The second and third-largest fires on record in California, along with one smaller blaze, continue to burn through hundreds of thousands of acres, though lower temperatures and higher humidity over the past 24 hours have helped firefighters make progress in containing them.

Seven people have been killed by the ongoing Bay Area-adjacent fires, which in total have burned more than 800,000 acres, according to Cal Fire.

The three fires, called LNU Lightning Complex, SCU Lightning Complex, and CZU August Lightning, were all started by lighting earlier this month, beginning on August 15. They are 33% contained, 25% contained, and 19% contained, respectively. Major fires are also ongoing in Butte, Tuolumne, and Plumas Counties. Since the 15th, in sum, more than 650 new wildfires have been catalyzed, consuming over 1.25 million acres.

In addition to the widespread damage to life and property, including the destruction of 1,400 structures, the sprawling wildfires are compounding a public health crisis brought on by the pandemic. A recent Harvard University study showed that sustained exposure to relatively small increases in particulate matter, such as is found in wildfire smoke, “leads to a large increase in the COVID-19 death rate.”

“A new illness, like Covid-19, can tip the scales for someone who is chronically ill and can cause them to decompensate while putting them more at risk for worse outcomes,” said Dr. Nico Conti, who practices internal medicine.

“Comorbidities typically complicate acute medical conditions — whether they’re chronic or new — and put people at risk for more complicated hospital stays and just overall complicate their ability to get better,” he said.

As they have done in past natural disasters and crises, community health centers are finding new ways to help support acute public health needs.

“Tuesday night, I realized it was going to be another one of ‘those’ situations,” Sharen Carey, a physician’s assistant and executive director of Big Sur Health Center, told Direct Relief. Carey has experienced seven fires in the area and has been helping firefighters through the clinic since the mid-1980s.

Big Sur Health Center is running a pop-up clinic at the field headquarters for fire incident command personnel and firefighters in Pfeiffer Big Sur State Park who are fighting the Dolan Fire.

She and her team see patients for 2 to 3 hours in the morning and evening, treating sprains, strains, lacerations, eye and ear infections, and severe poison oak reactions. Poison oak is rife in the area and often leads to symptoms such as blisters or an extremely itchy rash, which necessitates treatment with types of steroids.

Since the nearest hospital is dozens of miles away and other care options are limited in the area, the clinic’s work helps keep firefighters in the field while also reducing costs and providing immediate relief. Direct Relief was able to support their work with a Wildfire Kit, prescription drugs including steroids, PPE, wound care, stethoscopes, and hand sanitizer.

“Most firefighters are out there doing a really difficult job. They’re crashing around in poison oak, it’s hot, they’re sweaty, it’s itchy, they’re breathing smoke, they come in and drop at night, sometimes without even eating, because they’re so tired,” she said.

“We’re so appreciative of them being here and getting the fire out as soon as possible. It’s an honor to be part of that, and to be able to go down and help them. It’s a joy for us, and instantly rewarding.”

A donated shipment also went to Community Medical Centers in Stockton, Calif., which included PPE, stethoscopes, nutritional supplements, hand sanitizer, and flashlights.

Three additional community health centers in the area, as well as farmworkers in Santa Maria, Calif., have also received PPE and Kits. Marin County Public Health and Contra Costa Public Health received Kits and oxygen concentrators to help support firefighters and the Medical Reserve Corps.

The Wildfire Kit, created by Direct Relief last year, contains medicines and supplies that have been most requested during wildfires by healthcare providers. They are designed to enable the treatment of about 250 people for 3 to 5 days.

In addition to the kits, Direct Relief is also helping bring research to the state decision-makers and local clinics with a map analyzing the locations which have the most vulnerable populations, as indicated by chronic conditions, age, access to transportation, income, and living in a building with 10 or more units.

Due to social distancing guidelines, some of the thousands of fire evacuees are bring sent to hotel rooms paid for by the Red Cross. Though it is not a new intuitive, more people are being sent away from community shelters in an attempt to allow for more social distancing. Even prior to Covid-19, the Red Cross and other aid groups have tried to limit crowded group shelters, since the risk of outbreaks is elevated, as evidenced by the outbreak of norovirus following 2018’s Camp Fire in Butte County, Calif.

Direct Relief is in communication with 1,090 community health partners and in the fire-hit areas and will continue to respond with medicines and supplies as requested. Additional shipments are planned to go out this week. The Direct Relief Research and Analysis team remains in touch with CalOES and the Department of Public Health as well as Facebook in an ongoing effort to provide data to help inform an optimized response from state-level emergency and public health officials.