamstime.com

PM 2.5 causes lung inflammation and inactivates alveolar macrophages, reducing the ability of the body to prevent viral infection (Renwick et al. 2004).

The Individual Response

There have not been very many large-scale studies of interventions for reducing personal exposure to wildfire smoke, but nevertheless experts have several suggestions.

  • Evacuation is a good way of avoiding exposure by eliminating it for the individual.

  • Research has also recommended staying indoors and limiting physical activity

  • Regulatory agencies recommend pairing this advice with improved filtration equipment in the home and work environments.

  • Lastly, personal protective equipment in the form of N95 or P100 respirators are effective in the short-term to reduce exposure to wildfire smoke (Laumbach 2019).

Unfortunately, each of these approaches come with drawbacks, mainly in the fact that none are very well-suited to extended periods of smoke exposure, as occurred in much of California this fire season.

  • Evacuation takes a toll by inflicting stress, and certain people may not have places to flee to for an extended period.

  • The effectiveness of remaining indoors is related to how well ventilated a building is and how easy it is for smoke to filter into the building, and improving the filtration of a building may be prohibitively expensive for some.

  • Respirators may not be effective if the people using them aren't aware of how to fit them properly, and the increased difficulty of breathing associated with use of an N95 may have more significant impacts on populations that are more susceptible to PM 2.5 exposure (Laumbach 2019).

Individuals can take these actions to protect themselves from wildfire smoke, and administrators can implement policies to provide these solutions to individuals as well, but more research needs to be conducted on the effectiveness of these approaches (Holm et al. 2020). But due to the weaknesses of each approach it is likely that as long as wildfires continue with their current frequency and severity they will continue to be a significant source of exposure to PM 2.5 on the West coast.

Image Source: EPA

Small air filtration devices can be effective in improving the air quality during extreme smoke events, depending on the efficiency of the unit and how quickly smoke filters into the building (Laumbach 2019).

Policy and Management of Wildfires

The public health literature on the impacts of wildfire smoke often makes two points about these fires: their scale and intensity is due in large part to forest management practices in the US and global climate change, and fire seasons are only expected to become longer and more severe in the future as the climate continues to warm (Henderson 2020).

Fires on the West coast were not always as severe as they are now. Prior to the 1800s, fire was common in western ecosystems but rarely reached the severity that modern fire seasons achieve. In the last 200 years however, forest managers have focused on suppressing all fires, big or small, which over time led to a buildup of vegetation in forests that catches fire more easily and facilitates the spread. Research has indicated that management practices which reduce these fuels and lead to thinner, less dense forests would reduce the severity of wildfires (Mueller et al. 2019). Some of the practices with proven success include:

  • Mechanical thinning

  • Whole-tree harvesting

  • Seasonal controlled burning

A forest floor with an abundance of combustible biofuels (Rummer et al. 2003)

It is easy to just list these practices and recommend that forest managers implement them, but of course performing them on the scale necessary to address the problem will take a massive commitment in funding. In California, about $100 million dollars are spent annually on sustainable forestry practices of the kinds mentioned above. Overwhelmingly, fire budgets favor suppression of fires over implementing proactive practices. In the period from 1998 to 2018 CalFire spent about 90% of its budget on fire suppression annually while spending 7% annually on sustainable practices. The United States Forest Service, an agency that often participates in forest management, makes cuts to their budgets for healthy forest practices whenever the costs of fire suppression are larger than the budget allocated to them. Generally speaking, government entities are forced to make tradeoffs between fire suppression and sustainable practices, rather than given the funds to adequately address both (Taylor 2018). Adequately funding proactive healthy forest practices is an important component of reducing exposure to wildfire smoke.

