Philadelphia emergency rooms aren't seeing an increase in people with respiratory symptoms

Tara Mott hadn't even heard about the wildfires in Canada when she started feeling tightness in her chest.

The 24-year-old actuarial analyst from New Jersey has had asthma since she was 7. After struggling for years to control her asthma — sometimes needing multiple inhalers a day — she started seeing new doctors at Jefferson Health three years ago and got on a regime that usually keeps her symptoms under control.

This week, her asthma mitigation measures weren't enough. "No matter how many times I would take my inhaler, it really wasn't doing the job," Mott said. When she learned about the fires up north, she understood why.

» READ MORE: Thinking about going outside? Here's what to know about the risks from breathing wildfire smoke

Emergency departments throughout the Philadelphia region were on alert Thursday for an influx of patients struggling to breathe, though as of late afternoon, most had not seen an increase in cases. Still, doctors warned that the danger hasn't passed for those who are vulnerable to air quality issues: inflammation can take a few days to build up before becoming problematic for people with asthma.

"I am wondering what tomorrow and the next day will bring," said James Reingold, the chair of the department of emergency medicine at St. Christopher's Hospital for Children. "And I definitely feel like I’m holding my breath for the weekend."

While people with underlying conditions are most at risk of developing breathing problems, the poor air quality puts everyone at risk.

"The impact goes much further," said Jamie Garfield, a professor of thoracic medicine and surgery at Temple University Hospital.

The particles in the air are so small that they can enter the blood stream and contribute to heart disease, the Temple lung physician said.

Despite the elevated risk, emergency departments at Temple University Hospital, Jefferson Health, Tower Health, and Main Line Health had not seen an increase in patients as of midday Thursday.

» READ MORE: Your health questions about Philadelphia's worst air quality day in a decade, answered

"We are seeing a couple of patients here or there who come in with respiratory symptoms," said Brian Lahmann, chair of the department of emergency medicine at Reading Hospital and for the Tower Health system.

The Children's Hospital of Philadelphia and St. Christopher's, which is part of Tower Health, are also not seeing increases in the number of patients suffering from respiratory symptoms.

» READ MORE: Bad air quality poses a particular risk to children with asthma. In unequal Philly, those kids are mostly Black and Hispanic.

For many families, the risk of going outside is clear upon opening the door, said Reingold, of St. Christopher's.

"You can go out and smell it — it looks gross, it smells gross, it burns your eyes," he said.

St. Christopher's emergency room saw a handful of babies Thursday — infants are more susceptible to poor air quality because their airways are smaller— but have not seen the spike of patients they were fearing.

Philadelphia health commissioner Cheryl Bettigole said the slow emergency rooms are a sign that residents have heeded the city's warnings.

"I was driving through North Philadelphia last night, and those streets, which are normally pretty crowded, were empty," she said. "I think people really have been paying attention to this warning and staying inside."

Still, not everyone can heed the guidance to stay inside — whether for parental duties or work for the many people whose jobs are outdoors.

That's why, doctors said, it's important for anyone who must go outside to take precautions, like wearing a mask — preferably an N95, which is designed to capture small particles like the kind in this week's wildfire smoke.

Jaleesa Robinson, 31, wore a mask outside of St. Christopher's on Wednesday, where she had brought her 13-year-old daughter for treatment of a foot issue.

Robinson, a hiring manager, recently developed asthma, but said the air didn't seem so bad when she left for work that morning. By late afternoon, she could feel her airways constricting. She grabbed her asthma inhaler from her purse and pumped the medicated mist into her lungs, then covered her face with a black cloth mask, she said.

"As soon as I came out here in this mess, it started affecting me," she said. Robinson said she would have stayed home, where she's running an air-conditioner with a special filter, but her daughter's foot was bothering her, so she packed up the kids and headed to St. Christopher's.

"We’re definitely going to try and stay inside until this mess passes," she said.

» READ MORE: Workers again ponder whether their jobs are essential, as poor air quality poses risk to outdoor employees

At a food distribution in a community garden in Hunting Park, people with pre-existing conditions shared their struggles breathing with representatives from Esperanza, a faith based multi-service organization serving North Philadelphia with emphasis on the Hispanic community.

"They can just feel the impact of the poor air quality on their body and it's making them very uncomfortable," said Jamile Tellez Lieberman, Esperanza's senior vice president for community engagement, research and health equity.

For people with manual labor jobs, wearing a mask for long periods of time can be difficult. Another difficulty: the lack of frequent updates in Spanish about the air quality updates, Tellez Lieberman said.

"A lot of them are unsure or a little bit uncertain," she said. "Like, what's the best thing to do?"

Health officials and experts said they were relieved that more people haven't experienced serious symptoms from the poor air quality so far. But they stressed that, in the future, more systemic change is needed to mitigate these kinds of events.

Staff writer Wendy Ruderman contributed to this article