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Brigid Bergin: It's The Brian Lehrer Show on WNYC. I'm Brigid Bergin from the WNYC and Gothamist Newsroom filling in for Brian Lehrer today. Brian will be back on Monday. Now, we move on to another top story. New York City's sudden drop in air quality this week due to a dense mass of Canadian wildfire smoke. Today, city public children are learning remotely at home instead of in their classrooms. While the sun is out, you might even see a little blue sky, the air quality index is back under 100 for now.

There are still a lot of questions. It's just the beginning of wildfire season. Is this what our new future is going to look like? How will we protect ourselves moving forward? What will the city do to keep us informed as we adjust to this new reality? With us now to answer these questions and more is the Commissioner of New York City's Department of Health and Mental Hygiene, Dr. Ashwin Vasan. Dr. Vasan, thank you so much for joining us today.

Dr. Ashwin Vasan: Thanks for having me, Brigid.

Brigid Bergin: You're also here with us to discuss the crisis of youth, mental health, and social media use. Just yesterday, you and Mayor Adams held a summit on the topic, so we'll go to that as well. First, let's talk about what we've been experiencing this week. It's the first time we've gotten to speak with someone on our air about the city government's response to the hazardous air quality that we have collectively experienced. Can you start us off with your assessment of the situation and where we are right now?

Dr. Ashwin Vasan: Yes, I'm happy to. Look, it's been quite the week, quite a remarkable week. As we look outside, of course, as you mentioned in your preamble, the skies are clearing, and that's a good thing. The air quality index this morning was in the mid-60s. That's down from over 400 just a couple of days ago, which was extremely hazardous. Forecast suggest that this beautiful weather is going to continue through the weekend. While the air quality index might fluctuate over the weekend, we can't really anticipate the effect of smoke on sea breeze and wind conditions. We don't expect it to reach those same hazardous levels.

That also means then, our guidance changes. Rather than encouraging everyone to stay indoors as much as possible, as we've been doing over the last couple of days, we recommend limiting time outside and reducing activity levels if you are unusually sensitive to particle pollution or unusually vulnerable. That is, people with heart or breathing problems, older adults, fragile adults, people with immune system problems who might still be sensitive to current conditions. These folks should limit their time outdoors. They should avoid prolonged and intense outdoor activities.

For all New Yorkers, listen to your body. If your eyes are watering or your throat is sore or you're out of breath, go inside. Of course, if you're really having trouble breathing, call 911. As a parent, I have three small kids. For children and families, just know that children with asthma are especially sensitive to poor air quality and should really limit their time outdoors. I'll be outside with my kids this weekend, but I'm going to really check on how they're feeling. If there's any issues, I'll bring them inside, and caregivers across our city should do the same. I'll continue to recommend masks, which are a useful tool if you need them.

If you have to be outside, if you are experiencing symptoms and you can't get inside, wear a high-quality mask. Those are available, N95's available at all local police precincts and all firehouses city-wide. This can reduce your exposure to harmful pollutants. Of course, for all New Yorkers over this weekend, just stay informed. Go to our Twitter page, our Instagram, our Facebook, go to our website nyc.gov/health/airquality. Sign up for Notify NYC and keep up to date on the AQI using the airnow.gov website.

Brigid Bergin: Commissioner, thanks so much for that. Listeners, if you have a question for Commissioner Vasan about how the city will handle air quality emergencies going forward, or questions about how to keep yourself safe, protect your own health now, give us a call, 212-43-WNYC. That's 212-433-9692. Commissioner Vasan, I know that I personally just breathe a little sigh of relief, and probably some other listeners who also have small children, about trying to get those kids back outside this weekend. It sounds like what you're saying is it's okay, it's safe to be outside for kids, but just to keep an eye on it. Is there a threshold that we should be watching that would change that? Will the city communicate that?

Dr. Ashwin Vasan: 100%. We will be in touch if things change. We don't expect them to change dramatically, but you never know. We didn't expect our air quality index to be above 400 on Monday. We will be in touch immediately as soon as something changes if something changes. We start to get really concerned and this is why we started to message on Tuesday to the public when air quality indices reach above 150. That's when we start to ramp up messaging and ramp up communication about the precautions that people can take.

I think for parents, for all New Yorkers, get outside this weekend, do it safely, really listen to your body, and know your own underlying health. If you've got breathing problems, if you've got a heart problem, if you're elderly or frail, if you're dealing with a medical illness right now, stay a little bit more inside, reduce your exposure. There's no reason to get out there when we have fluctuating air quality levels and we think that this will pass by early next week altogether.

Brigid Bergin: Doctor, you mentioned some of the symptoms that people might be experiencing, the sore throat, the watery eyes, but are there any other symptoms that people should look out for after extended exposure to this hazardous air?

