>> Welcome to "MetroFocus" I'm -- Donald trump was indicted making him the first former President in U.S. history to face federal charges.

He's been charged with seven counts related to his mishandling of classified documents including willfully retaining state secrets in violation of the espionage act.

We'll be bringing you more on this story next week as it unfolds.

But tonight, our coverage continues on the biggest story impacting New Yorkers from this past week, the smoke that engulfed our city and turned our blue sky into an apocalyptic shade of orange.

Though the air quality is improving, questions remain about the long-term impact on lunes of smoke-filled air, what is the real impact on our bodies when we breathe in this smoke and what is the city and state doing to protect people from conditions like these and the inevitable future watt strosk weather events climate change will cause.

Here to answer those questions and more, as part of our peril and promise special reporting is Dr.

Flood.

He's a professor of population health signtieses -- scientists and director of the Coronel center for pandemic response.

Dr. Verma welcome to "MetroFocus."

>> Thank you for having me.

>> Yeah, let's just start with our lungs.

I feel like the past three years with the pandemic and then adding on this recent event, our lungs have been through quite a lot.

What is understood about breathing in this kind of toxic air?

>> It's a really great analogy you drew there between the breathing in of pathogens, viruses and bacteria, and now breathing in pollutants, things that come as a result of the wildfire smoke and obviously industrial pollution.

There's a lot of stuff that we know and there's a lot of stuff we don't know.

Let's focus on what we know.

What we know is that this type of air has a really complex mix of all different types of particles.

We don't actually what each of those particles do but we know one particular type, those that are the smallest, if you read about it they'll call it ph-2.5, particulate matter that's very, very small.

That we know from a lot of research in laboratories and looking at large populations is very dangerous to humans.

Basically you breathe it in through your nose and mouth.

It go into your lungs.

Then it goes from your lung into your airways.

Long-term exposure to this has been documented to be a cause of heart attacks, of strokes, and in some estimates around the world it's estimated to cause 10% to 15% of heart attacks are attributable to this type of air pollution.

Long-term exposure is what we're most worried about here.

>> I don't want to be alarmist in any way but this almost sounds a little bit like what we came to understand after the air pollutants in the air after 9/11.

It took several years to see the full effect of the impact because, again, those tiny particles, people were breathing those in and getting just horrifically sick and in some cases losing their lives.

I'm not saying that's what you're predicting for this situation, but is there something similar we can understand where the full understanding won't be maybe for a few years?

>> You're absolutely correct that there is a lot that we don't know.

Now of course, I spent a lot of my time working overseas.

I spent three years living in Beijing from 2008 to 2011, where the air quality, frankly, was very similar to what it has been in New York the past few days.

We know that people can live in this air.

But we also know that there are these longer term side effects and short-term side effects of difficulty breathe, eye and nose irritation.

But as you note there may be other risks as well too this is incredibly hard for scientists to actually tease apart.

You can do studies, for example, in the lab with animal models, but humans, if you think about it, we're breathing every moment of our lives, right?

And what you're breathing varies a lot depending on where you are.

It's hard for us to design studies because you don't really know what any individual is breathing at any given moment.

You can't randomize people to different groups like we do for, say, a drug trial or vaccine.

>> There was a lot of talk especially during the height of the smoky air, that was about people who were at high risk or people who were at risk in thesr importance of them to stay out of the, you know, open air.

Can you tell us more about who is at risk?

>> So we know that in the short term, that means like from the days you're breathing this, what happens to you, that anybody who has any type of underlying lung problem or heart problem, you know, those are two things that make it difficult to breathe, is going to be at a higher risk of having some type of complications.

Let's make that pretty straightforward.

Let's say you have a child with asthma or you're an adult with obstructive lung disease, we call it copd.

This is going to make it harder.

You're going to most likely have an increase in your cough.

Maybe an increase in your wheezing you might have a lot of difficulty breathing.

So what we worry about as physicians is people running out of their medications or even worse having so much difficulty breathing that they, you know, go to the hospital.

And I was just looking before we did this interview at the data from the health department.

They released E.R.

visit data, usually comes about 24 to 48 hours after it happen.

Sure enough, the peak day for asthma visits in 2023 was on Wednesday.

We don't have the data yet for Thursday or Friday, but from two days ago that's the peak.

That's the group we worry about.

Of course there are other people that may be at risk too.

Women who are pregnant.

You know, they often have difficulty breathing as a result of complex body changes.

This can make their breathing worse.

So the real advice out there is to make sure that if you fall into one of these groups or quite frankly, anybody, you may not know you have some underlying susceptibility.

Really wear one of those high quality masks any time you're breathing air outdoors.

