The Salvation Army provided meals and care to survivors of the Maui and Kula wildfires. A report by the University of Hawaiʻi Economic Research Organization updates the health and social recovery of 2,000 wildfire-impacted adults and children. PC: The Salvation Army (8.10.23)

Nearly two years after the devastating Maui wildfires, survivors of the disaster are showing encouraging signs of recovery, although problems with healthcare access, children’s mental health and housing instability persist, according to a report by the University of Hawaiʻi Economic Research Organization.

The results come from the latest update of the Maui Wildfire Exposure Study, which surveyed 2,000 wildfire-affected adults and children since the Aug. 8, 2023, wildfires that displaced thousands of residents and killed at least 102.

Encouraging trends:

Improving adult health: Reports of worsened health and symptoms of depression among adults are beginning to decrease, suggesting emotional healing is underway.

Reports of worsened health and symptoms of depression among adults are beginning to decrease, suggesting emotional healing is underway. Strong community support: Three out of five participants report dependable support from family or neighbors.

Three out of five participants report dependable support from family or neighbors. Job market recovery: More than half of those who lost their jobs due to the fires have successfully returned to work.

Persistent challenges:

Healthcare access: A significant barrier remains, with 1 in 3 residents reporting difficulty accessing medical care.

A significant barrier remains, with 1 in 3 residents reporting difficulty accessing medical care. Housing and food instability: Nearly half of the affected population continues to reside in temporary housing; food insecurity is a common concern.

Nearly half of the affected population continues to reside in temporary housing; food insecurity is a common concern. Children’s mental health: While most children appear physically healthy, early indicators of mental health strain are surfacing, underscoring the need for continued support.

Findings for adults

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Data collected through January of this year from 1,800 adult wildfire survivors shows “the long arc of recovery,” the UHERO report says.

Overall, 41% of adults report declining health compared with the previous year, with half showing depressive symptoms, 26% moderate-to-severe anxiety, and 4.2% suicidal thoughts in the past month.

Physically, 74% have elevated or hypertensive blood pressure, and more than a quarter present symptoms of reduced lung function.

Access to healthcare continues as a “persistent barrier,” according to the report. About a third of participants say they’ve had difficulty scheduling appointments or getting prescriptions, especially for chronic respiratory conditions.

“The social recovery is equally uneven,” the report says. About 41% of adults remain in temporary housing, and 25% are still unemployed but looking for employment.

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“Despite these struggles, 61% report high levels of support from family and friends – demonstrating the continued strength of community bonds.”

Children resilient, but ‘red flags’ about emotional well-being

For children impacted by the disaster, the study shows signs of physical healing, “but their emotional well-being raises serious red flags.”

Fifty-one percent of children, ages 10 to 17, have screened positive for depression, with 22% in the severe range. Nearly a third report anxiety, and almost 45% show signs of post traumatic stress disorder – 4.3% at severe levels.

“One in four report low self-esteem, and many are experiencing functional challenges at school and home.”

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The UHERO report says there’s a “growing concern” with cardiopulmonary health. One in three children tested showed elevated or high blood pressure, with Filipino youth most affected, with 15.2% categorized as having Stage 2 hypertension. Nearly 20% of children have impaired breathing capacity, especially among Asian and Filipino children. Girls have slightly more severe lung issues.

“These findings point to the need for sustained investment in pediatric care, trauma-informed school services, clean indoor air, and culturally tailored health programs,” the report says. “Without early intervention, these risks could become lifelong health burdens.”

One-year follow-up

One-year follow-up data is available for 424 participants.

“Within this group, we are beginning to see meaningful signs of recovery,” the report says.

These signs include: reports of worsening health dropping from 48% in year one to 36% in year two; suicidal thoughts dropping by almost half; and significant falling rates of severe depression and anxiety.

“These improvements suggest that emotional healing is underway for many,” UHERO reports. “At the same time, PTSD remains widespread, affecting nearly one in three participants. Physical health indicators – such as lung function – have worsened for many, pointing to gaps in long-term care.”

However, access to health insurance has improved dramatically, with the uninsured rate cut by 4% because of outreach efforts and programs such as Kaiser Permanente’s Health Access Program.

“Still, many residents – especially in rural areas – struggle to get the chronic and respiratory care they need.”

The big picture

The report concludes that: “The data suggest that while the road to full recovery remains long, meaningful progress is underway. Strategies such as outreach- driven health insurance enrollment, trusted community partnerships, and culturally rooted social support have helped many residents regain stability. At the same time, long-term challenges like chronic physical health conditions and trauma recovery as well as permanent housing needs require renewed investment and attention.”

