By Sara Amandolare

With vast forests, suburban developments and urban skyscrapers burning in recent months and years, it may seem like few places in America are safe from the fire. Around the world, experts warn that fires are a worsening of the global crisis. In the United States, 8% more fires occurred in 2020, compared to 2019killing about 3,500 people and injuring 15,200.

Lawmakers, local communities and nonprofit organizations rushed to help in the aftermath. California Residents created mobile food pantries for people displaced by the 2021 Dixie Fire. The Red Cross and corporate donors are heading Help for survivors of the Marshall Fire in Colorado, which was contained in January. Survivors of a January building fire in the Bronx, New York, received prepaid debit cards from the Mayor’s Fund, along with offers of help from lawyers and Famous.

But it’s less clear how that response might evolve in the coming months, years and decades, according to doctors, advocacy groups and researchers who have experience with similar types of disasters. According to experts, many people are not receiving the health care and other forms of assistance they need throughout their lives.

Historic droughts and heat waves related to climate change have led to longer and more intense wildfire seasons in the western United States in recent years. Climate change has also created the conditions for disastrous fires around the world, increasing probability from Australia’s extreme bushfires in 2019 and 2020, for example.

And more and more people are living uncomfortably close to wildfires, because development in wildfire-prone areas has been expanding for decades. That includes areas where the natural and built environments converge, known as the wildland-urban interface or WUI, where an average of 3,000 structures per year were lost to fires between 2002 and 2016. Approximately one-third of all US households They are located in the WUI, an area that grows by 2 million acres each year.

The COVID-19 pandemic may have caused fires Also, because more people started cooking at home and venturing outdoors (and using fire pits and patio heaters) more often. Additionally, wildfire-affected areas have attracted increased numbers of new residents since the pandemic started.

Every year, thousands of people are injured in fires, including 96.7% of people treated in burn centers, live. They face “multiple phases of survival,” he says Dr. Steven Sandoval, associate professor of surgery and medical director of the Suffolk County Volunteer Fire Burn Center at Stony Brook University Hospital. Doctors may need to order fur grafts in the first 2 weeks after a burn injury, for example, putting patients at risk of suffering blood clots, pneumoniaand skin infections, he says. A resident who suffered third-degree burns in the 2018 Camp Fire in Paradise, CA, died from complications 9 months after arriving at the hospital.

Burn survivors may also have scars above and below the surface of the skin. Over time, scars may become thicker and tighter, and scars over joints may prevent its full range of motion. As a result, survivors may need to spend weeks in a rehabilitation hospital to relearn how to walk, eat, and bathe. More than a decade after being burned, survivors can develop new wounds in addition to vulnerable scar tissue. Many have chronic illnesses. itching and stinging sensations in their healed burns and grafts, according to Lisa Rae, MD, associate professor of surgery at Temple University Lewis Katz School of Medicine. Itching, in particular, “prevents you from sleeping when it matters and can be a real factor in your quality of life after recovering from a burn,” he says.

Smoke inhalation injuries can also have long-term effects. Some survivors have neurological symptoms, such as difficulties with memory and thought processing, due to smoke-related illnesses. carbon monoxide poisoning, according to Sandoval. They can also have permanent lung damage or a narrowing of the upper airways that makes it feel like they are “breathing through a straw,” says Rae, who is also director of the Temple Burn Center at Temple University Hospital. All of these conditions can deplete energy and exercise tolerance, further altering the quality of life.

Many survivors have PTSD and nightmares of the event, and have high rates of depression and anxiety, according to Rae. At least a third of people affected by the Marshall Fire in Colorado are expected to need mental health care therapy As they recover, potentially within months or years, according to experts at the University of Denver Disaster and Trauma Recovery Clinic.

“It is a life-changing event for such a high percentage of survivors. Everything you thought you were going to do changes,” Rae says.

The climate change portion of President Joe Biden’s Build Back Better Act could help stop wildfires in the future. If passed as a standalone bill, it could include an investment of approximately 555 billion dollars in a clean energy transition in the United States, curbing fossil fuel emissions that contribute to climate change and extreme weather conditions.

Policymakers also now have the opportunity to improve the support system for those affected by all types of fires, including the Bronx and Philadelphia Disasters, that are among the 10 deadliest home fires in the US since 1980. They can begin by acting on the basis of growing data about the long-term needs of survivors. The federally funded Recording model system has identified numerous persistent challenges, from scar numbness to memory difficultiesleading some doctors to advocate that burn injuries be reclassified as a chronic condition by the Centers for Medicare and Medicaid Services. This could expand data collection, potentially improving overall care and reducing medical costs for survivors.

The reclassification could also put pressure on insurers and employers to support survivors during their recovery, according to Jeffrey C. Schneider, MDprogram director of the Boston-Harvard Burn Injury Model System and medical director of trauma, burn and orthopedic rehabilitation at Spaulding Rehabilitation Hospital in Boston. Burn survivors can often find relief through specialized scar massage therapy, for example, but their sure it may not cover it. According to Rae, many patients with burn-related disabilities have difficulty returning to work and paying for home care.

“I’m lucky to have occupational therapists here who specialize in burns and continue those treatments for my patients, but that’s not available nationwide,” he says. “As far as recovery goes, certainly unemployment and health benefits, both physical and psychological, are probably where our overall system needs to improve.”

Schneiderwho treated the survivors of the 2003 disco station fire while preparing to become a rehabilitation doctor, acknowledged that public attention on any given tragedy would surely dissipate over time. “But for people who live with these problems, their problems continue. That’s why I always ask: How can we address the needs of these people after attention to events diminishes?”