City and state syndromic surveillance data, which track patterns in emergency department visits, have yet to detect an increase in patients seeking medical assistance for asthma, chronic obstructive pulmonary disease or other respiratory complaints. But NYC Health + Hospitals, the city’s public system, has seen an uptick in patients with smoke-related respiratory symptoms in some of its emergency departments, a spokesperson said Wednesday night.

And if history is any indication, the smog that suffocated the city on Thanksgiving weekend 1966 suggests the current cloud of smoke could have a delayed but deadly health impact.

“No illnesses attributed to pollution,” a front-page New York Times story proclaimed on Nov. 27 that year. The following year, a study found the three-day smog had caused 168 deaths.

Scientific research has linked exposure to fine particles from wildfire smoke with a number of health issues, both in the short and long term. Children and older adults are particularly vulnerable, as are New Yorkers who have underlying lung or heart conditions, state and city health officials are warning.

Across the Hudson River in New Jersey, some warning signs have already emerged.

Hospitals in the northern part of the state reported an increase in respiratory cases among patients in the emergency room, New Jersey Hospital Association President and CEO Cathy Bennett said Wednesday.

“As the air conditions persist, we remain concerned for those with respiratory illnesses and other chronic conditions, as well as those living and working in urban communities,” Bennett said in a statement. “We urge New Jerseyans to continue heeding the warnings to stay indoors with windows closed to minimize the health risk.”

But signs of negative health effects are not always immediate, experts said.

It can take some time for those pollutants, which include microscopic particles of carbon monoxide and nitrogen dioxide, to settle into a person’s lungs and cause an inflammatory reaction, according to acting state Health Commissioner James McDonald.

“Someone may be out in the air today and be doing ok with it, but tomorrow they might wake up with a cough and they might when they work a bunch say, ‘I’m not feeling so good,’” McDonald said during a virtual briefing Wednesday.

Robbie M. Parks, an assistant professor of environmental health sciences at Columbia University who is studying the health impact of wildfire smoke, said he was mildly surprised by the data because there is not typically much of a lag between exposure and increased ER visits.

One recent analysis found a small same-day effect on ER visits and hospitalizations for respiratory issues. Other consequences might be less apparent: researchers from the U.S. Environmental Protection Agency found evidence of decreased cognitive performance within hours of exposure.

Parks said it’s helpful to think of exposure to fine particulate matter as a threat multiplier — something that compounds other stressors on the body, such as extreme heat, that may eventually “tip the scale” and lead to a health emergency or even death.

That is especially true for lower-income communities of color that already have poorer air quality and higher rates of asthma and chronic lung disease.

Ramon Tallaj, chairman of the nonprofit physician network SOMOS Community Care, said its clinics in the Bronx, central Brooklyn and upper Manhattan saw an increase in calls and visits related to kids with asthma. SOMOS primarily cares for low-income patients from communities of color.

However, it is possible that officials’ advice to stay indoors is mitigating the more severe health effects seen after other major wildfires, Parks added. He expects the full impact will become clearer next week.

In the long term, Parks said the stressor of fine particle pollution can also harm people’s mental health. Exposure among pregnant people may lead to poorer health outcomes for their babies, such as preterm birth and low birth weight — leading causes of death before the age of one.

Health officials for now are focusing on prevention. They are urging people to protect their health by limiting outdoor activities, closing their windows and using air purifiers. Older adults and people with heart problems or breathing issues are advised to stay indoors.

Social services providers are distributing masks to homeless New Yorkers across the city and trying to find indoor options for people living on the street who have respiratory issues and other chronic health concerns.

“While many of us have the means to stay inside to avoid the extremely poor air quality today, our homeless neighbors do not have that same privilege,” the Center for Urban Community Services, a nonprofit, said in a statement.

McDonald said New Yorkers should wear a mask, preferably a high-quality one like the KN95 masks that became ubiquitous during the pandemic, if their region’s air quality index exceeds 300 and they have to go outside.

“I’m interested in preventing problems,” he said. “I really don’t want folks to get sick.”

Daniel Han contributed to this report.

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