It's meant to fit they are type of pollution like it's meant to filter small viruses and bacteria.

>> So that brings me to my other question.

I know that, you know, people were talking about masking up again, the city was giving out n-95 masks.

Should we consider masks, perhaps, to be an ongoing, maybe not every day, but an ongoing part of our future?

>> You know, again, I lived in Asia for -- in Beijing for three years and before that five years in Bangkok.

These are places that, number one, they have a long-standing problem with air pollution.

And number two, they been through bird flu outbreak, the first Sars outbreak, the COVID outbreak.

In a lot of those places it's common for people to wear masks.

Many of my colleagues did on a regular basis.

When there's an air quality event, whether it's due to an infection or pollution.

soy do think it's part of the sort of arsenal, you know that people need to have.

You move to a cold weather climate, you buy hats and gloves.

Move to an area that's going to be more polluted, think about having a mask available.

That doesn't mean we want to see people wearing masks all the time.

We're all humans.

We respond to facial cues.

These are important.

But it's something that people need to be not partisan or political about.

It's a basic safety measure you may need to use, whether it's during a surge of respiratory viruses or a surge related to pollution.

>> It's interesting that you bring up partisan or political because unfortunately, mask wearing during the pandemic became partisan, became very political.

And I'm wondering is there anything that, you know, government institutions can do to help mitigate, I guess, the long-term damage of, you know, dangerous air.

Dangerous water.

Things like that.

When there has been -- there is such a growing skepticism about some of the institutions that used to be trusted.

>> You make an excellent point about changing human behavior.

When those messages will largely come from government and there's a gap in how people trust their government officials.

So you know, in addition to all the things that we know that need to be done related to climate change, preventing these types of fires in the first place, the one area that's been underinvested in by governments and shouldn't be considered partisan is improving indoor air quality.

What I mean by that is, during COVID, I hope some people recognized the fact that, you know, one of the interventions that governments wanted to get people to do was to use indoor air pure fiers.

Either a filter in your central heating ventilation system or one of those standing room devices.

Of course the only people that can afford to do that are people with the money or institutions that have the ability to invest in it.

So really what this comes down to, like a lot of interventions is regulation.

Government putting out and enforcing standards on indoor air.

One of the great things that this, you know, that this White House and administration did in the past year was pull together a summit, there's now very clear guidance from C.D.C.

and from the E.P.A.

about how to improve indoor air.

That means getting these filters installed.

Getting air purifiers.

Starting with public spaces that government can do and moving on to commercial and residential.

That's snag, it's like clean water, right?

We don't have to fight about filtering the water because lock ago governments recognized that everybody deserves clean water now is the time for to us recognize that everybody deserves clean air, it doesn't matter whether you're a republican or Democrat or whether you believe in it or not, your air will be clean because it's there already.

That's the way it should be.

>> You know, you sort of mentioned, talked about how this kind of air quality issue happens all over the place and for people who are on social media, at least, during the height of the smoke coming over the metropolitan area, might have seen a lot of advice from people on the west coast who deal with this constantly trying to give advice about how to mitigate these problems, how to keep yourself safe.

Is there anything that we can learn from what states like, you know, California, Washington, Oregon, how they have dealt with these issues?

>> Yeah, absolutely.

I have many friends and family on the west coast that have been enduring this for many years.

I think that there's a couple of things.

The first is early warning systems.

Right?

There's been some criticism in the media about how the governor, the mayor should have responded.

My perspective on it is, you know, look.

The most important thing is to be forward-looking.

I think what we need is similar to the way in which, you know, New Yorkers are notified routinely about coastal storm, as they're emerging, in the Atlantic or in the south, you know, we stay on the ready like, maybe five or six days if now there may be a big storm.

We need to be thinking about how to do that with air quality.

I hope that at the state and city level they're thinking about how to help prepare the public nor.

Because you can't just suddenly say everyone wear masks today.

People need to stock up and have them available or if they happen to have air filters, knowing they can do that.

Number one Zehrly warning.

Number two is, I think there has to be thought about what to do for those people in the city and there's a whole lot of them in this city as we know who will not have access to clean air.

That particularly includes people who are unhoused, right.

So just like the city sets up cooling cents for the heat emergencies, it should invest in building the air fire case systems to also make those clean air facilities as well.

It's not that difficult to engineer a system where you put in these air filters on top of your air-conditioning to filter it out.

I think those are two types of very straightforward interventions thing, you know, city and state government can do to help prepare us for a future in which these events are unfortunately going to be more likely than no.

>> All right, doctor, I want to thank you so much for taking time to help give us some deeper understanding and perhaps assuage some fears.

Thank you for joining us on "MetroFocus."

>> Thank you for having me.

>> Absolutely.