Dr. Ashwin Vasan: Yes, 100%. If you start experiencing intense headache, any vision problems, chest pain, symptoms of chest pain like arm pain or neck pain, significantly after being outside, really trouble breathing, especially trouble breathing after normal activity. That's when you should really be calling your provider or calling 911 if it's a real emergency.

Brigid Bergin: We have a texter who asked the question, what AQI does the Commissioner recommend for outdoor masking?

Dr. Ashwin Vasan: Well, in general, and again, it's not about everyone masking versus some people masking. When the air quality level is above 150, it starts to get unhealthy. Like, really pretty significantly unhealthy and that's when we start saying, in particular for vulnerable populations, go outside and mask. As you saw in the last couple of days, we recommended that all New Yorkers mask when they're outside.

Now that we're back below 150, and in fact, we're below 100, though that might fluctuate again, above and below 100 today and over the weekend. We're saying that most New Yorkers can go outside, especially if they're healthy, but if you have any concerns, if you have any underlying health conditions, or if you're feeling symptoms and you can't get indoors, wear that high-quality mask and they're widely available across our city.

Brigid Bergin: Doctor, this is something I think New Yorkers are learning still about. This is not something that's happened with a lot of frequency here. I'm wondering, what are some of the long-term health effects of extended exposure to the kind of smog we saw this week, especially for people who have to work outside? Delivery workers, construction workers, folks who have to be outside all day?

Dr. Ashwin Vasan: Yes, and we think a lot about those folks in particular, because prolonged exposure is damaging. All you have to do is look at the health statistics and premature deaths and causes of death of people in parts of the world that are chronically exposed to poor air quality. My family comes from India. I've visited India many times. Big cities in India, especially ones like Delhi, have chronically poor air quality. You can see that play out in their data. They have significantly more excess deaths, premature deaths due to complications of exposure to poor air quality.

That's why we're saying very clearly this is a public health issue. Climate change is a public health issue. Something that is happening thousands of miles away has landed right here on our doorstep. Here in New York City, it's no longer an abstraction, if indeed it was for anyone lingering out there who doesn't think it's real. We need to galvanize action to mitigate these extreme weather events by reducing carbon in our atmosphere and thereby keeping temperatures down in our planet.

Brigid Bergin: Dr. Vasan, we had a conversation about this topic yesterday, and one of our callers asked about, what the city was doing to help people who are homeless? We know when the city's temperatures dip below a certain level, the city issues a code blue. Was there anything done to get people off the streets during the worst of this smog crisis?

Dr. Ashwin Vasan: Absolutely. Our partners at the Department of Homeless Services ramped up their outreach. They not only deployed more street outreach workers to address the needs of street homeless and unhoused New Yorkers, but also leverage shelter workers to do the same. They got boots on the ground to go try to find people in extreme need who were unhoused and exposed. It's an extremely difficult situation to not have a place to go. Our DHS workers did a great job.

Brigid Bergin: We got another question via text, and it's pretty straightforward. "Is it okay to open our windows now?"

Dr. Ashwin Vasan: Yes, I think it is okay to open your windows. I think if you have an air purifier, if you have an air conditioner, I would still recommend that you keep those windows closed and use those. I think if you don't and your temperatures in your apartment or your house are getting elevated, we think it's safe enough to open your windows, especially for limited amounts of time as the air fluctuates and improves over the weekend.

Brigid Bergin: We have some callers with questions. We're going to go to Keith in Brooklyn. Keith, welcome to WNYC.

Keith: Thank you. After 911, Christine Todd Whitman was the head of the EPA, and her and Giuliani, they basically said, "Oh, the air quality is fine," because they wanted to reopen the economy in lower Manhattan. They were lying. How do we know that when they say that the air quality is fine now, how do we know that we're not being lied to again?

Dr. Ashwin Vasan: Thanks for the question. I don't know that you heard me say the air quality is fine. I said that we would be back to normal early next week. Normal for this time of year is a consistent air quality index of below 50, consistent. That means day after day. We're not there yet. We think we will fluctuate below 100, maybe slightly above 100, which is why we're advising these precautions. As Commissioner Iscol has said in previous-- The emergency management commissioner and myself have said in previous public events, it's not that uncommon, though, to have poor air quality days in a hot period in June due to high temperatures, due to more traffic, due to less rain. We can be exposed to these air quality events, and we always put out messaging to New Yorkers to take extra precautions, but no one is saying the air quality is perfectly normal or perfectly fine right now.

Brigid Bergin: To that point, we also know that wildfire season is really just starting. Dr. Vasan, can you talk about how people can be better prepared or prepare for the future? We've talked about masks and air conditioners, but are there other things that we can do as best practices going forward?

