In Coeur d’Alene, Idaho, the eye-watering haze forced Camp Sweyolakan to pack up 150 kids and cut short their week in the mountains. In Denver, the acrid smell clawed at the throat and led Kathryn and Dennis Wright to scrap a long-awaited family camping trip.

And in Green Bay, Wis., the smoke filled Sarah Cramer’s lungs and tightened her airway, prompting her to interrupt her 9-year-old son’s reading of a National Geographic book. She felt like she’d been hit with a second slam of COVID-19, but this time it was the very air that plagued her.

The smoke from Western wildfires that has settled over much of the Pacific Northwest and America’s northern tier, wafting even into parts of New England, is bad enough for adults. But for children, the smoke is a summer wrecker, spoiling outdoor fun and driving kids too long penned up by the pandemic back inside.

“You want to put a big bubble over them,” said Steve Jurich, executive director of Camp Fire in Spokane, Wash., who had the unpleasant duty of shutting down his organization’s sleepaway camp in northern Idaho in early August because of the unhealthful air. In these last two summers, Jurich’s camps have never lost a day to the pandemic; masks kept operations going. But for two summers in a row, he has had to shut down one of his camps temporarily because the air was too foul to play outside.

Wildfires are an annual occurrence in the American West, but this summer they have been exacerbated by suffocating heat domes. The resulting haze is not just a vestigial wisp of fire; it is a carrier of tiny bits of burned trees, plants and some of the man-made stuff that melts in those blazes — particles that become ingredients of bad air, which makes its way into people’s lungs, bloodstreams and neurological systems.

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In St. Paul, Minn., Amy and Barrett Stoks’s three children have seen so much in this haunting passage of their lives. School became pictures on a screen. Friends became one more video experience. The Walgreens and the Target near their house burned down after protests against police brutality turned violent. As this summer approached, they hoped for a respite.

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But when Barrett took his eldest son, Finley, 9, to a state park last month, they weren’t allowed to make a camp fire due to the region’s severe drought. The Stoks kids “were, like, ‘What is going on?’ ” Barrett said. “So we got to kind of talk to them a little bit.”

The intense heat, the lack of rain, the fires, the smoke all led to family conversations about the climate and how the world is changing.

“I don’t think they fully understood it,” Barrett said. “They were kind of annoyed by it.”

Children’s reactions to this summer of smoke are often literal and basic. Last week, when the Stoks kids were told they could not go swimming because it was too smoky outside, Finn expressed his disappointment with a simple statement of the facts: “We were supposed to go swimming this morning and we couldn’t.”

His parents have sought ways to make the summer as normal as possible. They shifted their vacation destination from their usual place near Duluth to Lutsen, Minn., another 100 minutes up the coast of Lake Superior, where the air was clearer, though still abnormal. At the nearest hospital, visits to the emergency department are up this summer because of smoke-related ailments — asthma, COPD, allergies, strep throat and pneumonia — according to Kimber Wraalstad, chief executive at Cook County North Shore Hospital in Grand Marais, Minn.

The Stoks spent a few days at a Lutsen resort, where the parents had a Murphy bed and the kids shared a king-size mattress in a loft upstairs. The view toward Lutsen Mountain was a vista of thick smog.

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“We had the window open just a tiny bit and you could smell it when we woke up,” Amy said. They skipped their planned morning swim, stopped at a Dairy Queen and used the pool later in the day when the air had cleared a bit.

Minnesota’s air quality hit an all-time low earlier this month as wildfire smoke, which generally floats high atop the atmosphere, hung unusually low in places. When Amy travels these days, “there are all these, like, ‘Reduce your trips’ signs,” leading her to wonder if she should just give up and stay home.

She wants her children “to be out and be active and not sitting in front of a screen,” she said, “but then I think, maybe I shouldn’t be driving.”

Smoke knows no state or national boundaries. Fires this summer in Siberia have pushed smoke up to the North Pole. In the United States, 103 large fires in 14 states have burned nearly 2 million acres this year — roughly on average with the pattern over the past decade, according to the National Interagency Fire Center.

“These are big, hot fires and they generate very large plumes,” said Mark Friedl, an earth scientist at Boston University who studies smoke’s impact. “It’s a toxic cocktail of particulates. We’re nowhere near the stage of smoke having a great impact on the climate, but we are seeing larger, more frequent and more intense fires and if you have respiratory issues, you really should stay inside til the smoke clears.”

At the peak of the smoke, Jurich, the camp director in Spokane, was able to move his day campers indoors, into a Shriners’ center half an hour from the camp’s own site. But since his overnight camp in remote northern Idaho is entirely outdoors, he felt obliged to contact parents and have them pick up their kids.

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Smoky summers are, he said, “unfortunately the new normal for us.” But although children have grown accustomed to wearing masks, there is no getting used to canceling camp and making kids sit at home. “Boy, sitting here right now, I don’t have answers.”

In many places this summer, there can seem to be no escape. The pandemic and the wildfires have added up to a two-fisted assault on people’s breathing, creating a double whammy of anxiety over nature’s perils. Washington state health officials got so many worried calls, they issued guidance: “Is it wildfire smoke or COVID-19?”

Although some effects of covid and smoky skies can look similar — coughing, wheezing, shortness of breath — other symptoms, such as fever, chills, muscle aches and diarrhea, do not stem from smoke exposure. When in doubt, parents are advised to take their children to the doctor — and many are.

