A public health response to the Australian bushfire crisis

Until then, we can only surmise that the effects on human health, like those on our precious flora and fauna and on physical infrastructure, are enormous.

The effects of the bushfires on health include breathing and heart problems, due to prolonged exposure to smoke, and anxiety and other mood disorders, related to the trauma and dislocation directly associated with the fires.

It is likely that there will be other health effects. The severity of these health effects varies from premature death to less severe health outcomes, including hospitalisations and simply feeling unwell.

In many cases, it is hard to draw a direct causal link to the fires, but an excess of deaths and illnesses linked in time and place with the fires and smoke probably means that the fires are likely responsible ("where there is smoke, there is fire", so to speak).

The bushfires have severely harmed the health of Australians. The Public Health Association of Australia expresses its solidarity with people affected by the fires, including those workers who are dealing with its consequences.

As an organisation committed to promoting and protecting the health of Australians, we recognise that this disaster, like others, requires a complex and multilayered response.

The response begins with prevention.

Like many health problems, the actions required for prevention lie outside the health domain. Doctors and healthcare workers deal with the consequences, but must look to others for action on prevention. In this case, global warming is the primary driver of the increased duration and intensity of the fire season.

With all this in mind, the PHAA joins the voices of millions of Australians and calls on the Australian government to adopt a leadership role in advocating for global action to reduce warming. A rapid transition here and around the world is not just good for economies - it's good for public health.

Given that global warming is now upon us, we also need to take additional actions, advised by experts in fire management, to mitigate the risk of fires and the risk that humans will be impacted by them.

Advised by experts, we need to provide our fire services with all the resources they need to fight fires now and in the future, bearing in mind that the resources required will be substantially more than was considered adequate in the past.

Assuming that, despite efforts at prevention, fires will continue to occur, we also need to do better in protecting people from the health effects of fire and smoke.

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The role of masks, filters, air filtration devices and smoke refuges, together with the effect of certain behaviours, such as avoiding exercise and staying indoors, needs to be investigated so that health authorities can give proactive, evidence-based advice in future episodes.

The impacts on those who are vulnerable, such as those with pre-existing heart and lung disease, pregnant women, infants and the elderly, need to be highlighted. They may need special intervention.

The role of medicines in treating the consequences of smoke exposure also needs to be considered. We need better guidance about when to advise people to relocate. Finally, we need to consider interventions to promote resilience and the capacity to recover, both in individuals and in affected communities.

More research will highlight actions needed going forward. Those actions rely on a stronger, not weaker, public service - working in the national interest, free of vested interests. As we've seen in the wake of fire, terrible smoke and ash, public health messaging and public health promotion are crucial.

We urge Australian governments to acknowledge the need for a complex and comprehensive response to the fires. It is not enough to simply rebuild and restore. We need to mitigate the risk, adapt and prepare for the future.