Smoke brings a warning: There's no escaping climate's threat to health

A haze covers Philadelphia City Hall on Wednesday, caused by smoke from Canada's wildfires. (Joe Lamberti/AFP/Getty Images)

The cloud of smoke inundating the East Coast on Wednesday - fueled by more than 400 active fires burning across Canada, with more than half of them considered "out of control" - underscored how climate change's threat to human health can transcend national boundaries.

Dozens of East Coast counties issued health warnings as air-quality measures hit their worst marks in years, or even decades, prompting many elderly Americans and schoolchildren to shelter inside.

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The shroud above the Northeast prompted public health authorities to convene emergency meetings, hospitals to prepare for a possible uptick in patients and lawmakers to again call for legislation to tamp down the risks of a warming world. The acute public health threat posed by the fumes, which carry dangerous gases and fine particles that can embed in people's lungs and bloodstream, coupled with the transformation of major cities' skylines punctured many Americans' sense of invulnerability.

"Climate change is real. It is here. The extreme weather and disasters like these wildfires, thousands of miles away, land right here in our great city and impact our health," New York City Health Commissioner Ashwin Vasan said at a news conference Wednesday morning, urging residents to stay indoors, wear masks if needed outdoors and take other precautions. City officials said the air was the worst in more than 50 years - with an Air Quality Index score Wednesday that at one point reached 484, signifying "hazardous" conditions - and would likely last several days.

Wildfire smoke has posed a growing health risk in the United States for years, with Western states repeatedly reeling from fires and residents attempting to cope by purchasing personal air filters, staying indoors and adopting other ad hoc solutions. In interviews on Wednesday, federal experts touted guidance from the Centers for Disease Control and Prevention on how to stay safe. But the smoke enveloping the East Coast arrives at a moment when many Americans have tuned out warnings from public health officials in the wake of the coronavirus pandemic. Many people in affected areas continued their usual routines despite the intense haze, scratchy throats and other manifestations of the smoky conditions.

Jackie Dehart, who works at a coffee shop in the Flatiron District in Manhattan, said that she had seen many customers lingering in the shop's outdoor seating area. "It feels apocalyptic," said Dehart about the orange-ish smoke. "But a friend eased my fears when they told me that forest fires are natural and good for the forests."

Health officials stressed that wildfire smoke should not be inhaled by anyone and could lead to short- and long-term complications. Officials said they were most worried about vulnerable groups such as people with lung disease, diabetes or Alzheimer's or who are pregnant.

"These particles cause inflammation in the lungs, but they also pass through into the bloodstream. They embed themselves in the walls of our blood vessels, and they still have inflammation there as well," said John Balbus, the acting director of the Office of Climate Change and Health Equity at the Department of Health and Human Services. "For somebody who has really bad heart disease, they can trigger a heart attack - but for everybody, they can lead to inflammation and increase the threat of what we call atherosclerosis, of hardening of the arteries."

The warnings were echoed at the U.S. Capitol, where lawmakers said they shared public health experts' concerns and called for legislation to combat climate change.

"I urge every single American and Canadian impacted by the smoke to take precautions to stay safe and follow public health guidelines in their communities," Senate Majority Leader Charles E. Schumer (D-N.Y.) said on the Senate floor.

It may take time to fully understand the impact of the current smoke cloud on the Eastern Seaboard, said Aaron Bernstein, a physician who leads the CDC's center for environmental health.

"When you breathe in wildfire smoke, you can get sick on the same day - many people do," Bernstein said. "But we absolutely do see effects several days [later] after people breathe it."

The smoke plaguing the Eastern United States has been sparked by devastating blazes that have upended life from coast to coast in Canada, swallowing homes and other structures, and forcing more than 100,000 people in nine of the country's 13 provinces and territories from their homes since early May, according to officials from Natural Resources Canada.

As of Wednesday, more than 2,200 wildfires had burned so far this year, according to Canadian officials. In the Atlantic province of Nova Scotia, unusually intense blazes this year have already scorched more land than has been burned in the last 10 years combined.

"This is a scary time for a lot of people," Canadian Prime Minister Justin Trudeau told reporters at a news conference on Monday, promising to do "whatever it takes to keep people safe."

If fire activity continues at the current pace, Canadian officials said this week, scientific modeling shows that Canada is on track to experience the worst wildfire season in its recorded history.

"People have said, 'Well, it's a new normal.' No, there is no such thing as a new normal," said Werner Kurz, senior research scientist with Natural Resources Canada. "The only thing that's normal right now is that with climate change the situation is going to get progressively worse."

The Canadian fires have also spawned some of the smokiest conditions in cities such as New York, Detroit and elsewhere that have been seen over the past two decades, said Marshall Burke, an associate professor in the Department of Earth System Science at Stanford University.

Scientists have detailed how a warming world can fuel more - and more intense - fires. The Intergovernmental Panel on Climate Change, a group of some of the planet's foremost researchers, has said that unless humans drastically reduce the burning of fossil fuels, wildfire seasons are likely to grow longer and that more area will burn.

Lisa Patel, executive director of the Medical Society Consortium on Climate and Health, which raises awareness about the health effects of climate change, said at the current rate, wildfire smoke could be the predominant form of air pollution many humans breathe by the end of the century.

"This is a reminder of what many of us in the health world have been saying for a long time: Climate change is going to affect all of us," she said.

West Coast-based officials said that images of the smoke-shrouded East Coast felt disturbingly familiar.

"A lot of us are remarking on that it's [like] a transformational day in San Francisco three years ago, when it never got light . . . [and] felt like being on the on the surface of Mars," said Wade Crowfoot, California's natural resources secretary.

In New York City, physicians grappled with the eerie sensation of being in a dust bowl. Ronald Crystal, a pulmonologist at Weill Cornell Medicine in New York City, said he could "barely see" nearby buildings out of his office window, and he was worried about the health effects of the bad air on some of his patients.

Experts on Wednesday said they were encouraging many of the same tactics that were recommended to fight the coronavirus pandemic, such as filtering the air indoors and wearing well-fitting masks as needed.

"A lot of the covid recommendations hold in this situation as well," said Peter DeCarlo, an associate professor of environmental health and engineering at Johns Hopkins University, although he noted that Americans in areas affected by wildfire smoke should keep their homes' windows and doors closed, rather than air them out, as experts encouraged them to do to reduce covid risks. DeCarlo also suggested that people in cars keep their windows closed and recirculate the air in hopes of removing particles through the car's air filters.

The experts acknowledged that some Americans had grown skeptical of public health advice in the wake of the covid outbreak.

"It's unfortunate a mask became so politicized during the pandemic," said Linsey Marr, an environmental engineer at Virginia Tech. "A good-quality mask . . . will definitely protect your health and reduce your exposure."

Marr said that a mask could help remove particles from the air but cautioned that it could not stop all "smelly gases," which is why some people "may still smell smoke" even when wearing a well-fitting, high-quality face covering.

"The mask needs to allow . . . oxygen to get through so you can breathe the air. But that doesn't mean it's not working," she said.

Lauren Cohen was one of those masked New Yorkers. She is 28 weeks pregnant, and her doctor advised her to wear a mask and not attend the Yankees game Wednesday night - a game later postponed.

"The world is burning, like this is not good, we need to pay attention to climate change and all of the things that are causing this," Cohen, 40, said. "It truly felt, like, apocalyptic last night, and it was like a glimpse into, if we don't do anything, then this is what the world is going to look like."

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The Washington Post's Amanda Coletta contributed to this report.

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