Confluence physician tells Wenatchee board wildfire-smoke action plans halved asthma emergency visits; district readies air purifiers

WENATCHEE, Wash. — A Confluence Health physician briefs the Wenatchee School District board on Dec. 2, saying local use of coordinated asthma and wildfire‑smoke action plans was associated with sharply reduced health care visits among children with asthma during recent smoke episodes.

"There were 50 percent less respiratory related emergency department visits for kids with asthma who had an asthma action plan and wildfire smoke action plan compared to children with asthma who didn't have one," said Dr. Bindu Nayak, an endocrinologist and parent who said she has tracked regional emergency‑department and outpatient encounters since 2021. Nayak added that outpatient visits dropped by about 71 percent for children with an action plan.

Nayak described PM2.5 (particulate matter smaller than 2.5 microns) as the main pollutant in wildfire smoke and said smoke exposure increases asthma attacks, emergency visits and hospitalizations. She highlighted local data from the September–October wildfire season that showed peaks in PM2.5 coinciding with higher pediatric respiratory visits and noted a disproportionate impact on Hispanic children in the district.

The presentation included an indoor‑air check at Wenatchee High School on Oct. 7, when sensors used by the Chelan‑Douglas Health District recorded indoor AQI values in different parts of the building ranging from about 133 to 244. "The HVAC equipment lacks high quality filtration to be able to adequately clean the air when the air quality index is high," Nayak said, noting the high school was built in 1971 and is not well sealed against smoke infiltration.

Nayak recommended two lines of work: medical and household mitigation (as downstream interventions) and building resilience (upstream). She credited an asthma action plan and a wildfire‑smoke action plan used by some local primary‑care providers — one developed by Dr. Mary Crocker at the University of Washington — and distributed copies to board members.

District officials described steps the district has already taken and will continue to use during smoke events. "We have purchased air quality index readers," said Superintendent Corey (first name given in the transcript). "Chelan‑Douglas Health District loaned us air scrubbers and extra air purifiers, which after running continuously did bring down the air quality to a healthy level over several days." The district also said it retained about 35 of the DIY box‑fan filter units and has procedures to mobilize air scrubbers and purifiers quickly when smoke returns.

Board members asked whether the asthma action plans are stored in electronic health records and accessible to school nurses; Nayak said the plan is part of the patient's electronic health record once it is completed by the health care provider and that rollout to all clinics is ongoing (she said roughly 30 percent of pediatric patients with asthma at one clinic had a plan in place).

Nayak cautioned that while portable air purifiers and DIY box‑fan filters reduce exposure indoors, the long‑term health solution is making school buildings more resilient — including upgraded HVAC filtration or replacement where necessary. District representatives reiterated interim readiness to deploy purifiers and work with the health district while a longer‑term facility plan (including a potential new high school) is pursued.

The board did not take formal action on new policy at this presentation but discussed next steps for coordination with health providers, school nurses and the health district.

What’s next: District staff said they have purchased AQI monitors for schools, kept a stock of purifiers and will continue to coordinate with Confluence Health and Chelan‑Douglas Health District on distribution and rapid deployment during smoke episodes.