Story at a Glance

One of the least appreciated consequences of wildfires is their impact on human health. However, particulate matter exposure has been repeatedly linked to cardiovascular disease, lung disease and dementia.

Following the Maui fires, a large study showed many Lahaina residents developed a wide range of chronic physical and psychiatric complications.

Likewise, after many wildfires, sensitive patients (e.g., those with chronic inflammatory disorders) had significant exacerbations of their pre-existing diseases.

The lungs utilize a lining of glutathione to protect themselves from particulate matter. As such, replenishing that lining with nebulized glutathione is one of the most effective treatments for wildfire illness.

Chronic Obstructive Pulmonary Disease for decades has remained one of the top causes of death. Since COPD typically arises from cigarette particulate exposure damaging the lining of the lungs, nebulized glutathione provides a safe and affordable life-changing treatment for this condition.

This article will review the science of particulate illness (e.g., COPD) and discuss some of the most effective treatments we’ve found to treat it.

California just experienced a devastating set of wildfires that is on its way to becoming the costliest disaster in US history. As such, a significant national focus has been directed to the series of reprehensible errors and policies that gave rise to the disaster.

However, while a significant focus has gone into the political failings that led to these fires and their immense costs, very little attention has been given to another critical facet of the disaster—the health impacts of this disaster, which are particularly important to understand as more and more of these devastating wildfires are happening (e.g., consider the current fires in South Carolina).

Note: as I show here, many of those “mistakes” in California are remarkably similar to what caused the devastating Lahaina fire. For example, in both Maui and Los Angeles, numerous close calls led to residents in each area asking for the same infrastructure repairs, but in both cases, those requests were repeatedly ignored, and had they not been, the disaster would have never happened. Likewise, in the aftermath, the local governments have blocked the reconstruction efforts (which has been even more devastating for those who lost their homes).

Wildfire Toxicity

Whenever a wildfire (or another event that releases a significant amount of aerial toxicity, such as the Twin Towers collapsing on 9/11) occurs, we regularly see a significant number of people develop long-term illnesses from inhaling that smoke. Furthermore, individuals who already have sensitivities (e.g., from chronic inflammatory diseases) tend to become significantly worse after these events happen.

Because of this, I typically advise doing one or more of the following:

•Leave the area until the fire is over.

•Try to stay inside.

•Wear an N-95 mask or respirator while outside.

•Consider getting a filter for your house (e.g., a decent HEPA filter) that can filter out the smoke particles.

Note: in the days after 9/11, first responders were deceptively told the air was “safe.” Many who breathed it became severely ill (e.g., over 63,500 registered a 9/11 illness, roughly 10,000 developed cancer and over 2,000 died), and are still struggling to get medical or financial support over 20 years later.1,2,3,

Sensitive Patients

One of the biggest problems of our current age (and RFK Jr.’s reason for running for president) has been an “unexplained” explosion of chronic illness—particularly autoimmune, psychiatric, and neurological disorders (e.g., over half of Americans now have a chronic illness). However, because these illnesses have primarily resulted from modern technologies that diminish human vitality, there has been immense resistance to acknowledging them (as doing so would threaten all of the markets for those technologies).

Since individual susceptibility to an environmental toxin varies greatly, the most sensitive members of society tend to be the ones who initially develop these illnesses (and are the ones who suffer the most severe injuries from toxic pharmaceuticals).

As such, there is a large portion of “sensitive” patients (discussed here) living with debilitating chronic inflammatory illnesses (e.g., mold toxicity, Lyme disease, fibromyalgia, and chronic fatigue) who are misunderstood and largely neglected by the medical system. In turn, many of us believe this neglect to be incredibly shortsighted as they represent the “canaries in the coal mine” who can warn us about the grave dangers of our modern environment and provide pivotal insights on how to treat these challenging diseases (e.g., the lessons I learned from them were directly applicable to COVID-19 vaccine injuries).

Note: the two best frameworks I have found to account for the myriad of challenging symptoms these patients face are an unresolved “cell danger response” and fluid obstructions throughout the body (e.g., blood clots) triggered by an impaired physiologic zeta potential—both of which amongst other things can be caused by vaccination.

From these patients, we’ve learned chronic inflammatory illnesses often develop or dramatically worsen once a person surpasses their toxicity threshold (which is often caused by factors like impaired circulation or detoxification), and once this threshold is crossed, it becomes much harder to reverse the damage. Wildfire smoke, for example, exacerbates existing circulatory disorders and inflammatory conditions, often triggering flare-ups and periods of prolonged debility for sensitive patients with these illnesses, but also can be “the straw that broke the camel’s back” and trigger these illnesses.

