Yakima County, Washington was subject to the extrordinary Washington Wildfire Season of 2020 in which unhealty air (PM2.5) persisted for a 14-day period. This remarkable fire and smoke season began in tandem with the COVID-19 pandemic. SARS-CoV-2 virus, like inhaled particulate matter is known to cause respiratory illness or injury. This study sought to determine through publicly available data whether increased levels of PM2.5 were associated with increased cases of COVID-19. Using a 12-day lag analysis, Pearson product correlations were performed between PM2.5 24-hour averages in Yakima County Washington and daily confirmed cases of COVID-19 for data available on March 1, 2020-October 15, 2020. In addition, total running cases of confirmed COVID-19, daily mortality and total running mortality rates were compared in the lag analyses. All days (PM2.5) in the lag analysis were found to have a statistically significant positive correlation with COVID-19 case counts and total running counts of COVID-19 (p<.001) with correlation coefficients ranging from 0.24-0.28. The total running mortality rates were also significantly associated with daily PM2.5 (p<.001); however, the daily mortality rates were not found to be statistically significantly related to PM2.5. This simple analysis provides preliminary evidence that increased air pollution (PM2.5) is associated with higher rates of confirmed COVID-19 cases. However, further research is required to determine the potentially confounding factors in this relationship.

Risk factors associated with prenatal depression have been studied extensively, but it is unclear whether typical risks are relevant during the COVID-19 pandemic. This mixed-method study involved surveys and interviews with women in their third trimester of pregnancy to understand prevalence and correlates of prenatal depression during a pandemic event. Survey participants included 378 pregnant women in the United States with due dates between April and December 2020 who self-reported depressive symptoms using the 10-item Edinburgh Postnatal Depression Scale (EPDS). Participants were predominately white, married, and highly educated. A subset of 21 women participated in qualitative interviews. In total, 56.3% of women reported depressive symptoms consistent with clinical levels of prenatal depression. Correlates of depressive symptoms included younger age, unmarried status, lack of access to paid parental leave, feeling unsafe in current romantic relationship, fear and worry about upcoming childbirth, and change in birth plans due to the COVID-19 pandemic. In-depth interviews with participants revealed key themes around pregnant women's experiences with fear and anxiety, mixed emotions, and grief and loss. These findings underscore the pervasive impact of the COVID-19 pandemic on women during the perinatal period, with specific implications for the care of women with prenatal depression and their families. The heightened potential for prenatal depression in the context of the COVID-19 pandemic is concerning given the potential adverse effects of maternal depression. Practitioners must work together to engage in additional assessment of risks of prenatal depression to ensure support for expecting families is readily accessible.

Yakima County, Washington, a rural county with an urban core suffered disproportionately under the conditions presented by the COVID-19 pandemic and summer wildfires of 2020. With an infection rate of over 700 per 100,000 population at the height of the pandemic, the county concurrently experienced 14 consecutive days of an air quality index in the unhealthy to hazardous range in August 2020. This paper examines the contributing socioeconomic, geographic, and environmental vulnerabilities that make Yakima County particularly susceptible to the continuum of expected COVID-19 disease and related outcomes and suggests comprehensive areas of investigation to mitigate its impact on special populations, including Hispanic-Latino communities, agricultural, food production, and other essential workers.

The COVID-19 pandemic has transformed the health care landscape and shifted individuals’ expectations for and interactions with essential health services, including pregnancy-related care. This study explores alterations to individuals’ pregnancy and childbirth decisions during an infectious disease pandemic. A convenience sample of 380 pregnant individuals with an expected delivery date between April and December 2020 consented to enroll and complete an online questionnaire on their pregnancy and childbirth expectations during the COVID-19 pandemic; a subset of respondents ( n = 18) participated in semi-structured phone interviews. Survey data were analyzed quantitatively while interview data were analyzed using a thematic content analysis until a consensus on key themes was achieved. Respondents reported substantial stressors related to shifting policies of health care facilities and rapidly changing information about COVID-19 disease risks. As a result, respondents considered modifying their prenatal and childbirth plans, including the location of their birth (25%), health care provider (19%), and delivery mode (13%). These findings illuminate the concerns and choices pregnant individuals face during the COVID-19 pandemic and offer recommendations to engage in compassionate, supportive, and person-centered care during a time of unprecedented risk and uncertainty.

Yakima County, Washington is an area with prolonged exposure to poor air quality (PM 2.5) and has been one of the hardest hit counties in cases per capita of COVID-19 in the Western US. The physical health impacts of poor air quality exposure and COVID-19 have been well documented. However, the mental health impacts of these concurrent exposures are unknown. A pilot study (n=232) surveyed households using random-digit-dialing (RDD) in Yakima, County in Dec 2020-Jan 2021 to understand the spread of COVID-19 in vulnerable communities. Air quality behaviors and contexts including home filtration systems and use of community shelters during poor air quality events were measured. Mental distress was measured by the John Hopkins's Mental Distress COVID-19 Community Response Survey. Descriptive data analysis along with Spearman's rank correlation analysis were performed. Nearly half of the sample (45.3%) did not have access to air quality mitigation measures in their homes. The majority of the sample (54.3%) reported wanting to access clean air shelters during major air quality events such as the smoke and wildfire season of 2020. Participants who were unable to mitigate poor air quality in their households as well as those who were unable to access community clean air shelters were observed to have higher levels of mental distress (p<.05). This study adds to the body of evidence that environmental exposures play a significant role in mental health and that compounding impacts of climate change should be studied more in depth. Household interventions should be explored as COVID-19 has brought community protection measures to a halt, while climate change induced natural disasters will only increase in the future.