So you’ve been evacuated. Or smoke has rolled in, making the skies hazy and you’re nervously checking your phone to stay up-to-date on wildfires — which isn’t made any easier now that Meta has booted all Canadian news from its platforms including Facebook and Instagram.
In May, The Tyee published an article with resources for how to prepare for an emergency. It guided readers through packing a bag for an evacuation and accessing financial supports in the aftermath.
With entire cities being evacuated due to wildfires, it felt like a good time for a followup on how to take care of your health during the worst fire season ever. What happens, for example, if you forget your prescription? How do you protect yourself from smoke during an evacuation? How do you find harm reduction services in a new community to which you’ve evacuated?
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Let’s start with smoke.
There are a number of resources to track air quality reports, like the provincial Air Quality Health Index, or the BlueSky Canada smoke forecast with an interactive map tracking wildfires and smoke for North America.
Because of the particulate matter in smoke, breathing it in can irritate your respiratory system and cause an immune response, which may lead to inflammation in other parts of the body, says Dr. Menn Biagtan, vice-president of health initiatives and programs with the BC Lung Foundation.
Biagtan says common symptoms can include itchy throat and eyes, runny nose, cough, phlegm production and wheezing. If a previously healthy person is getting these symptoms they may not need medical attention, he adds. But pay attention if you or someone you know has pre-existing heart and lung conditions like asthma, COPD, heart disease or diabetes.
If you don’t have pre-existing conditions but experience shortness of breath, severe cough, dizziness, heart palpitations, chest pain or worsening symptoms, you should seek medical attention.
The BC Centre for Disease Control has more information on the health impacts of smoke exposure, but there’s not a lot of research done on the longer-lasting health effects of wildfire smoke.
When you’re in an area with a lot of smoke and unable to spend time indoors with a HEPA air filter, the Ministry of Health has several recommendations. Stay hydrated to help your body deal with inflammation caused by smoke. Wear a respirator or multi-layered face mask. Try to avoid exercise or other activities which make you breathe heavily.
What kind of respirator or face covering should I wear?
An N95 mask is the “most common” respirator used to protect against wildfire smoke, according to WorkSafeBC.
Biagtan says a well-fitting N95 mask can help filter 90 per cent of the fine particulate matter in wildfire smoke that irritates the respiratory system.
However, it won’t protect you from ozone, another byproduct of wildfire smoke that can be hazardous to humans when inhaled, he adds. If you are pregnant or have a heart or lung condition, Biagtan recommends asking your health care professional if you should wear one because “wearing a mask for these people makes breathing harder,” and to be mindful of your body temperature when wearing a mask in case you are at risk of heat stroke.
You can keep wearing and reusing an N95 to protect yourself from wildfire smoke so long as it fits snugly against the skin on your face and the mask isn’t dirty or wet.
WorkSafeBC also notes that blue surgical masks are loose-fitting, do not form a tight seal with the face and are not designed to filter fine particulate matter, gases or vapours in smoke. So whenever possible, stick with an N95.
Can rolling up the car windows help reduce smoke exposure?
WorkSafeBC recommends closing a car’s vents and windows and, if possible, turning on a car’s air conditioning “recirculate” mode while in a smoky area and rolling the windows down in good air quality areas to prevent carbon dioxide from building up in a car.
Biagtan adds it’s a good idea to check your car’s air filter and see if it needs to be replaced, too.
What if you forgot or lost your prescription?
Most pharmacists in the province will be able to look up your medical history, including your prescriptions, through a provincial electronic health record called CareConnect, says Michael Mui, communications manager with the BC Pharmacy Association.
The “vast majority” of prescriptions can be renewed by a pharmacist and, if a doctor referral is needed, pharmacists can help connect patients to a hotline set up to help patients connect with a doctor to renew a prescription, he adds.
There are some exceptions, like with narcotics, which have different rules and regulations around who can dispense medications.
Where to find harm reduction services in the community to which you’ve evacuated?
Evacuation centres have contact information to connect evacuees with local mental health and substance use services including harm reduction and overdose prevention sites, the Ministry of Mental Health and Addictions told The Tyee.
The ministry says anyone can call 310-6478 for mental health concerns or for information on how to access substance use services like harm reduction and overdose prevention services, opioid agonist treatment, safe supply and counselling.
If you’ve been evacuated to a community in B.C., Toward the Heart has an interactive map that lists harm reduction services, like overdose prevention or supervised consumption sites, and places that offer drug use supplies and take-home naloxone kits. The interactive map lets you explore services offered across the province or lets you search for services near your address.
The BC Centre on Substance Use also has a Google map that lists clinics and pharmacies in B.C. offering opioid agonist therapy programs.
