On September 10, state officials detected the Bolt Creek Fire burning in Washington’s Cascades. Soon after, smoke drifted down from the mountains, bringing a cloud of pollution that briefly made Seattle’s air quality the worst of any major city in the world, with an air quality index of 157, or “unhealthy” on the federal scale of 0–500 that quantifies pollution and the estimated health concerns. Even at these levels, smoke hung visibly in the air, irritating throats and hazing the skyline.

A day later, as smoky air continued, the King County Regional Homelessness Authority (KCRHA) opened a 50-bed air-quality shelter, available to people of any housing status. But just four people used it during the day, and six stayed overnight. This was not Seattle’s first smoke shelter—officials have operated similar ones in past years. And while vital to those who have no other options, it’s an imperfect response, said Anne Martens with KCRHA.

“Severe weather shelters tend to be the old congregate model of mats on a floor, and it's not exactly a desirable situation,” said Martens, noting many people want to remain in place to protect belongings or stay close to others, which can still be dangerous in smoke.

Smoke events are becoming more common in the Northwest, driven by climate change, which makes extreme wildfires larger and more likely. Several times in recent years, cities like Vancouver, Seattle, Portland, and San Francisco have experienced thick smoke that tints the sky orange and severely degrades air quality for days at a time. Local officials are still struggling to figure out the right way to respond, faced with infrastructure unprepared for the current threat of climate change, and a public that may not understand the danger smoke poses. In the meantime, the most vulnerable suffer the impacts of these gaps, unable to afford personal mitigations when the system does not protect them.

Martens adds that uptake at their shelters generally increases when events continue for longer periods. But still—it’s just a fraction of the folks outside in the smoke, people who often have underlying conditions that may be exacerbated by exposure.

“We have to figure out a more permanent solution than this stopgap of mats on the floor,” Martens said. “It's funny to say that housing is a solution to climate change, but for this population, it is the healthcare infrastructure that they need.”

September 2022’s smoke led Seattle community organizer Ixtli White Hawk to stand up mutual aid resources: distributing furnace filters and box fans, which can be rigged together for an air filter nearly as good as expensive store-bought options. She began this work in 2020 during another smoke event out of concern for community members already at risk for covid-19. They have delivered dozens to elders and those with respiratory or chronic health conditions.

“A lot of times, folks don’t know where to access some things, and access to resources should not be hindering someone’s health,” White Hawk said.

Smoke remains a difficult problem to address at scale. Exposure can lead to difficulty breathing, decreased lung function, and can exacerbate existing heart and lung disease. Dr. Deepti Singh, an assistant professor at Washington State University’s College of the Environment, studied the impact of wildfire smoke during the 2020 season in a paper published earlier this year. Her research found at one point in time, 68 percent of the western US was impacted by smoke, carrying the risk of negative health impacts to more than 43 million people. Her team also analyzed 20 years of past data, and found an increase in the number of days people are exposed to smoke.

“It's not just acute exposure, it's not just a couple of days in a few years, it's like almost every wildfire season, for multiple weeks people are being exposed,” Singh said. "And so the health impacts of that are not fully understood. We know they're bad. We just don't know how bad.”

She encourages local governments to treat smoke events as they do other extreme weather events like heat or snow, and prepare responses accordingly. She recommends shelter areas for people with high-quality filters to get out of the smoke, and formal preparation ahead of smoke. Education is part of it: messaging that helps people understand the dangers of wildfire smoke exposure.

Executing these recommendations can be complicated. In King County, there is no requirement that shelters filter air, though officials provide recommendations to operators. (And Anne Martens of KCRHA says the primary air shelter does have HEPA filters, in part thanks to COVID response funding.)

Addison Houston, climate adaptation lead for Public Health–Seattle and King County, said the traditional guidance has been to direct people with smoke-impacted homes to public spaces like malls and movie theaters that were presumed to have better air handling systems. But they’d never been able to conduct surveys to confirm these places were improving air quality above outside conditions.

“Smoke has definitely been a high-level concern of ours, especially regarding climate change and climate-driven hazards…,” said Houston. “And we don't really have adequate infrastructure right now to provide proper filtration. So that makes it a very high-level public health risk of concern that we have, knowing that we just don't have the level of infrastructure to help really insulate the public when the smoke events roll in and impact our air quality on a regional level.”

Houston said the department would like to compile an accounting of publicly accessible facilities that can serve as clean air refuges: buildings with MERV 13 filters or better—think classic corrugated furnace filters, but rated for the tiny particles in smoke. All county libraries have had filters to handle smoke since 2020 thanks to pandemic upgrades, and some city facilities do as well. (The health department is also currently developing an urban heat island mitigation plan, which will include a wildfire smoke strategy, and the regional homelessness authority is a month or two away from formalizing a tiered severe weather activation policy, which will include smoke response.)

