A remarkable number people who were affected by smoke during this year’s LA wildfires turned to the internet for help, rather than to the hospitals that were preparing to receive them.
When wildfires swept through Los Angeles neighborhoods in January, and much of the city was blanketed in smoke, evacuations were triggered and schools were closed.
Naturally, hospitals were expecting an influx of patients affected by the smoke, but the influx never happened. Instead of jamming into waiting rooms, people stayed home and opened their laptops.
A new study from the University of Washington and Kaiser Permanente Southern California reveals that the health surge officials expected did occur – but it mostly happened online, rather than in person.
The researchers reviewed electronic health records from 3.7 million Kaiser Permanente members and discovered that the first week of the fires produced a sharp shift toward virtual care.
Virtual visits for respiratory problems jumped 42% above typical levels. Meanwhile, people living closest to burn zones logged 44% more virtual cardiovascular visits, while those elsewhere in Los Angeles County recorded 40% more than expected.
Outpatient respiratory visits also rose, with increases of 27% among those near burn zones and 31% for county residents overall.
Applying these trends to the region’s insured population, the team estimated more than 15,000 excess cardiovascular virtual visits, nearly 18,500 additional respiratory virtual visits, and almost 28,000 extra respiratory outpatient appointments during the fires’ first week.
Joan Casey, a UW associate professor of environmental and occupational health sciences and of epidemiology who led the research said: ‘We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care. While the fires clearly impacted health, virtual care likely enhanced the ability of providers to meet the health care needs of people experiencing an ongoing climate disaster.’
The findings suggest that when climate-driven disasters strike, people are increasingly choosing – or being forced – to seek medical help remotely. Smoke kept many indoors while evacuations pushed others far from routine care.
The research team compared residents based on their proximity to the fires, defining ‘high exposure’ as living within roughly 12 miles of a burn zone. They looked back three years to determine usual visit patterns and then assessed what actually happened beginning on 7th January, when smoke levels peaked and disruptions spread across the county.
Injury and mental-health-related visits also climbed: outpatient injury visits were 18% higher among the highly exposed, while virtual injury visits rose 26% and 18% among the highly and moderately exposed groups. Neuropsychiatric outpatient visits increased by 31% and 28%, respectively.
A clear pattern emerged: the closer people lived to the fires, the more likely they were to seek virtual care for smoke-related symptoms. Highly exposed members recorded 42% more virtual respiratory visits, compared with 36% for moderately exposed and 31% for minimally exposed residents.
Study co-author and UW epidemiology doctoral student Lauren Wilner noted that disaster planning often focuses on physical capacity rather than digital demand. ‘While healthcare systems often plan to increase the number of hospital beds available or clinic staffing during an emergency, this work highlights the importance of considering virtual care capacity.
‘This may be particularly true for climate disasters like wildfires, during which people are advised to stay indoors or when people must evacuate – motivating them to seek care online if at all possible. As climate disasters increase in frequency and intensity, it is essential that health care systems know how to prepare for a sudden and dramatic surge in health care utilization.’
Photo: Jessica Christian
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