Note: This entire situation is analogous to one of the most common side effects of the COVID-19 vaccines: either a new autoimmune disorder or a worsening of a pre-existing condition. To illustrate—an Israeli study found that 24.2% of those receiving a booster developed an exacerbation of a pre-existing autoimmune condition.

Wildfire Illness

From working with patients who were adversely affected by wildfires, we’ve seen that:

•Early treatment and avoiding smoke exposure can reduce long-term health impacts (especially for those who are already on the verge of a chronic illness).

•In younger individuals, wildfire smoke exposure will cause respiratory conditions like asthma or COPD to worsen (or onset if they were already on their way to developing them).

For older patients, the most significant issues were cognitive issues (e.g., my colleague had numerous patients receiving long-term treatment for their cognition who became significantly worse after the systemic inflammation triggered by the wildfires). Heart attacks and strokes could also occur in those predisposed to them.

Note: there is quite a bit of research showing particulate exposure (e.g., from pollution) causes cognitive impairment in all ages and accelerates the progression toward Alzheimer’s.1,2,3,4

The Consequences of a Wildfire

After the deeply traumatic Lahaina fire occurred in 2023, Hawaii decided to comprehensively study the health effects on the survivors (which is fairly unusual). This unique dataset, in turn, provides some helpful insights into what those in Los Angeles may experience in the coming years.

That study found that six months after the fires:

•Only 24% of the participants remain in their pre-wildfire homes, 65%, are in temporary homes (e.g., hotels), and 11% have moved to new permanent homes.

•58% lost their jobs, 24% are still jobless and searching, and 74% reported a drop in their household income. Additionally, 35% of households reported difficulties having enough food for the family (compared to a baseline of 20.5-23.7%).

•49% said their health is now worse than it was prior to the wildfires, 24% reported that they do not have steady access to medical care, and 13% reported not having health insurance (compared to 1.7% of Maui residents being uninsured in 2022).

•Over 20% had elevated blood pressure, 8-18% of participants had blood work indicating compromised kidney function, and up to 74% of participants had signs of poor respiratory health (49% exhibited signs of mild to severe lung obstruction, and 33% had compromised lung function linked to impaired tissue oxygenation).

Note: lung injuries often follow wildfire smoke exposure, but this is the first time I’ve seen the extent of this problem quantified. Presently, I believe many of those issues result from the positively charged smoke particulates destroying the glutathione lining of the lungs, injuring the endothelium and impairing the physiologic zeta potential.

•55% reported depressive symptoms (compared to a baseline of 33%), with the rates increasing with age (e.g., depression was reported by 75% of those between 50-59 years old). Additionally, 34.6% reported low self-esteem (compared to a 13-14% baseline), and 1.3% reported suicidal thoughts compared to a 0.8% baseline). Finally, the majority of respondents reported anxiety, but no comparative baseline was provided.

•The participants reported that they found community aid organizations to be more helpful than FEMA, state aid agencies, or county aid agencies.

In the University of Hawaii’s most recent data release, they found that the majority of the fire survivors were still experiencing significant symptoms (associated with wildfire smoke exposure) at least once a month and that the majority (60.4%) had not received medical attention for their symptoms.

Note: a few months later (in a subsequent update of the report) the physical health outcomes stayed the same, but the mental ones worsened (e.g., 30% of participants reported symptoms of moderate or severe anxiety, and 4.4% had suicidal thoughts). Likewise, years after, many are still struggling with finding housing (with many families simply leaving Hawaii).

Why Do Wildfires Make People Sick?

In addition to the immense stress created by having your home burn down, there are three models that explain why the smoke from wildfires makes patients ill.

The Kendrick Model:

Dr. Malcolm Kendrick has made a convincing argument that heart disease arises from inflammatory or mechanical damage to the protective lining of the blood vessels. This is because blood clots form to patch that damage, and over time, those clots transform into the atherosclerotic plaques classically associated with heart disease.

In the case of wildfires (and the particulates they release):

The Klinghardt Model:

Chronic illnesses often result from a mix of factors, including heavy metals, infections, and environmental stressors.

Dietrich Klinghardt has proposed that wildfires release heavy metals stored in trees (which are then inhaled), contributing to increased toxicity in already vulnerable individuals.

Research confirms that wildfires release mercury and other toxins, adding to environmental stress, particularly in areas with past mining and during the hottest wildfires.

Many toxic materials are released from combusted buildings (including now banned building materials like lead paint and asbestos, both of which cause significant health issues when inhaled).

Negative Ions and Zeta Potential:

Zeta potential, the electrical charge influencing blood flow (discussed here),when negative, plays a pivotal role in sustaining health. Conversely, positive ions, including those from vaccines, pollution, and wildfire smoke, impair it, worsening illness.