Climate change is the other major factor increasing the frequency and intensity of wildfires (Mueller et al. 2020). As with forest management, the solutions to limiting warming are very well established, but they have yet to be acted upon sufficiently. A recent report by the World Resources Institute highlights that global greenhouse gas emissions would need to be cut in half globally by 2030 and reduced to net zero by 2050 in order to limit global warming to 1.5 degrees Celsius. The report warns that the intense wildfire seasons experienced so far are a result of just 1 degree Celsius of warming, and that with the commitments most nations currently have in place, we are on track for a 3 degrees Celsius increase in global average temperatures (Lebling et al. 2020).

As with forest management, there are clear steps to be taken by governments to address climate change. To list them all would be extremely challenging, but briefly political science academics, activists and some politicians have coalesced around a consensus that involves bundling policies to address climate change with social policy and economic investments to offset the negative side effects of transitioning to a sustainable economy (Bergquist et al. 2020).

The common thread of both of these contributing factors is that the clear solutions are not currently being acted upon. Without a significant shift in public policy, it is likely that exposure to wildfire smoke and its associated health impacts will become increasingly prevalent in the future. In particular, exposure to PM 2.5 in wildfire smoke as a share of total PM 2.5 exposure is likely to increase as industrial sources like power generation and vehicle emissions transition to renewable energy (DeBell 2006). If there is another widespread outbreak of a respiratory virus in the future, whatever outcomes related to wildfire exposure we are currently experiencing may be even more severe.

Decompressing: Getting Involved

In any discussion of systemic problems like wildfires and climate change it can be easy to feel a sense of discouragement and dread about the future, so it's important to end on a note of what steps individuals can take to address it. My advice is to join or contribute to a movement that is addressing issues that you believe are significant.

Political scientists have long pointed out that policymaking at the state level and lower in the US is an extremely resource-constrained affair; state and local decision-makers don't have the same access to analysis and information that national politicians do and they aren't professionalized to the same extent, meaning they don't have nearly as much time to dedicate to thinking about and designing policy. This means that local policy is dominated by interest groups and the bills they sponsor, which local politicians then sponsor and vote on (Kouser 2005).

Furthermore, due to gridlock at the national level, these local policymaking settings have become increasingly important for passing significant legislation (Grumbach 2018). Practically speaking, this means it makes sense for individuals to try and make an impact on legislation by making their voice heard in organizations that lobby on the issues they care about, because these organizations currently have such high leverage.

The processes which have caused our current fire seasons and the resulting wave of smoke are very well understood, but as pointed out in the reports cited above, they are not being acted upon (Lebling et al. 2020, Taylor et al. 2018). Rather than a sense of inevitability, people need to understand that there are ways to push legislators to consider these ideas through advocacy.

Works Cited

Bergquist, P., Mildenberger, M., & Stokes, L. C. (2020). Combining climate, economic, and social policy builds public support for climate action in the US. Environmental Research Letters, 15(5), 054019. https://doi.org/10.1088/1748-9326/ab81c1

DeBell, L. J. (2006). Spatial and Seasonal Patterns and Temporal Variability of Haze and its Constituents in the United States, Report IV.

EPA AIRNow Archives. Retrieved November 21, 2020, from https://cfpub.epa.gov/airnow/index.cfm?action=airnow.mapsarchivecalendar

Grumbach, J. M. (2018). From Backwaters to Major Policymakers: Policy Polarization in the States, 1970–2014. Perspectives on Politics, 16(2), 416–435. https://doi.org/10.1017/S153759271700425X

Henderson, S. B. (2020). The COVID-19 Pandemic and Wildfire Smoke: Potentially Concomitant Disasters. American Journal of Public Health, 110(8), 1140–1142. https://doi.org/10.2105/AJPH.2020.305744

Holm, S. M., Miller, M. D., & Balmes, J. R. (2020). Health effects of wildfire smoke in children and public health tools: A narrative review. Journal of Exposure Science & Environmental Epidemiology, 1–20. https://doi.org/10.1038/s41370-020-00267-4

Jaffe, D., Hafner, W., Chand, D., Westerling, A., & Spracklen, D. (2008). Interannual Variations in PM2.5 due to Wildfires in the Western United States. Environmental Science & Technology, 42(8), 2812–2818. https://doi.org/10.1021/es702755v

Kan, H.-D., Chen, B.-H., Fu, C.-W., Yu, S.-Z., & Mu, L.-N. (2005). Relationship between ambient air pollution and daily mortality of SARS in Beijing. Biomedical and Environmental Sciences: BES, 18(1), 1–4.