Dr. Ashwin Vasan: Yes. Look, wildfire season is-- this is the start of wildfire season, but it's really not common for Canada to have wildfires like this in June. What this means is that the ground and the temperatures are high, the ground is dry and the temperatures are high because they haven't gotten enough rain, and we're seeing a massive set of wildfires earlier than we've ever seen them before. Once again, this is climate change in action, and we have to take this seriously and it's a collective global challenge. It's not just a New York City challenge. For New Yorkers to expect that a wildfire thousands of miles away would land on our doorstep was really an unexpected event.

It's not typical for wind patterns to blow smoke down the Eastern Seaboard. It just so happens that we had a low pressure system sitting next to us, to the west of us, that drove that air down the Eastern Seaboard. What this means is that climate change is real. There's going to be more extreme weather events. Fire season is going to start earlier and earlier. It might be more severe. We all need to be more prepared. That means keeping masks on hand. That means going to the airnow.gov website more frequently to check the air quality levels and certainly at the city, we're learning a lot from this, too, about the ways we communicate, the ways that we get information out there quickly to ensure that what we think may be the new normal, more events like this, that this becomes routinized as a part of our preparedness.

Brigid Bergin: Dr. Vasan, I want to pick up on that thread in terms of lessons learned, also in terms of communication. Certainly, what we've seen is much of the critique of the administration's handling of the situation has been centered on how it communicated. Some say a lack of communication, or some look at the timing of the communication. People were walking around without masks for several days during this event. What's the plan moving forward in terms of how to communicate with the public about something like this?

Dr. Ashwin Vasan: I think the speed of this situation was pretty profound, pretty fast. We got out there early through social media, primarily, to notify people in line with the state, mind you, when AQI went above 150. That was about midday on Tuesday. In none of our models or in none of our predictions did we anticipate it reaching above 350 or 400 in the subsequent 24 hours. That wasn't a part of what we could forecast because smoke is incredibly hard to forecast. As well, this was a very atypical set of wind conditions for the Eastern Seaboard to blow the smoke in this way in our direction.

I do think there were a set of unique factors here, and the fact that we were putting out messaging as a city early, I think is a good sign. We're always learning, and this was a unique event, and we will debrief, decamp once we're out of it and think about how we do this going forward. I think looking at how we prepared and brought city agencies together to respond, I think there was a lot to be proud of here and we'll learn what we can going forward.

Brigid Bergin: Dr. Vasan, there are many cities in the world, particularly in Asia, that experience these levels of air pollution regularly. New Delhi in India and Beijing in China come to mind. Other cities out west in this country have also encountered that orange gray sky that New Yorkers saw this week. Have you sought advice from other city health officials around the country or in other parts of the world that deal with hazardous air conditions more often?

Dr. Ashwin Vasan: 100%. First, we've been in touch with the federal government through the National Center for Environmental Health at the CDC. We've been in touch through them with colleagues in California and Oregon who deal with these wildfires more frequently. To a person, they're all saying very similar things to us, that our communication has been clear, it's been effective, and that the speed with which the smoke entered our city and sat and lingered above our city was quite unique. There's a difference between dealing with this on a chronic basis and dealing with it on an acute basis. We were dealing with this over the matter of hours. I think people just need to also remember that it was a fast-moving situation.

Brigid Bergin: My guest is Dr. Ashwin Vasan, Commissioner of the New York City Health Department and Mental Hygiene. Very quickly, I need to do a little business, and then we have one more topic to discuss. This is WNYC FM HD and AM New York, WNJT-FM 88.1 Trenton, WNJP 88.5 Sussex, WNJU 89.3 Netcong, and WNJO 90.3 Toms River. This is New York and New Jersey Public Radio live streaming at wnyc.org. Dr. Vasan, I want to switch gears before we end. Yesterday, you and Mayor Adams held a summit on social media and its impact on young people. Why is this a priority for the administration at this moment and what was the goal of the summit?

Dr. Ashwin Vasan: I'm so glad we're talking about it. It's a little bit ironic that we're talking about it this week that we're dealing with an environmental toxin in our air. This city has a long history of addressing those toxins. You mentioned in your preamble or one of the callers mentioned. Our improvements in air quality, we've addressed tobacco, we work on improving the quality of our water and our buildings. All of that is through the tools of public health. Now, we have this digital toxin. It's a toxin that's all around us. We're all exposed to it. It's highly addictive and particularly for developing brains of our young people, it's toxic.