He highlighted a need to examine our existing housing infrastructure. There is no comprehensive federal indoor air quality standard in the U.S., meaning apartment buildings and high-rises may not be required to filter smoke from the air. Houston said such a standard could help level the playing field, and push developers to invest in air quality during construction as opposed to expensive retrofits. Compounding the problem, even if buildings have appropriate filtration, people in spaces without air conditioning will still open windows, which defeats the benefits. The Northwest historically lacks air conditioning; Seattle has the fewest homes of any U.S. metro area at just 44 percent, according to a 2021 report.

An EPA spokesperson said there is no federal requirement that air quality shelters improve indoor air quality, though the agency offers guidance. Similarly, the EPA recommends operating air shelters to help reduce the exposure to wildfire smoke, but “communities are not obligated to provide these shelters, although many choose to do so.”

“We really do need to take a comprehensive step back, and look at how we're designing and building our built environment for the purposes of health, which has not really been done,” Houston said. "Traditionally, we focus on the economics and the return on investment. But we aren't factoring in the health impacts and the benefits of healthy buildings and healthy environments.”

In the meantime, the department has distributed box fan air filter kits since 2020, giving away 3,000 units to date, with another 2,000 set for 2023. Those have been directed to high-need communities in the name of equity, but are just a small fraction of the people impacted by smoke. Similarly, in Portland, the city government has started a program to distribute air conditioners to at-risk households following a deadly, record-setting 2021 heatwave. These can also help address smoke, allowing people to keep their windows closed when air quality drops.

“The number one element of a resilience strategy has to be making sure that no one's left behind,” said David Heslam, executive director of nonprofit Earth Advantage, which manages the program.

He added - preparation is key. The air conditioner program is designed to prepare homes for heat, not as a last-minute emergency response. In that vein, Missoula, Montana, is finding new solutions for smoke preparation and climate resilience. The community has lived with fire and smoke for years, though they’ve experienced longer, smokier seasons that now stretch into September, said Caroline Lauer, Climate Resilience Coordinator for Climate Ready Missoula. The group is a collaboration between the city, county, and nonprofit Climate Smart Missoula.

She attributes the push to an alarming season in 2017, when several wildfires led to poor air quality in Missoula County.

“And that, I think, got it on everyone's radar in a much more visceral way,” Lauer said. "And it became a more common topic of conversation and more frequently popped up as ‘we’ve really got to do something about this.’”

Now, Climate Ready Missoula coordinates an action plan to prepare for smoke at scale. They hosted their first annual “Wildfire Smoke Ready Week,” in July 2021, and have been distributing air filters to low-income families. The health department is studying indoor air quality in commercial buildings. They’re also trying to help people understand the threat of smoke with an upbeat jingle warning about particulate matter in the air, pushing people to learn more about filtration, and preparing ahead of time.

“We also worked with a local brewery to brew a special beer called ‘Deep Breath,’ with the idea that what we all want to be able to do in the summer is take a deep breath,” Lauer said. “And we use that beer as an educational opportunity to talk about wildfire smoke and talk about how you can clean your indoor air.”

They are still learning lessons about smoke response. For example, they’ve found clean air shelters may have low uptake because those with homes are reluctant to leave. So now they try to focus efforts on helping people shelter in place and create a clean air space in one room of their homes. For those without other options, the public library has been updated with high-quality filters—a standing piece of infrastructure ready for smoke, not a pop-up option that must be announced during an emergency. There have been hiccups. Lauer pointed to a public space in town that upgraded its air handling system to combat smoke. But then smoke came later than expected in September, when cooler temperatures meant the system wasn’t running, so the air wasn’t being cleaned.

“If people are leaving to a public space to cool off, we should make sure that they're breathing clean air too,” Lauer said. “I think the more efficient our buildings are, and how we think about that through code and incentives and all of that will really be key for people to stay safe in the smoke.”

She still believes they’re just at the tip of the iceberg in terms of smoke response and hopes new funding from the federal Inflation Reduction Act (hailed as the biggest climate bill ever) will help support their work. Because just as fire has always existed on the landscape, smoke has become a modern part of living in the West.

That’s been true in Ixtli White Hawk’s experience. She recalled some of the worst recent smoke events in Seattle: “apocalyptic” skies that darken the sun and choke those venturing outside for more than a few minutes. While she’s glad to help where she can through air filters, she also believes a more coordinated response is needed to combat this climate impact—both for those who have homes and suffer smoke impacts, and those living unsheltered.

“This is the kind of stuff that there needs to be more of a plan,” she said. “Because we know this is not going to go anywhere. It’s not something that's just gonna happen one year or two years. I think that as a society, as a community, there needs to be more of a city-wide support for folks.”