Negative ions, however, enhance zeta potential, improving health and helping with conditions like breathing and burns.

Chronic inflammatory conditions (e.g., those seen in complex patients) make individuals more susceptible to the effects of positive ions (e.g., from wildfire exposure).

Both tobacco smoke and positive ions slow the movement of the cilia (tiny beating hairlike structures), which the respiratory tract uses to clear particulate matter from it, while negative ions increase that movement. In small animals, providing negative ions was found to counteract the effects of tobacco smoke, while providing positive ions concurrently was found to slow cilia movement 3 to 10 times as much as tobacco smoke alone.

Treating Wildfire Injuries

There are a few approaches I and colleagues have observed to help wildfire injuries (the most important of which is to reduce your exposure to wildfire smoke as soon as possible). Some of the most helpful treatments for existing injuries we have found include:

•Utilize treatments that restore the physiologic zeta potential of the body.

Note: one aspect of restoring zeta potential is drinking deionized water (which also tends to be the most purified water available), and having a sufficient amount of that water is particularly important when addressing wildfire injuries.

•Intravenous Vitamin C (when administered early, it greatly helps with wildfire-induced inflammation).

•Treatments directed at treating the underlying chronic inflammation in the patient (e.g., what existed before the wildfire smoke exposure).

•Nebulized Glutathione.

•DMSO, as DMSO heals a variety of challenging lung disorders, it treats allergic lung conditions (e.g., asthma), improves circulation throughout the body (e.g., DMSO is very helpful for strokes) and effectively heals burn injuries. For example, after sheep experienced a lung injury from inhaling smoke, nebulized DMSO with heparin was found to significantly reduce lung damage to their lungs.

Note: that broad swathe of uses highlights DMSO’s wide range of therapeutic properties (e.g., it is best known for its remarkable ability to treat chronic pain, arthritis and musculoskeletal injuries).

Pulmonary Glutathione

Glutathione, a powerful antioxidant, is one of the primary mechanisms the body uses to protect itself from toxins (e.g., heavy metals and free radicals) and is a commonly used therapeutic within integrative medicine for a variety of illnesses.

The lungs, in turn, depend upon glutathione to protect themselves from damage (along with maintaining the survival of the lung cells), and thus concentrate glutathione at the interface where oxygen in the airway enters the circulation. This protective layer in turn, is consumed by injurious substances (e.g., cigarette smoke), and once it is depleted, future smoke exposures will significantly damage the lung tissue. As such, in chronic lung diseases, glutathione’s presence within the lung is diminished.

Because of this, nebulized glutathione (which gets glutathione directly to that critical interface within the lungs) is one of the most useful therapies we have identified for treating wildfire injuries.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is typically caused by particulate damage to the lungs (e.g., from smoking), and as such, nebulized glutathione (which protects the lungs) is also very helpful for COPD (e.g., see this study and this study). Typically, we find it only halts the progression of the disease (presumably because it prevents more otherwise exposed lung tissue from being damaged by particulate matter). However, in some cases, it can create dramatic results (e.g., when used for a COPD exacerbation).

This is extremely consequential as none of the existing pharmaceutical therapies for COPD (all of which have side effects) can halt its awful progression.

Note: the lack of awareness of using nebulized glutathione to treat COPD is both extraordinary and predictable as chronic diseases of the respiratory tract are the fourth most common cause of death in the United States, which makes them a vital monopoly to maintain (e.g, in the United States alone, 24 billion dollars was spent on COPD in 2023).

Sourcing Nebulized Glutathione and DMSO

When I first started this publication, I made a decision to avoid promoting specific supplements as I felt for the mission I’d set out to do (bringing forth useful information that could directly help many) should not be obscured by any potential conflicts of interest. Once I realized I needed to provide a few (as otherwise it would not be feasible for many to implement the suggestions I’d provided), I ran into a new issue—I would frequently create supply shortages of the supplement and hence make it impossible for many of those here to obtain it (e.g., despite my best efforts to avoid it, I recently caused a nationwide supply shortage of DMSO).

Note: in many ways, this is analogous to the “breaking points” that occur in natural disasters, as much in the same way those systems (e.g., hospitals) are not designed to handle a much higher load and hence fail under stress. A small market exists for many of the forgotten therapies I use, so currently, they can’t be rapidly scaled up to meet a surge in demand.

Because of this, my current approach is to initially restrict who those product recommendations go to, both so that the initial group can get them without everything being out of stock (and hence be able to collect the initial data on their efficacy that can be used by the rest of the community here), but also so that the suppliers, seeing the increased demand, have time to ramp up their production of the supplement.