Kondo, M. C., De Roos, A. J., White, L. S., Heilman, W. E., Mockrin, M. H., Gross-Davis, C. A., & Burstyn, I. (2019). Meta-Analysis of Heterogeneity in the Effects of Wildfire Smoke Exposure on Respiratory Health in North America. International Journal of Environmental Research and Public Health, 16(6). https://doi.org/10.3390/ijerph16060960

Kousser, T., & Kousser, P. T. (2005). Term Limits and the Dismantling of State Legislative Professionalism. Cambridge University Press.

Laumbach, R. J. (2019). Clearing the Air on Personal Interventions to Reduce Exposure to Wildfire Smoke. Annals of the American Thoracic Society, 16(7), 815–818. https://doi.org/10.1513/AnnalsATS.201812-894PS

Lebling, K., Ge, M., Levin, K., Richard, W., Friedrich, J., Elliott, C., Chan, C., Ross, K., Stolle, F., & Harris, N. (2020). State of Climate Action: Assessing Progress toward 2030 and 2050. World Resources Institute. https://files.wri.org/s3fs-public/state-climate-action-assessing-progress-toward-2030-and-2050.pdf?b.t67NZeeztoDpk5xPAdcZ7xaw6egqra

Mehmood, K., Saifullah, Iqbal, M., & Abrar, M. M. (2020). Can exposure to PM2.5 particles increase the incidence of coronavirus disease 2019 (COVID-19)? The Science of the Total Environment, 741, 140441. https://doi.org/10.1016/j.scitotenv.2020.140441

Mueller, S. E., Thode, A. E., Margolis, E. Q., Yocom, L. L., Young, J. D., & Iniguez, J. M. (2020). Climate relationships with increasing wildfire in the southwestern US from 1984 to 2015. Forest Ecology and Management, 460, 117861. https://doi.org/10.1016/j.foreco.2019.117861

Reid, C. E., Brauer, M., Johnston, F. H., Jerrett, M., Balmes, J. R., & Elliott, C. T. (2016). Critical Review of Health Impacts of Wildfire Smoke Exposure. Environmental Health Perspectives, 124(9), 1334–1343. https://doi.org/10.1289/ehp.1409277

Renwick, L., Brown, D., Clouter, A., & Donaldson, K. (2004). Increased inflammation and altered macrophage chemotactic responses caused by two ultrafine particle types. Occupational and Environmental Medicine, 61(5), 442–447. https://doi.org/10.1136/oem.2003.008227

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Stephens, S. L., Moghaddas, J. J., Edminster, C., Fiedler, C. E., Haase, S., Harrington, M., Keeley, J. E., Knapp, E. E., McIver, J. D., Metlen, K., Skinner, C. N., & Youngblood, A. (2009). Fire treatment effects on vegetation structure, fuels, and potential fire severity in western U.S. forests. Ecological Applications, 19(2), 305–320. https://doi.org/10.1890/07-1755.1

Taylor, M. (2018). Improving California’s Forest and Watershed Management. California Legislative Analyst’s Office. https://lao.ca.gov/Publications/Report/3798

Voiland, A. (2020, October 2). California’s Nightmare Fire Season Continues [Text.Article]. https://earthobservatory.nasa.gov/images/147363/californias-nightmare-fire-season-continues

Xing, Y.-F., Xu, Y.-H., Shi, M.-H., & Lian, Y.-X. (2016). The impact of PM2.5 on the human respiratory system. Journal of Thoracic Disease, 8(1), E69–E74. https://doi.org/10.3978/j.issn.2072-1439.2016.01.19