Every day for months, Kirsten Connor started her day the same way.
"My morning routine was I would wake up and check the air quality app, the Fires Near Me app and get up and lay out my asthma medications for the day. It was a bit of a ritual," Ms Connor said.
As smoke haze from bushfires near Braidwood and the South Coast choked Canberra for weeks on end, the Kaleen resident spent most of the summer inside her home, trying to avoid the hazardous health conditions outside.
In all of the years since she was first diagnosed as being asthmatic, Ms Connor said she had never experienced conditions as bad as those in the ACT during the Black Summer fires, where air quality in the ACT was at one point the worst in the world.
"It was the worst period of time to have to deal with asthma," she said.
"It was a case of making sure everything was closed and keeping the air con and air filters on. If I did have to leave the house, I had to make sure I dosed myself with ventolin and take my preventer puffer."
Those living with asthma and other respiratory illnesses were among the hardest hit by the weather conditions generated by the summer's bushfires. Now a new report has confirmed the toll the smoke haze and bushfires had on people's health.
The report, released by the Australian Institute of Health and Welfare, revealed a surge in presentations to emergency departments for respiratory conditions, along with a surge in medication issued to treat asthma.
While the report examined the short-term effects of the bushfires on people's health, medical experts have said it could still be years before the full extent of health issues becomes clear.
Hospital presentations for respiratory diseases along the South Coast and Braidwood areas at the height of the bushfire crisis in those areas increased by 50 per cent between December 29 and January 5, compared with the same time the year before.
Across the whole of NSW, emergency presentations were also up by more than 50 per cent during December and early January.
Women were more likely to have been admitted to emergency for asthma and respiratory conditions compared with men at the peak of the bushfires.
The report also found sales of inhalers in the ACT surged dramatically during the height of the bushfires.
Between January 5 and 11, when the air quality in Canberra during the summer was at its worst, sales of inhalers jumped by 204 per cent compared to the same time in 2019.
From the week of December 8 until January 18, sales were more than 75 per cent above levels from the year before.
A similar situation was seen for respiratory medication issued through the Pharmaceutical Benefits Scheme, where rates increased by as much as 80 per cent in Canberra, which triggered shortages at many ACT-based pharmacies.
Marg Gordon from the National Asthma Council of Australia said it was not surprising to see the surge in asthma presentations in the wake of the bushfires.
"People in areas not directly impacted by the bushfires, including built-up areas, are also at risk as winds can carry smoke and ash particles long distances," she said. "Smoke also lingers for days or weeks after a bushfire, so the effects can be ongoing."
Group head at the institute, Richard Juckes, said while presentations to emergency increased during the fires, it was the opposite situations for visits to GPs.
"Visits to GPs decreased in areas coinciding with times of bushfires and smoke," he said. "It may be because of the health advice that was issued to stay indoors and avoid the smoke, so people postponed non-urgent visits."
While the ACT saw a 26 per cent boost in GP visits during the week of December 22 last year, the following week at the height of the bushfire crisis on the South Coast saw a drop in appointments. The largest decreases were in the South Coast and Braidwood areas.
Chief executive of Asthma Australia Michele Goldman said more needed to be done in order to make places safer for people living with respiratory illnesses.
She said more severe cases of asthma and lung diseases were likely to surface in coming years.
"The fear is that exposure to smoke can cause existing conditions to worsen and it often causes new lung diseases to develop," she said.
"Research needs to look at the exposure to different concentrations of smoke over time to see what it does to the airways."
Even after the bushfires in the ACT stopped burning and the smoke subsided, Ms Connor said it took several weeks for her asthma symptoms to lessen.
"As soon as the air cleared, it wasn't like things were immediately better, it can take a while to recover."