In the final part of this article, I will review the exiting options for sourcing nebulized glutathione (both for clinicians and those without medical licenses) and its dosing, the same for DMSO (where to obtain it, common protocols for standard uses, and how its used to treat lung conditions such as via nebulization) along with a few other options for treating wildfire illnesses.

Female and gender-diverse teenagers are more likely to experience worsening mental health during high school than their male classmates.

A study of more than 6600 Australian teenagers tracked high school students from years 7 to 10, allowing researchers to study how mental health symptoms developed over time.

The findings suggest mental health symptoms are “alarmingly common” and increase as teenagers grow.

Nearly three in 10 teens had probable major depression, almost one in four reported high mental distress and nearly one in four had moderate-to-severe anxiety symptoms by year 10.

“While our sample wasn’t representative, it provides further evidence that current generations of teenagers are suffering more than those before them,” lead author Scarlett Smout said.

The findings suggest mental health symptoms are “alarmingly common” among teenagers. (Dean Lewins/AAP PHOTOS)

Females and gender-diverse teens experienced greater symptoms of distress, anxiety and depression, compared with males.

This was especially the case for those from less affluent backgrounds.

Experts say more research is needed to understand what was driving poor mental health among Australian teens as well as investment in prevention and support programs.

“Adolescent mental health is a hugely concerning and growing public health issue,” Public Health Association of Australia chief executive Terry Slevin said.

“The teenage years are a foundational time in our children’s lives, setting up their mental wellbeing for the future.

“This study shows that mental health symptoms in our younger generation are disturbingly common, deteriorate over time and are affecting some of the more vulnerable segments of our community.”

Lifeline 13 11 14

Kids Helpline 1800 55 1800 (for people aged 5 to 25)

If you’re wondering what’s next for a region ravaged by wildfires, consider this possible future:

Much of Los Angeles County and surrounding areas is about to need therapy. If not immediately, then soon. And possibly for years.

Mental health woes – in the form of everything from anxiety and depression to unexplained rage and suicide – could plague the city long after the current disaster fades from the news. Post-disaster Los Angeles might even appear as if it’s stuck in the COVID era, with a small but noticeable slice of the population battling a persistent and sometimes deadly disease.

Those are informed predictions from people working in a relatively new, self-explanatory field of psychology known as collective trauma.

Experts in collective trauma describe the Palisades and Eaton fires as a combined “instigating event.” By that, they mean the fires, collectively, are a potential super spreader of mental suffering, not unlike other community-wide disasters such as the 9/11 terror attacks, Hurricane Katrina and the Las Vegas mass shooting.

Nobody can say exactly how many people will be affected, only that most people will not suffer to the point that they need help. “Collective” doesn’t mean everyone. But experts do say at least some fraction of Los Angeles County’s 9.7 million residents – meaning tens of thousands of people when you include some in neighboring counties – will experience mental health challenges powerful enough to require psychological or psychiatric treatment.

Experts also can’t say for sure who those people will be. They only can say with certainty that children are more likely than adults to suffer short-term woes (though kids also are more likely to bounce back quickly), and that struggling with mental health after an event that has (so far) killed 27 people and wiped out or damaged an estimated 12,000 structures isn’t a character flaw.

“The need for help is going to be immense. And it could apply to anybody. It’s not about strength or intelligence or anything like that,” said Charles Figley, a professor of psychology at Tulane University who has studied how people fared, mentally and emotionally, in the wake of events such as Hurricane Katrina and the Gulf War, among others.

Academics, of course, aren’t alone in predicting this.

This week, the state started running public service ads urging fire victims who are feeling anxious or uncontrolled grief to call CalHOPE, a phone resource that’s typically aimed at helping young people who are struggling with mental health challenges. The Los Angeles County Department of Mental Health has field counselors in some disaster recovery centers, helping people sort through issues as diverse as nightmares and nausea that might be a short-term result of fire-related stress. And the Substance Abuse Mental Health Services Administration has set up a hotline for people who, pre-fire, were struggling with addiction or mental health issues.

Several nonprofits also are gearing up to offer mental health help. The Red Cross has a hotline for people experiencing fire-related stress. And OurHouse, a grief support group in Woodland Hills, has published a resource page for people struggling to cope with the fires. Last week, the same group also launched a series of Zoom events in which people can share tips about issues such as talking about the disaster with kids and sharing their grief, and a page of 500 mental health counselors who are offering free services.

That level of outreach isn’t overkill. In fact, trauma experts say the surge of people seeking care now could be the tip of a much bigger iceberg. The mental health aftermath of the fires is something that could take several months, or even years, to fully play out.