Some hospitals are finding a significant increase in covid cases in places that suffered severe smoke. New research by the Desert Research Institute in Reno, Nev., found an 18 percent spike in covid diagnoses during a period of smoke heavy enough to drive people indoors.

“People were spending more time socializing indoors,” expanding their opportunities to contract the virus, said Daniel Kiser, a scientist at the institute. “Also, viral particles could be hitching a ride on the smoke particles.”

Another study, based in California counties where wildfires caused persistent smoke, found that COVID-19 cases jumped by more than half during a period of heavy smoke.

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The research doesn’t leave parents with a lot of good choices, Kiser said: “Being outdoors, you’re exposed to particulates from the wildfire smoke and being indoors, you’re potentially exposed to” the coronavirus. “It’s a double-edged sword.”

For parents such as Sarah and Dan Cramer, the choice between finding relative safety from covid outdoors and taking refuge from smoke indoors is forced by their children’s health.

On a midsummer morning, Sarah sat with her son Jack on the porch swing outside their house in Green Bay. As she sipped tea and Jack read to her from an early readers book, she suddenly struggled to breathe. Having already had a bout with covid last year, she went straight to the medicine cabinet for the inhaler she had left over from that ordeal.

The whole family got covid early in the pandemic, after Dan, then a massage therapist at the Gaylord National Resort in suburban Maryland, was exposed to the virus during last year’s gathering of the Conservative Political Action Conference. Dan and the kids had mild cases, but Sarah, who is 39, was ill for two months. They later moved to Wisconsin after Dan got a job at a Green Bay hotel.

This time, Sarah’s coronavirus test came up negative. The federal government’s real-time air quality tracker, airnow.gov, revealed the likely culprit behind her strained breathing: tainted air from wildfires.

Breathing remains a strain for Sarah when she goes outside. Even inside, she needs three puffs a day on the inhaler and frequent changes of the air-conditioning filters to feel OK.

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Sarah’s breathing problems upended her kids’ schedules. She had to scratch her plan to volunteer at her 11-year-old daughter Lilly’s outdoor nature camp, and the family canceled trips to the public pool.

“I just have to tell them, ‘Mommy can’t sit outside right now,’ ” she said.

The farther smoke drifts from its source, the weaker its odor becomes, making it harder for people to recognize that the slight haze creating lovely sunsets may also pose a health risk to their children. But in suburban Denver, it takes only a glance out the window at the soupy, smoke-filled air for Dennis and Kathryn Wright to know what they’re up against.

Both of their small children require medication to control asthma. Yet even keeping Carson, 7, and Maya, 4, in the house all day hasn’t kept their rising first-grader from needing his albuterol inhaler, which protects him against coughing spasms.

This summer’s record heat in Denver has produced a spike in smog, which forms when intense sunlight mixes with chemicals from fossil fuel combustion. The smog and wildfire smoke create a toxic stew that can trigger asthma attacks and increase the risk of heart and lung trouble even for healthy people.

The word from experts on what to do about it can seem contradictory. The Centers for Disease Control and Prevention advise staying inside: “The best way to protect against the potentially harmful effects … is to reduce your exposure … Limit your outdoor exercise when it is smoky outside.”

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At the same time, the CDC advises people to head outdoors to limit exposure to covid: “If you want to spend time with people who don’t live with you, outdoors is the safer choice! You are less likely to be exposed to COVID-19 during outdoor activities, even without the use of masks.”

For the Wrights, the choice has been clear.

In early August, the smoke got so bad that many Denverites couldn’t even see the 14,000-foot peaks of the Rocky Mountains, normally visible from most of the city. “It was a really, really rough weekend for anyone with lungs,” said Heather De Keyser, a pediatric pulmonologist at Children’s Hospital Colorado.

Pediatricians say long-term exposure to the pollutants in smoke can damage children’s immune systems, making it harder for their bodies to defend against allergens later in life. So the Wrights canceled a vacation with Kathryn’s parents near Steamboat Springs — a spot they’d reserved last spring — because they didn’t want the kids outdoors for an extended period.

The Wrights try to give the kids age-appropriate explanations. “We will explain how the smoke and particulate will travel through the air over a given current from far away, and we want to make sure that when the air isn’t good for us, we stay inside,” said Dennis, 41, who is wrapping up a master’s degree in epidemiology.

Carson, ever curious, asks lots of questions, and his parents offer details he can grasp.

“We do make sure we talk about what is happening with the earth and we talk about what we can do to help things, like why we recycle, why we are cautious about driving somewhere when we can walk, why we garden,” Dennis said. “We don’t want to overload them at this age. At the same time, we don’t want to lie to them either.”

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In the months to come, the Wrights foresee tough trade-offs between spending time outdoors to steer clear of covid and staying inside to avoid the polluted air.

“Meeting with friends at a distance at a local park has been OK,” Dennis said. But if friends invite them to the park during bad smoke periods, “we would likely have to decline. It wouldn’t be in our kids’ best interest.”

Last week, as some of the nation’s smokiest air descended on Colorado from California’s Dixie Fire and other blazes, the Wrights set up camp inside their house, busying Maya with a sequin-covered cardboard “Girl Power” collage and Carson with a robotics kit and a three-dimensional puzzle.

Finally, being cooped up got to be too much.

“We did let them outside for just a little bit,” said Kathryn, 42, a project coordinator at Colorado’s education department. “They needed to get out.”

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Fisher reported from Washington, Oldham from Denver and Regan from St. Paul. The Washington Post’s Dan Simmons in Green Bay, Wis., contributed to this report.