The wildfires that burned in the Los Angeles area in January surged through highly populated areas, causing catastrophic damage. The two largest fires, the Palisades and Eaton fires, together destroyed over 16,000 homes and other buildings, killed 29 people, and displaced thousands.  

Such losses are familiar to Joshua Weil, an emergency room physician who lived and worked through the Tubbs fire in northern California in 2017 — at that time the most destructive fire in the state’s history. Weil treated injuries from the fire and worked to evacuate a hospital in the city of Santa Rosa. The fire also destroyed his home.  

“Living through the fire changed my life, and it changed a lot of things for my family as well,” said Weil.   He shared his experiences and insights at a recent Climate Conversations webinar that explored urban wildfires, their impacts, and lessons learned that can help communities prepare.  

Multiple states — California, Arizona, Colorado, Texas, Montana, and others — are now facing increased wildfire risks, noted moderator Michael Méndez of the University of California, Irvine, whose research focuses on how climate change affects vulnerable populations.  

“The best way to cope is to better understand extreme wildfire events and the methods to prepare our communities, and especially those that are most at risk and socially vulnerable,” he said.

Urban fires pose unique problems

Wildfire activity in the U.S. is increasing as climate change leads to hotter and drier conditions, according to a 2022 National Academies report.  

In addition, more people are living where urban and wild lands meet, explained Christine Wiedinmyer, associate director of science at the Cooperative Institute for Research in Environmental Sciences, University of Colorado, Boulder.  

“We have a lot more people moving into this wildland-urban interface — moving into areas with flammable vegetation,” she said. “And when you have people in those areas, you have more likelihood of human-caused ignitions — power lines, people burning things that might create a fire.”  

Wiedinmyer explained that urban fires present distinctive problems and unknowns in terms of impacts on air quality. When vegetation burns, it produces smoke containing particulate matter, greenhouse gases like carbon dioxide and methane, and other gases, she said. But with urban fires — where burning homes and garages are also generating smoke — “it’s a totally different suite of pollutants that are getting sent up there, and the impacts could be very different in terms of health and ecosystems downwind.”  

These questions are the subject of ongoing research, said Wiedinmyer. “There are lots of efforts to try to understand what exactly is being put up into our air, and into our water systems, and into our soils, after you start burning these human structures and human materials.”

Impacts on physical and mental health

Weil spoke about how fires affect health in both immediate and long-term ways. During the Tubbs fire, he treated burns and smoke inhalation injuries, as well as ankle and arm injuries sustained as people fled.   In the days and weeks after a fire, power outages can cause additional problems, he noted — medications that need refrigeration may not have it, and dialysis machines can’t operate.  

There are long-term risks from exposure to wildfire smoke as well, including a heightened risk of cardiovascular problems like heart attacks and strokes, said Weil. Pregnant women are at increased risk of pre-term labor. The very young, very old, and outdoor workers are especially vulnerable to impacts of particulate matter in the air.  

The mental health impacts of living through a fire also need attention, Weil said. In the years that followed the Tubbs fire, Weil’s hospital in Santa Rosa had the second busiest ER department for psychiatric emergencies among Kaiser Permanente’s 21-hospital network in the state.  

“There are a lot of implications for what happens to a community when you suffer such great loss,” said Weil. “We lost over 5,000 structures, people were displaced from their homes, people were displaced from their jobs. Some people just said, ‘I’m leaving the community,’ so we had trouble filling jobs. It’s very disruptive to have a major event like this in a community, and it has long-term effects. This is one of the areas we’re still studying and trying to learn more about.”  

Méndez too emphasized the importance of “thinking beyond property values” when considering the impacts of fires and their downstream consequences — from mental health impacts to loss of jobs to loss of a sense of community.

“You need a plan”

The speakers also discussed proactive steps communities and families can take to plan for fires or other disasters. Méndez stressed the importance of identifying vulnerable populations who will need extra care in the event of a fire — children, the elderly, homebound individuals, farm workers, and other outdoor workers. He urged state and federal governments to “build those relationships ahead of time, before the next disaster, and incorporate them into your plans and policies and procedures to be able to reach and connect to these hard-to-reach populations.”  

Health systems need a plan in case hospitals and clinics are evacuated or closed because of power outages and staff shortages, said Weil. Women will still need a place to deliver their babies, people will need dialysis, emergency surgeries will still need to be performed. “Supply chains — supplies, but also delivery systems — are all disrupted, and so you need a plan for how you’re going to deliver this health care in this now-disrupted environment,” he said.

Wiedinmyer spoke about planning for air-quality problems: “One of the things people want to know is ‘What am I breathing? Is it healthy?’” She mentioned instruments like PurpleAir, low-cost tools people can use to monitor the air around them for particulate matter and other pollutants, which can then contribute to a community map of air pollution. To protect themselves against smoke, people can wear masks and build inexpensive air filters using box fans and HVAC-system air filters, she added.  

Weil also offered practical suggestions for individuals, urging people to walk through their home or apartment with a cell phone, recording videos of their possessions in case it’s ever needed for insurance purposes. Those in fire-prone areas should have a “go bag” ready, including a change of clothes, backup medications, and glasses, he said.

Beyond that, he noted that people should have a list of items to grab if they have an additional 15 minutes, and another if they have two hours to prepare. He also suggested having a paper list of important family and friend phone numbers in case cell phone batteries die.  

“Having that kind of backup and redundancy — personally and for systems — becomes critically important,” he said.  

Watch the webinar or access a collection of National Academies reports on wildfires.