New research assessed how the January 2025 Los Angeles wildfires affected health care use and how people sought care during the emergency. When uncontrolled fires moved from the foothills into urban areas, thick smoke spread across the region, air quality fell and many residents evacuated. Local hospitals prepared for a surge in patients, but a large in-person surge did not appear.
The study analyzed health records for 3.7 million Kaiser Permanente members and compared observed use in the week after the fires ignited on January 7 to expected levels from the prior three years. High exposure was defined as living within about 12 miles (20 kilometers) of a burn zone; moderate exposure meant living in Los Angeles County but farther than 12 miles.
Findings showed notable increases in virtual visits, especially for respiratory and cardiovascular complaints. Respiratory virtual visits rose 42% above expectations, while cardiovascular virtual visits increased 44% near burn zones and 40% across the county. The authors also reported more in-person outpatient visits for respiratory problems, plus higher visits for injuries and neuropsychiatric symptoms. On January 7 outpatient injury visits were 18% higher among highly exposed members; virtual injury visits rose 26% and 18% in highly and moderately exposed groups, and outpatient neuropsychiatric visits rose 31% and 28% in those groups.
Extrapolating to all insured county residents, the team estimated an excess of 15,792 cardiovascular virtual visits, 18,489 respiratory virtual visits and 27,903 respiratory outpatient visits in the first week. Lead author Joan Casey said, “We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care.” Coauthor Lauren Wilner emphasized that virtual care capacity is important during climate disasters when people are asked to stay indoors or must evacuate. The work involved Kaiser Permanente Southern California and authors from several universities, with funding from the National Institute on Aging and the National Institute for Environmental Health Sciences.
Difficult words
- exposure — how near a person is to a danger
- evacuate — to leave a dangerous place quicklyevacuated
- surge — a sudden large increase in numbers
- outpatient — a patient who does not stay overnight
- virtual visit — a medical appointment by video or phonevirtual visits
- extrapolate — to estimate results beyond known dataExtrapolating
- neuropsychiatric — relating to nervous system and mental symptoms
- cardiovascular — relating to the heart and blood vessels
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- What are the advantages and disadvantages of virtual care during a wildfire or similar disaster? Give reasons from the article.
- How could hospitals and health systems use these study findings to plan for future climate-related emergencies? Give one or two concrete ideas.
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