If you’ve been evacuated to Alberta, a small group of health-care workers has created a list of clinics in Edmonton and Calgary where evacuees can access methadone, kadian and Suboxone as part of opioid agonist therapy to treat opioid use disorder.
The most important thing is to make sure you have your identification, and the second most important thing is to know the name of your regular pharmacy, says Mona Kwong, pharmacy advisor for the BC Centre on Substance Use.
Having the label of the medication you’ve been taking or a screenshot is also helpful, but almost any pharmacist in B.C. will be able to look up your medical record and all prescriptions, doses and schedules if you have your ID and pharmacy information, she adds.
If you travel outside the province, a pharmacist will still be able to troubleshoot to find your prescription so long as you’ve got your ID and pharmacy name, she says.
That’s true for every medication, from blood pressure pills to methadone.
There’s a College of Pharmacists of BC resource for how to access medications during an emergency.
Where it gets a bit trickier is supply and coverage.
A pharmacist can only dispense if they have the supplies, so it’s a good idea to call ahead and check if they have the medication you need, Kwong says. Small-town pharmacies may run out of certain medications for a couple of days, whereas urban centres are less likely to face similar supply chain issues.
Provincial and territorial programs that cover medications also are limited to the province or territory they operate in, so someone from Yellowknife may not have their medication covered if they fill a prescription in Alberta. Once again, people should call ahead and ask a pharmacist what coverage they get, Kwong says.
The Ministry of Mental Health and Addictions says during an evacuation or disaster, emphasis is placed on locating existing mental health and substance use patients to “ensure that there is no interruption to their specialized mental health and substance use care needs, for example meds and assessments.”
The ministry says it considers factors like safe supply and risk of racism or stigma when planning evacuations and is working with Interior Health to prioritize individuals who need specialized mental health and substance use care within communities being evacuated.
Toward the Heart is a BC Centre on Substance Use program and posts alerts on its website about toxic drug reports and public health alerts. For example, an alert from Aug. 21 warned stimulants in the Vancouver area were contaminated with fentanyl.
The Toward the Heart map also lists places to find safer sex supplies.
Are there specific resources for Indigenous communities who have been evacuated?
Yes, Interior Health says additional supports are available for First Nations, Métis or Inuit through Interior Health’s Aboriginal Mental Wellness Team, which you can reach by emailing email@example.com.
First Nations Health Authority staff can be found at evacuation centres to help Indigenous evacuees access “mental health counselling services, traditional wellness resources and provide a culturally safe contact for bridging to needed health care resources,” according to the Ministry of Mental Health and Addictions.
What happens to your MSP coverage when you’ve been evacuated to a different province?
If you’re regularly covered by the Medical Services Plan and travel to a different province, “MSP will help pay for unexpected medical services provided the services are medically required, rendered by a licensed physician and normally insured by MSP,” according to the government website about medical benefits outside of B.C.
That’s thanks to an agreement signed by all provinces and territories except Quebec that allows Canadians with a valid provincial health care card to have a doctor or hospital bill their respective province or territory instead of the patient for physician and hospital services. In Quebec, you can still get medical care but you may be billed directly and then reimbursed.
This agreement covers procedures like cancer treatment, dialysis or other regular medical care where a patient gets to go home at the end of the day rather than stay in hospital, says Sandra Paun, acting director of Insured Health Services with Yukon Health. Depending on where a patient lives, they may already have to regularly travel to a different province or larger urban area to access specialized medical treatments, she adds.
So the difficulty isn’t finding a place that can offer the treatment, it’s making sure that patient sticks to their treatment schedule, Paun says.
But other health care is not covered if someone is outside of their home province or territory. Medical care not provided by a physician (for example, a nurse practitioner or physical therapist), for example, is not covered. Neither are ambulance services and prescriptions.
The B.C. government warns these costs can add up to several thousand dollars and “strongly advises” people to purchase additional insurance if travelling out of province.
Are there specific mental health resources for evacuees?
Yes, evacuation centres offer mental health supports. Health Emergency Management BC and the Provincial Health Services Authority are providing psychological services through staff and volunteers in Merritt, Vernon, Salmon Arm, Penticton, Kelowna and Kamloops, the Ministry of Mental Health and Addictions told The Tyee.
Health Emergency Management BC is also providing psychological first aid for evacuees. Frontline staff and responders and are co-ordinating with regional Indigenous Liaison staff, Canadian Red Cross, First Nations Health Authority and the Canadian Mental Health Association. Additional resources recommended by the Ministry of Mental Health and Addictions include the following.
Michelle Gamage, Local Journalism Initiative Reporter, The Tyee