When wildfires spread from the foothills into urban Los Angeles in January 2025, many residents evacuated and air quality dropped sharply. Despite concerns about overwhelming local hospitals, a new study shows that health care demand shifted toward virtual services instead.
Researchers from the University of Washington and Kaiser Permanente Southern California examined the electronic health records of 3.7 million Kaiser Permanente members in the area. Their findings, published November 26 in JAMA Health Forum, indicate that while overall health care visits increased after the fires began, much of this increase was seen in virtual consultations.
In the week following the fire ignition, there were 42% more virtual visits for respiratory symptoms than expected among Kaiser Permanente members. Virtual cardiovascular visits also rose by 44% for those living near burn zones and by 40% for those within Los Angeles County.
Outpatient visits for respiratory symptoms saw substantial increases as well. Those living near burn zones or within Los Angeles County made 27% and 31% more virtual cardiovascular visits than expected, respectively.
The researchers estimated that across all insured county residents, there were an additional 15,792 cardiovascular virtual visits, 18,489 respiratory virtual visits, and 27,903 outpatient respiratory visits during the first week of the fires.
Joan Casey, associate professor at UW who led the research team, said: "We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care." She added: "While the fires clearly impacted health, virtual care likely enhanced the ability of providers to meet the health care needs of people experiencing an ongoing climate disaster."
The study also found increases in injury- and neuropsychiatric-related health care usage. On January 7th alone—the day fires started—outpatient injury visits were up by 18% among highly exposed members; virtual injury visits increased by 26% among highly exposed groups and by 18% among moderately exposed groups. Outpatient neuropsychiatric visits rose by more than a quarter above expectations for both exposure groups.
Exposure level influenced how much people used health services virtually: minimally exposed members made 31% more respiratory-related virtual visits; moderately exposed members made 36% more; and highly exposed areas saw a rise of 42%.
Lauren Wilner, a doctoral student at UW and co-author on the study stated: "While healthcare systems often plan to increase the number of hospital beds available or clinic staffing during an emergency, this work highlights the importance of considering virtual care capacity." She continued: "This may be particularly true for climate disasters like wildfires, during which people are advised to stay indoors or when people must evacuate - motivating them to seek care online if at all possible. As climate disasters increase in frequency and intensity, it is essential that health care systems know how to prepare for a sudden and dramatic surge in health care utilization."
