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A yellow sky and hazy air hangs over Big Trees Market in Arnold. Smoke from wildfires burning throughout California, Oregon and Washington has clouded much of the West Coast.

Local hospitals and clinics have reported an increase in patients complaining of respiratory problems, paralleling the onset of smoke from 25 major wildfires that continue to burn throughout California.

Although the uptick in these visits cannot be definitively distinguished from the effects of COVID-19 or other illnesses, CEO of Mark Twain Health Care District and internist Randy Smart, MD, says he’s seen a notable increase in patients he believes are affected by smoke at his own practice in Valley Springs. 

“I can’t give you hard numbers. I just know it’s happening,” Smart told the Enterprise on Tuesday.

Passive smoke inhalation exacerbates symptoms in patients with pre-existing respiratory conditions, like emphysema, and increases the rate of heart attacks in individuals who are already at-risk, Smart said.

While there are currently no fires burning in Calaveras County, drift smoke from across the state has resulted in unhealthy levels of air pollution in the area.

On Monday, Calaveras County Health Officer Dean Kelaita, MD, and the Calaveras County Air Pollution Control District issued a joint air quality advisory to notify the public of potentially hazardous conditions.

Kelaita warned of a “complex mixture” of gases and small particles made from burning organic materials that can penetrate deep into the lungs and cause a range of health problems.

“The Highway 4 corridor from Murphys through Copperopolis and the entire Highway 49 corridor are currently experiencing very unhealthy levels of smoke,” the advisory reads. “Other areas of the county are also experiencing substantial smoke pollution. These conditions may persist for several days.”

Smart classifies current smoke exposure in the county as “short-term” and says it should not have any lasting effects on otherwise healthy adults, though some might experience acute bronchitis, irritated airways and red eyes during exposure.

“For the most part, the experts agree if you’re having short-term exposure like we are now, it’s just not enough of a cumulative effect that you or I would get lung cancer or develop heart disease because of that,” he said.

However, studies have shown that children in smoky environments are at higher risk of developing asthma as an adult, and pregnant women are more likely to deliver infants that are underweight, Smart said.

Other effects on otherwise healthy individuals are the “very real” mental health impacts, especially in the compounding conditions of COVID-19, public safety power shutoffs and societal stress.

Smart says he’s seen an increase in patients experiencing panic attacks, breathing anxiety and claustrophobia.

“People right now are pretty stressed, and they’re using all their reserves to get through the day. And I don’t mean physical reserves, I mean emotional reserves,” Smart said. “So these people who are kind of borderline depressed or borderline anxious or borderline angry, when you throw in the smoke, it just kind of tips them over the edge.”

Fortunately, air pollution increasing the risk of contracting COVID-19 is one thing people don’t need to worry about – especially if they’re staying inside and utilizing an air filter as experts have recommended.

“I don’t think I would expect to see an increase of COVID due to smoke in normal people. Maybe in more vulnerable people, respiratory patients could get worse. But I have not seen any objective data,” Smart said.

Cloth face masks are not effective in limiting smoke exposure, according to experts, and therefore should not be relied upon for protection.

In addition to following the county’s recommendations of staying inside with doors and windows closed, turning off air conditioning units that bring smoky air inside and avoiding activities that would cause indoor air pollution, Smart highly recommends installing high-efficiency particulate air (HEPA) filters in home HVAC systems.

“Whatever folks are telling you about taking protective measures, those are really good ideas,” Smart said.


Dakota graduated from Bret Harte in 2013 and went to Davidson College, NC where she earned a bachelor's degree in Arab studies. After spending time studying in the Middle East and Europe, she is happy to be home, writing about the community she loves.

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