Doctors say there will be unpredictable and lasting consequences, especially for children, the elderly and asthmatics

As unprecedented bushfires continue to burn along Australia’s east coast, medical professionals are warning of unpredictable and lasting consequences for public health.



“I think for the population, what they feel, and the concern they have about this, is probably reasonable,” said Chris Moy, chair of the Australian Medical Association’s ethics and medico-legal committee.



Moy said the lasting impact of the bushfires and “the concern with respect to the air quality” was founded. He said “there are people who are going to probably die from these conditions”, particularly those “right at the edge of lung capacity”.

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He said at this point, the best thing the public could do was follow “common sense” advice such as staying indoors and heeding warnings. However, as the season dragged on, there were “psychological aspects of being stuck inside”.

David Caldicott, a consultant emergency physician at Calvary hospital in Canberra, had seen this first-hand over the past few days, as the Canberra region suffered its highest pollution day on record. He said there had “definitely been an uptick in people”. While he noted an increase in elderly patients, asthmatics and those with other respiratory issues, he said the “psychiatric element associated with the potential threat of fire is something that’s often forgotten when people are focusing on respiratory diseases”.

“I don’t think you can underestimate the psychological impact of not just the smoke but the existential threat of fire,” he said. “Canberra’s memories are long ... There are people who are anxious and who are vulnerable at times of anxiety who are presenting, looking for reassurance.”

Nigel Cooper, senior manager of programs at Asthma Australia, said: “One of the key things for us is that I don’t think we’ve actually ever seen anything like this before.”

Asthma Australia is conducting a survey on the impacts of bushfire smoke on asthmatics.

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Cooper said that while increases in presentations to emergency departments would be captured, “the data that will be quite hidden will be how many people lost time from work, how many people increased their medication usage, how many people didn’t exercise or stayed home”. The survey aimed to address those hidden burdens.

Cooper was also concerned about the lasting impact on those whose asthma symptoms had been exacerbated.

“You’re experiencing increased usage now of your puffers, well how long is that going to last for? How long are you going to be like this? We don’t really know that. It’s a real concern.”

Caldicott warned that parents should be particularly mindful of the impact smoke exposure can have on children.

“The usual hazards of childhood are quite different to this sort of chronic exposure,” he said. “People can stay inside [but] it’s terribly difficult for parents of small kids. I have small kids myself and I don’t want to stash them in front of the telly, but that may be what we have to do for the next few days or as long as this persists.”

In Canberra, Caldicott said: “The only thing that we can do now is try to reduce the harm that the smog is causing”.

However, he is a firm believer in the saying “prevention is better than cure”.

“This is a significant medical event that tracks directly back to the issues of climate change,” he said. “You remember those photos that they used to put out. ‘This is what happens to your face if you use meth?’ The before and after. Well Australia is the ‘after’ photograph of what climate change does.”

In September 2019, the AMA formally declared climate change a health emergency. Moy said the AMA’s motion passed because climate change has direct health effects.

“This is a health effect,” he said. “Let’s just call it, and Blind Freddy can see this. And it is having effects on people at the moment.”

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Allison Hempenstall, registrar committee chair of the Australian College of Rural and Remote Medicine, said: “We have to be a united strong voice for the health of our patients and our community and our nation.”

She said: “We need to push for governmental change, prioritising climate change policy which is something that the government isn’t doing at present … The health implications of climate change are only going to be fixed by addressing climate change itself. We need to be moving away from fossil fuels and moving into sustainable and renewable energy sources.”

Caldicott believes this crisis might be a turning point for Australia.

“Climate change is an issue like high cholesterol or high blood pressure,” he said. “It’s one of these things that sneaks up on you and you don’t know that you’re suffering from it until you actually have a heart attack or a stroke.

“We don’t actually have to be on fire to realise the truth. You just have to smell the fire and it’s a shame that parliament isn’t sitting at the moment. Because this would definitely be a salient reminder to the people that the rest of Australia sends us, about what actually happens when you do things wrong.”