“Based on what we’ve seen after Katrina, and what I’ve learned by studying other events, and the war, I think your fires are going to strain (mental health) resources and surprise a lot of people,” Figley said.

Long trauma

People who study collective trauma don’t always agree on every detail about what it means. And research into how disaster-hit communities fare, collectively, over time, is limited to a few huge events that have happened in this century, when the concept began to be widely studied.

But most experts agree on a couple basic points.

First, the emotional toll of the fires will extend far beyond the subset of people who lost loved ones or friends or pets or homes. So-called second-level victims – evacuees, witnesses, people who didn’t lose homes and are feeling survivor’s guilt; even news consumers – also can be affected in some way.

Second, experts say the emotional and mental problems that emerge in the wake of disaster could be as life-altering as any other type of trauma that might befall an individual or a family.

“A substantial minority of people will experience acute mental health problems,” said Dana Rose Garfin, an associate professor who works at UCLA’s Center for Public Health & Disasters.

“The severity of those problems isn’t always connected to the extent of their individual loss as it relates to the event,” she added. “And while it’s common to experience problems in the immediate aftermath, problems that for most people will abate over time, it’s also not uncommon to experience problems for a while afterward, or for issues to emerge much later.”

That idea is echoed in some of the research about survivors of other recent disasters.

In 2019, psychologists from MIT, Harvard, Yale and the University of Massachusetts published a study looking at the mental health journeys of some survivors of Hurricane Katrina, which in 2005 killed 1,392 people, displaced about 650,000 others and destroyed or damaged an estimated 217,000 dwellings.

Twelve years after the floods, the researchers found that 1 in 6 of the Katrina survivors they studied were still suffering at least some symptoms of post-traumatic stress. Many others reported feelings of anxiety and depression, and some reported suicidal thoughts and suicide attempts.

And while many of the Katrina victims who suffered the longest were people who already faced economic stress and racial discrimination prior to the storm, researchers wrote that those issues weren’t as important as the disaster itself. “Exposure to traumatic events is a primary predictor of adverse mental health more than a decade post-disaster.”

Other studies suggest all of us – at least those of us who lived in this country during the pandemic, which killed about 1 million Americans – also have recently battled collective trauma.

A 2023 survey by the American Psychological Association, which asked 3,185 adults around the country about specific physical and mental health issues before and after the pandemic, found long-term increases in chronic physical ailments and mental illness two years after daily COVID-19 death counts were high. Younger adults (ages 35 to 44) and women saw the biggest changes, and nearly a third of American adults of all backgrounds said the pandemic left them so stressed that they don’t plan for the future.

The survey also found that a majority of respondents (61%) believe others expect them to “just get over it.”

The researchers behind the survey concluded that “coping with long-term stress requires a different set of skills than adjusting to temporary stressors.”

All of that could matter in post-disaster Los Angeles. Experts believe exposure to previous traumas – everything from being a victim of assault or spousal abuse, or being raised by adults who struggled with addiction – could make fire survivors more vulnerable to mental health problems.

Though Garfin was quick to note that it’s unclear how that might play out, she believes the fires could be part of a “cascading” series of incidents that, combined, could worsen some survivors’ long-term mental health.

“We are living in an era of compounding, cascading stressors. The amount and frequency of such issues, in this media environment, I absolutely think it adds to the problem,” she said.

“The fires just add to all that.”

News hurts

Another factor is news. How people get information about the fires – whether it is fact-based or rumor-based – could affect their long-term mental health.

After the 2013 Boston Marathon bombing, Garfin said, studies found a link between mental health problems and consumption of news. Generally speaking, reading or watching more news led to more problems.

But Garfin said there were – and probably are – stark differences based on what kinds of news stories people consumed.

Facts, she said, typically give disaster survivors some answers, which reduces uncertainty and eases stress. Fact-based stories also often offer ways for people to help others who’ve been directly affected by the underlying event, actions that can stave off mental health problems by reminding individuals they’re not powerless in the face of disaster.

Rumors and opinions, however, tend to do the opposite. They add to uncertainty and inflame two emotions – anger and fear – that can serve as fuel to long-term mental health woes.

Though the lines blur, legacy media tends to strive for fact-based news, while social media tends to put a news label on rumor or opinion.

In 2013, following the bombing in Boston, the media landscape included a lot of social media but was still dominated by legacy news sources. The 2025 news landscape, in Los Angeles, is different, with a lot more people are getting information from social feeds along with local television and legacy news.

That dynamic could make Los Angeles fire survivors more vulnerable to mental health problems in the future.

