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OAKLAND, Calif. — The raging Northern California wildfires that have burned thousands of structures and caused the deaths of at least 31 people are also fouling the air across the region, driving a significant uptick in hospitalizations and keeping many residents cooped up indoors.

Acrid air quality extends throughout the greater San Francisco Bay Area — well beyond the immediate fire zones — according to the Bay Area Air Quality Management District. Particulates and smoke have seeped into buildings in Oakland, Silicon Valley, and other areas well outside the fire zone. Homes and offices dozens of miles from the flames smell like campfires, and the air outside is thick with pollutants.

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Health officials said the air quality is particularly hazardous for anyone with chronic heart or lung disease, older people, and pregnant women.

Dr. Chad Krilich, chief medical officer for St. Joseph Health, which operates two hospitals near the burn area, said that beyond burn cases earlier in the week, there has been sharp rise in emergency department cases. His two hospitals have been seeing up to 180 patients daily, compared to a normal rate of 100 to 135 — mostly due to smoke inhalation. Some are referrals after the closures of two local hospitals located in the immediate fire zones.

Krilich said most of the emergency cases are patients with preexisting chronic conditions, such as asthma or chronic obstructive pulmonary disease, who are suffering from shortness of breath. Some have required hospitalization and a few have been placed on ventilators.

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“We are also seeing patients for exacerbations of chronic medical conditions such as stable diabetes or congestive heart failure” who depend on pharmacies, delivery services, and other community resources that no longer exist or have shut down due to lack of power, Krilich said.

Overnight, firefighters achieved better containment of two of the major blazes, and that has helped allow some local outpatient facilities to reopen. Care is also being provided at shelters by the Sonoma County Public Health Department, taking some of the pressure off area hospitals, Krilich said.

“But it gives you pause that the fire is only 25 percent contained, and we have a red-flag warning for wind over the weekend,” he said. “That can change things fast. We are safe for now, but have a plan in place should we need to evacuate.”

With smoke inundating the area, the view at sunset features an eerily beautiful blood-red orb and coastal views are blotted with smog.

Alameda County, immediately southeast of the fire area, has not seen an uptick in hospital visits, but is urging people to stay indoors when possible to avoid unnecessary exposure to the toxic smoke, said Sherri Willis, a spokesperson for the Alameda County Department of Public Health. “We’ve told the schools and day cares to keep the kids inside,” turn HVAC systems to “recirculate” settings, and reschedule all outdoor events and activities, she said. “Do what you can to stay out of this.”

Some residents of outlying area are using face masks, said Willis, but her department does not recommend them except for outdoor workers. Simple, commercially available masks that are not fitted with correct filters “can provide a false sense of security,” she said. Fitted “N95” masks can protect against fine particulates in wildfire smoke, but such masks are in short supply due to high demand, Willis said.

Public schools in many districts throughout the area — including all or most public schools in Sonoma, Napa, and Marin counties, and many in outlying areas — were closed Thursday and Friday in an effort to keep children at home and inside, away from the smoke.

Major sporting events might require rescheduling or could be moved out of the area — including Sunday’s NFL game in Oakland, between the Raiders and Los Angeles Chargers.

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