Yet the environment that these social media platforms exist in is almost entirely unregulated. Our most precious resource, our kids, are entirely defenseless and exposed. This was our attempt to convene national leaders from around the country, academics, experts, parent groups, government officials, scientists, but most importantly, youth leaders. We did this on a school holiday intentionally, so that in every discussion, we were being led by teens and youth leaders, giving us their first-hand experience so that we can develop an action plan to address this digital toxin using the tools of public health. What are those tools? It's education, its harm reduction because we know that social media is not going anywhere, but we need to learn how to use it more safely and responsibly. It's policy. It's research, and it could be regulation and litigation. The discussions we had yesterday are the kickoff for a roadmap of action that the city is going to take and lead on.

Brigid Bergin: Dr. Vasan, I just want to make sure that we underscore the point of how you see this digital media as a toxin. What is it doing to the brains of these young people? Why do you categorize it or compare it in the same way, and we've been talking about things like pollution in the air, or tobacco, or lead paint?

Dr. Ashwin Vasan: Yes. We are in the midst of a youth mental health crisis. We are seeing unprecedented rates of suicidal thoughts, depression, anxiety, loss of school, performance, academic performance, social isolation. The Surgeon General has called this out as a public health issue. We stated it very clearly in our mental health plan as a core pillar when we announced it as an administration in March because we know that our kids are hurting and social media is making it worse.

While the conversation there's a lot of nuance under it and data that we need to unearth and experience that we need to unearth, we can all agree that it's harming our kids, and it's time for us to get our arms around it. We don't have all the answers, but Public Health offers a lot of the solutions. That was what this conversation was all about.

Brigid Bergin: Doctor, your office provided some statistics on the mental health of New York City public school students. The percentage of students suffering is very high. As you pointed out, 38% of New York City high schoolers reported feeling so sad or hopeless almost every day for at least two weeks during the past 12 months that they stopped doing their usual activities in 2021. It's notable that Latino and Black students are reporting symptoms of depression at higher rates than their white counterparts. 42% of Latino students and 41% of Black students, compared to just under 30% of white students. I'm wondering, what do you make of the racial divide in the mental health amongst our city students? How is the administration seeking to address that?

Dr. Ashwin Vasan: Well, it's very clear that vulnerability is intersectional, and that while everyone is exposed to social media, that our young people of color are particularly exposed, and it's playing out in their mental health. There's other issues intersecting. There's not one reason for the mental health crisis amongst Black and brown youth in our city, but certainly, social media is exacerbating it or catalyzing it.

That's why yesterday, when we convened youth leaders, the majority of them were from Black and brown communities across our city and talking very openly about what they see online, how it hurts them, when they see violent content, when they experienced cyberbullying,when they see content that gives them distorted body images, and what they expect of us as adults. What do they want us to do to step in and help?

The message was very clear. They want better rules of the road, they want education, they want warnings, they want to understand better what boosted algorithms are and how they can avoid seeing the same harmful content over and over. They want their parents, caregivers, adult role models to control their social media use as well. It's very hard to tell a young person to get off their phones and get outside or go do something else, when we, all of us, are addicted to our phones more than we would like. This is a collective challenge. Young people are looking for us to lead, and they are looking for a seat at the table so they can lead. That was a very clear message from yesterday, and that's our commitment.

Brigid Bergin: My final question. I'm sure there are many parents listening that are concerned about the mental wellness of their children, the amount of social media they're consuming. Do you have any guidelines for how parents should approach this topic with their children to help them regulate their social media in their household? It certainly sounds like one of them would be to be mindful of their own use of social media in front of their children, but anything else that would be helpful for parents who want to take a proactive approach to this?

Dr. Ashwin Vasan: I'm a parent first. That's my most important job. I have three young kids, the oldest of which is almost 10 and is growing up as a digital native, a social media native and I am doing my best to limit her exposure to social media right now. Parents need to get smart. We will do everything we can to educate parents through content, guidance, information, education so that they can better understand the harms that social media is causing, not just through emotion and fear, but through information, and data, and education.

Number two is that parents need to talk to their kids. Not snatch phones away or punish, but really have an open conversation about what their kids are seeing online, what they feel when they see this content that's harmful. The parents giving some rules of the road around how to avoid that content, how to limit screen time. That's the third message, is that it has to be a family or a joint effort. You can't have a young person playing by different rules as adults if we aren't limiting our own screen time.

Creating screen-free time, screen-free dinner time. Just really limiting screen use as a family and rebuilding social connection in person, I think is essential and is a good start. We're going to be, as a part of this action plan, education for parents, for teachers, for stakeholders, is a really important key and we'll be issuing that guidance in the coming weeks and months.

Brigid Bergin: I am a big believer in screen-free dinnertime for sure [chuckles].

Dr. Ashwin Vasan: Me, too.

Brigid Bergin: We're going to have to leave it there. Thank you so much. My guest was Dr. Ashwin Vasan, Commissioner of the New York City Department of Health and Mental Hygiene. We really appreciate your time.

Dr. Ashwin Vasan: Thanks a lot, Brigid.

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