New Yorkers know now what living with big wildfires is like

As many New Yorkers have learned, wildfire smoke is unpleasant. It burns your eyes, irritates your throat, and makes breathing more difficult. It makes me sleepy and a little nauseated, although that is probably a symptom of my overwhelming climate dread. When the sky turned orange, I heard many New Yorkers discuss how strange and eerie it feels to be blanketed in smoke. One woman remarked that she’d never experienced anything like it. But for those of us who call the West Coast home, it’s all too familiar.

I grew up in northwest Washington State and spent summers in Idaho. It is my favorite place in the world: crystalline lakes, mountains layered with huckleberry bushes, perfect weather. On the drive to my grandfather’s, a cheerful Smokey Bear sign indicated the fire risk.

When I was younger, I viewed wildfires as a distant threat, something that prevented us from making s’mores during fire bans. As a teenager, my fear of wildfires started to grow. Smoke blew in often, and stayed for days. On the worst days, ash dusted the ground like snow. In case I sound dramatic, my nostalgia was corroborated by the Idaho Smoke Report, which showed an increase in smoke days reaching dangerous air quality during wildfire season 270% from 2001-2005 to 2016-2020. It changed how I feel about my favorite place and how I think about the future. My fear of constant smoky air has developed over years: the East Coast must also face this reality.

In September 2020, I was living at home in between college and med school. Eleven fires raged in Washington, 12 in Oregon, and 22 in California. The smoke converged in a plume across Washington and Oregon. Since I didn’t want to open the windows, I spent most of the day lurking in the relative cool of the basement. I was lucky to suffer no ill health effects besides a headache.

However, at the population level, the effects were startling. A study from the University of Washington found that during that week of increased smoke, all-cause mortality went up 8.6%, cardiovascular disease deaths went up 6.9% and respiratory disease deaths went up 9.4%. Wildfire smoke is unquestionably dangerous.

Smoke changes what you can do: it limits your exercise, cancels your plans to be outside, and makes outdoor work dangerous. From a medical perspective, I think about long-term health risks, which are difficult to measure for wildfire smoke. People with asthma, chronic obstructive pulmonary disease, and other respiratory problems can experience exacerbations when smoke and other particles enter the air. Firefighters inhale smoke at higher rates and have decreased lung function shortly after fighting fires.

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West Coast people, as casual and careless as they may seem to some East Coasters, have some tips to deal with smoke. During the worst of it here New Yorkers were wandering the streets, mostly maskless, sitting outside in the smoke. First things first: inside is better than outside.

The EPA recommends making a “clean room” by closing the windows and doors. Pro tip: you can use towels to block drafty windows. Central or window air conditioning can be helpful only if you’ve double checked that it won’t pull in air from outside; portable A/C with a hose should not be used. If you want extra credit, build a Corsi-Rosenthal box with a box fan and furnace filters.

In terms of masks, the EPA recommends N95s. (The stores I frequent in Upper Manhattan never carry these masks, much to my annoyance.) Public health guidance to reduce activity is crucial — which means closing things which can be closed. Officials must be ready to close non-essential businesses, distribute masks, and help get unhoused people inside.

Of course, where there is smoke, there is fire. In New York City, that’s hard to picture. Last summer, while I was visiting central Washington, the White River fire erupted on a nearby hillside. The sight of uncontrolled burning was breathtaking. At night, the flames danced brilliantly orange on the horizon.

Hundreds of highly trained firefighters arrived in a field and got to work fighting the fire. I got curious and entered the “fire city.” Talking to the firefighters, I learned about the intricacies of fire science, controlled burns, and brush management. It taught me an important lesson: any time I’m bothered by smoke, there are people risking their lives to stop the burn. Their weapons are science and teamwork and experience. In the fight for clean air, we need the same.

When smoke comes again, we need to be ready: with clear, rapid public health messaging, masks, and public indoor spaces.

Cunningham is an M.D.-Ph.D. student at Columbia University.