“What I’ve seen with the fires, is there has been a lot of really angry, defamatory stuff on social media,” Garfin said.

“If people don’t know what to believe, or what’s even true, that’s not healthy,” she added.

And what’s even mildly unhealthy for adults can be toxic for children.

Kids tend to use imagination to process news. That’s true when they’re taking in news about a new video game and it’s true when they’re watching or reading news about a disaster, like the fires. In both cases, kids’ imaginations will enhance whatever they might expect to get – joy or fear – from the issue in question.

In disasters, that can turn news into poison.

A 2006 study by community trauma researchers from Boston University that looked at how kids fared emotionally in the wake of 9/11 found a strong link between media consumption and future mental health problems. Though they looked at a variety of issues, including the mental health of parents prior to 9/11, the authors offered a bottom-line assessment about disaster news and kids:

“For younger children, the amount of television viewing predicted increased risk of PTSD symptoms.”

Nearly a generation later, a lot of local parents seem to have heard – or lived through – that message.

“We’re keeping our kids on a strict screen diet right now. And if I see fire news on their phone or tablets it gets taken away,” said Alyson Neagle, a mother who had to evacuate with her two girls, ages 11 and 9, from an apartment near the Eaton fire.

“But they know what’s going on,” she added. “And they even know that they probably don’t want to watch the news. I don’t think they’re eager to see that stuff.”

Club Fire?

Neagle, who is staying with friends until she and the girls can return to their apartment in South Pasadena, believes the fires still burning in Los Angeles eventually could spur something different than widespread mental illness – a sense of community.

The 38-year-old said she grew up in Delaware and moved to New York City in 2011, after she graduated from college. At that time, she said, long-time New Yorkers tended to bond – not fret – when they talked about the 9/11 terror attacks.

“It was like a club,” she said.

Tulane professor Figley said Katrina spurred something similar in New Orleans.

“The phrase is, ‘How’d you fare?’ Everybody asks it. And it means ‘tell me your story,’” Figley said.

“People in New Orleans are healthier, mentally, because of Katrina. Or if not healthier, they’re more bonded with each other.

“I’m not saying that’s how it will be in Los Angeles. Who knows?” he added. “But it’s possible.”

After a week and a half of unimaginable destruction , Los Angeles is at last beginning to look toward its recovery from the Palisades and Eaton fires. Traversing that stage will take years, not only because of the significant economic and political implications of the fires, but also because of what they will mean for the health and well-being of the thousands of residents who live in or near the burn zones.

Los Angeles isn’t navigating the crisis alone, though. In the wake of the deadly 2023 Maui wildfire, researchers at the University of Hawaii launched the Maui Wildfire Exposure Study , a multi-year effort to track the disaster’s physical and mental health impacts on residents. Though the demographics of West Maui differ greatly from those of Pacific Palisades or Altadena — two of the most affluent zip codes in the country — California public officials, medical professionals, and wildfire survivors can still learn from the ongoing work of the MauiWES.

To that end, I spoke yesterday with Ruben Juarez, one of the study’s lead researchers. Our conversation has been edited and condensed for clarity.

What is the Maui Wildfire Exposure Study?

The Maui Wildfire Exposure Study follows a comprehensive cohort of people affected by the 2023 fires. We collected data six months after the fire, and typically, we’re looking for the long-term effects. For 60% of the individuals who came to the study, it was their first health check since the fires.

It is a pretty interesting population: They’re underserved and typically lack access to health care. We found three main trends: The first was mental and physical health issues. Access to care was a big issue in Hawaii, and I’m hoping that’s not going to be the case in California, but it definitely was here. Housing, job, and food insecurity were other big issues, as were the social impacts.

What have you learned about the mental and physical health of people exposed to the Maui wildfires?

Pre-wildfire we knew that the rate of depression symptoms in the Maui population was about 30%. Post-wildfire, we’re seeing more like 52%, so more than one in two participants in the study were showing depression symptoms. Low self-esteem was another issue. Something that was really worrisome was suicidal ideation: Pre-wildfire, it was less than 1%; post-wildfire, at least for the people in the cohort, it was about 4% of the population. That’s more than a four-time increase.

The second issue is physical health: Nearly half of the participants reported worse health since the fires. We saw respiratory issues, such as coughing, wheezing, difficulty breathing, and also skin and eye irritation, fatigue, and weakness. We’re seeing that about 74% of the participants are facing a heightened risk of cardiovascular disease. We also performed a lung check using spirometry and oscillometry breathing. Based on the spirometry measure, 60% of participants may have poor lung health, and 40% may have mild to severe lung obstruction. We believe this is associated with the exposure to ash and the personal protective equipment individuals wore when they returned to the fire site.

