Home Depot is sold out of face masks, people sleeping in shelters have bandanas tied around their faces.
NAPA, Calif. — Home Depot is sold out of face masks, people sleeping in shelters have bandanas tied around their faces and residents even 50 miles away from the fires in northern California find themselves coughing and hacking as smoke and haze blanket the area.
The air quality index for San Francisco, Silicon Valley and the area around the fires was predicted to hit 180 on Thursday, according to the Environmental Protection Agency, or nearly five times what's considered safe.
That's even worse than famously polluted Beijing, whose southern suburbs were measured at 154 on Thursday by the U.S. embassy there.
"The federal (safe) standard is 35," said John Balmes,a professor of medicine at the University of California-San Francisco and expert on environmental health.
Residents who signed up for alerts from local authorities were barraged with air quality health advisories and Spare-the-Air alerts. Schools cancelled recess, teams cut sports practices and parents received notices that weekend football and soccer games might not be held.
The air quality level has been in the "unhealthy" to "very unhealthy" range since the fires began early Monday morning and is expected to stay bad as long as they continue. Wind and geography mean that the haze-affected area extends well beyond the towns where the fires are burning, putting millions of people in harm's way.
"It's smoke, it's particulate matter, it's even toxins from burning plastics and homes. All have very irritating qualities. People will have stinging eyes, trouble breathing, scratching throats and running noses," said Catherine Forest, a physician and expert on environmental toxins at Stanford Health Care in Palo Alto, Calif.
The levels of small particulate matter reported near the fires and further south around San Francisco are especially dangerous for those with pre-existing lung and heart disease, such as asthma, COPD (Chronic Obstructive Pulmonary Disease) and any kind of heart disease.
The best advice is to simply stay indoors with the windows shut and air conditioning or heaters set to recirculate air, said Forest.
"Don't go out if you can avoid it, don't exercise if you can avoid it. Keep the elderly, small children and anyone with heart or lung disease inside," she said.
But for the hundreds of thousands of people who have to go about their daily work, not to mention the tens of thousands in the fire area, that's impossible advice to follow.
A mask, but not just any mask
For them, the best bet is to wear a face mask. But it's got to be an OSHA-certified N95 particulate filtering mask.
"Not the flat hospital-type masks people sometimes wear. Those are worse than useless because they give you a false sense of security" and don't filter out the most dangerous small particles, said Forest.
The N95 masks have been in short supply in the Bay area due to the fires. At a Home Depot in Fairfield, Calif., where a fire was burning north of town and some areas were under evacuation watch, a steady stream of customers came in looking for masks. But the shelf was bare.
One man asked a Home Depot staffer if there were any left and when he was told no, asked if he could buy the one hanging around the staffer's neck.
"You're not the first guy who's offered that," said the staffer, who declined both to sell the mask and to give his name.
At an Orchard Supply Hardware in Berkeley, Calif., a woman answered the phone, "Good morning Orchard Supply, we are sold out of all masks, how may I help you?" The store was working on getting an emergency truckload of masks.
Johnston Medical, also in Berkeley, was one of the few stores that still had some of the masks recommended by the CDC on hand. Clerks scrambled to help shoppers find masks in picked-over boxes. After hanging up from yet another call, one clerk turned to the other: "Guess what they wanted?"
The empty shelves are only very local, unlike other times, said Balmes. During the global SARS outbreak in 2012 there was a global shortage.
"The Chinese were buying them all up," said Balmes.
When people do find the masks, there are tricks to making them as effective as possible. First is to get the right size. While hardware stores typically only sell the large size of the masks, they actually come in three sizes, small medium and large. Try medical supply stories for the smaller sizes that tend to work better for women and children, experts suggest.
Then bend the flexible metal strip at the top of the mask so that it fits the curve of the nose, to get it the tightest possible.
"They have to seal around, like a snorkel mask," said Balmes.
Such masks are commonly worn by people in cities like Beijing and Shanghai, where residents live with dangerous air quality for much of the year. By Thursday, they were becoming a regular sight on the streets in Napa, Sonoma and Mendocino.
For those in their cars, the best advice is to keep the windows rolled up and put the air system on recirculate rather than having fresh air come in from the outside.
"You can run the heater or the air conditioner, as long as you've got it on recirculate," said Balmes.
Overall, the poor air quality shouldn't pose a long term threat to healthy individuals as long as it doesn't last more than another few days, say the experts.
Healthy lungs are remarkably self-cleaning, said Forest. They’re lined with mucus-coated, hair-like projections called cilia. The mucus catches the tiny particles that we breath in and then the waving, beating motion of the cillium moves them up and out of the lungs.
“It’s kind of like a little escalator. It carries it up out of your lungs and you either swallow or cough it out. Either is fine,” she said.
Another option is to run a home air filter. As long as it’s got a HEPA (high efficiency particulate air) filter can catch most, though not all, fine particles, defined as 2.5 microns in diameter or less, which can irritate lungs.
“They’re so small you can’t see them, but they’ll make you cough,” said Baumes.
The trick with HEPA filters is to change the filters, said Forest. You can’t just buy them and run them forever without putting in a new filter, "or they end up not doing anything at all," Forest said.
Contributing: Jessica Guynn, from Berkeley, Calif.