We’ve written a lot about the dangers of wildfire smoke at Heatmap, but I think people are less aware of the risks of wildfire ash. Could you say more?

It’s really toxic. People need to take care of themselves. There are the harmful substances you’d expect in ash: lead, arsenic, asbestos — those are poisons.

Why was our population in Lahaina affected by this? Because they went back to the burned homes and did not wear any PPE. To me, that was crazy. The county said that wearing PPE was a voluntary decision, and that was a mistake. And PPE is not just a mask: you really need eye protection, gloves, footwear, and long clothing, because the ash is really toxic.

Even in small amounts, the poisons in ash can harm the lungs and the heart, and there are long-term effects, including cancer, which is one of the things we’re trying to prevent. In the case of Hawaii, for the initial batch of 767 individuals in the study, we did a heavy metal analysis — a comprehensive panel of 32 of the most expected heavy metals. We already knew that five of the most common heavy metals were found in ash present in Hawaii: arsenic, lead, antimony, copper, and cobalt. We learned that 20% of participants affected by the fires in our cohort were showing an elevated level of at least one of these heavy metals, which is not something that you would expect. We don’t want these things in our bodies at any level. People must know that these things are harmful and they need to take care of their health.

And that’s all just from people returning to their homes and sifting through the ash? Or can ash blow into an area that didn’t burn and affect people that way, as well?

Many participants were uneducated about the harmful effects ash has, especially when it has contact with your skin. But you should also avoid breathing or swallowing soot and ash at any cost. The effects were seen in individuals who had direct contact at a site or were indirectly exposed through smoke or blowing winds — but the majority was direct contact.

That’s so scary.

Not everything was bad news. We found some exciting ways to potentially address some of these issues. For instance, resiliency was at the top of the minds of many participants in the study: “How can I be resilient? How can I survive this catastrophe?”

We also found that lower-income individuals trust and use community organizations more than government services, like federal, state, and county agencies. This information could potentially help us intervene, especially when considering underserved populations like immigrant populations. They just don’t trust the government. Addressing issues through community organizations on the ground was extremely helpful because it allowed people to access the services they needed.

Another thing that we noticed that was super helpful was that people who maintain strong relationships with family and friends experience better health outcomes. Social isolation after a wildfire was really bad, especially for mental health problems. Individuals who are more connected with their friends, family, or are doing something in their community volunteering tend to have better health outcomes, particularly in terms of depression.

How close do you need to have been to a wildfire to experience these effects?

Individuals whose homes were on the perimeter of the burn area experienced more physical symptoms, worse quality of life, and worse mental health. But that doesn’t mean that if your house doesn’t burn, you will not experience any of the symptoms. Even if you didn’t go to a contaminated site, there was all the smoke over the city, and you’re exposed to that. Individuals who are not directly affected can be indirectly affected — at a lower rate, of course, as you’d expect.

Many of the mental health impacts you described were related to things like housing, job, or food insecurity, as well as the lack of access to healthcare resources following a fire. Would you expect mental health impacts to not be as bad in L.A., since it was a more affluent area that burned?

Yes. In fact, coincidentally, one of our scientific advisory board members is a resident of L.A., and he’s been saying that he doesn’t expect the health effects to be as bad in L.A. as they were in Maui because the shortage of doctors is not as big. Also, the type of demographic that is being affected is more affluent.

Having said that, in Hawaii, we had the advantage of winds that blew smoke and soot away. I was reading reports that in L.A., there were no winds, and the smoke was just staying there . In that case, the effects in terms of pulmonary health won’t just be the people directly affected, but the whole city.

What would you want emergency managers and medical professionals in Los Angeles to know about your study as they address the impacts of these fires?

First, we must emphasize to people that this is not a forest fire; houses are burning, full of toxic substances. People need to know that if they return to the burn zone, they need to take care of their health and ensure they are wearing PPE. We need to conduct many communication campaigns around this.

The second thing is, don’t underestimate the power of community and community organizations, especially in L.A., where there are many immigrant populations. Community organizations should be used to provide information because people don’t trust the government or FEMA officials.

The third thing I would emphasize is that after a disaster, when people struggle with housing, job, and food insecurity, their health becomes a lower priority. This is understandable, but unfortunately, neglecting your health at this time can worsen the long-term effects. It’s really important that we emphasize to individuals that even if you don’t have a house or a job right now, you need to take care of your health.

An example of this is in the aftermath of 9/11; years later, more lives have been lost due to exposure to environmental hazards than the disaster itself. If we don’t intervene early on, things can get really bad. That’s what we are trying to do: prevent those long-term effects from happening.