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An aerial view of Paradise after the 2018 Camp Fire.

When Erin Babnik awoke on the morning of Nov. 8, 2018, in Paradise, California, she thought the reddish glow outside was a hazy sunrise.

But the faint light soon gave way to darkness as smoke from the burgeoning Camp fire rolled in.

“The whole sky turned completely black, and there were embers flying around,” Babnik recalled. “I remember it smelling horrible.”

She hastily evacuated to nearby Chico with little more than an overnight bag. Her rented home, along with nearly every other structure in Paradise, would soon be reduced to ash.

Although several years have passed and thousands of additional wildfires have ignited across California, researchers are still unpacking the precise dangers of smoke from blazes like the Camp Fire. Already this year, plumes from Western fires are making their way across much of the U.S. and Canada.

One recent study found that smoke from the Camp fire was particularly noxious because it contained particulates from burned homes as well as vegetation – something officials fear will become more common as home-building pushes farther into the state’s wildlands.

Another study linked wildfire smoke to an increased risk of contracting COVID-19.

The findings indicate that as fire season ramps up, the dangers of respiratory illness and other serious side effects from smoke loom nearly as large as the flames.

The 2018 Camp Fire was the deadliest wildfire on record in California. At least 85 people died, and nearly 19,000 buildings were destroyed, mostly in Paradise.

The fire also generated a massive plume of heavy smoke that spewed dangerously high levels of pollution into the air for about two weeks, according to a study released this month by the California Air Resources Board.

Researchers examined data from air filters and toxic monitors to determine that smoke from the fire was in many ways more harmful than that of three other large fires that burned mostly vegetation that year – the Carr Fire, the Mendocino Complex Fire and the Ferguson Fire.

Elevated levels of chemicals such as lead, zinc and iron generated by smoke from the Camp Fire were detected in nearby Chico and as far away as San Jose and Modesto, the study found.

The lead was of particular concern because it has well-documented health impacts on blood pressure and reproductive systems and has been strongly linked to cancer and neurological disorders, especially in children, said Michael Benjamin, chief of the Air Quality Planning and Science Division at the California Air Resources Board.

“There are very good reasons why we try to keep lead out of the air,” Benjamin said, noting that federal and state governments already have taken actions to protect people against the chemical, such as banning lead paint and leaded gasoline.

Many of the buildings razed in the Camp Fire were likely constructed before the 1978 lead paint ban, Benjamin said. And many of the vehicles that burned likely contained chemicals such as zinc.

“When we have an incident like this, where you have 19,000 structures that burned in Paradise … all of those metals are vaporized and released into the atmosphere,” he said.

Lead levels in Chico, the closest available monitoring site to the Camp Fire, were 50 times higher than normal for one 24-hour period during the fire, Benjamin said.

The study results didn’t surprise David Little, who was editor of the Chico Enterprise-Record when the fire broke out and now serves as executive vice president of communications at the North Valley Community Foundation, which provides relief and recovery efforts for Camp Fire victims.

“We have fires here every year, but this was something spectacular and different,” Little said of the Camp Fire’s smoke. “It was like this curtain coming down. It went from blue sky to black, like someone turned out the lights.”

And the smoke wasn’t like what billows from a regular forest fire or brush fire, he said. It was more akin to a tire fire, where “black stuff comes out of the air and lands on you.”

“That’s what our whole county was enveloped in for many, many days,” he said.

The air board’s Benjamin said researchers have not yet tracked specific health impacts on residents who lived through the Camp Fire, but he noted that millions of people in Northern California were exposed to brief but elevated lead levels during its wrath.

Researchers are, however, beginning to examine the “negative synergy” between wildfire smoke and COVID-19, he said, noting that the coronavirus can “compromise people’s respiratory systems and make people more susceptible to the impacts of particulate and smoke.”

At least one group of scientists at the Desert Research Institute in Nevada already has found a correlation.

A study published this month in the Journal of Exposure Science and Environmental Epidemiology found that wildfire smoke may greatly increase susceptibility to COVID-19.

Researchers focused on about 36,000 patients at a hospital in Reno between Aug. 16 and Oct. 10, 2020 – the period most affected by smoke from Western fires like the August Complex, the Creek Fire and the Glass Fire – and found that an increase in particulate matter from wildfire smoke was associated with a nearly 18% increase in the number of coronavirus cases.

The findings are “important to be aware of as we are already confronting heavy wildfire smoke from the Beckwourth Complex Fire and with COVID-19 cases again rising in Nevada and other parts of the Western U.S.,” said Daniel Kiser, an assistant research scientist at DRI and one of the study’s co-authors.

The study controlled for variables such as the general prevalence of the virus and the number of tests administered. Scientists said the findings likely can be extrapolated to other areas affected by fires.

There are no definitive answers about how wildfire smoke and COVID-19 are linked, said Gai Elhanan, a health data scientist at DRI and another of the study’s co-authors. One possibility is that exposure to smoke is altering peoples’ immune response, while another is that the smoke creates an overexpression of ACE2 respiratory cells. A third is that the coronavirus’ particles may attach themselves to smoke particles, making people more susceptible to ingestion of the pathogen.

The effects of wildfire smoke also depends on what’s burning, Elhanan said.

“This is part of the complexity of what we inhale,” he said.

Neither study is the first to examine the harmful impacts of wildfire smoke: Last year, researchers found it contains fungi, bacteria and other airborne pathogens. But the latest findings add to a growing list of evidence about its dangers.

And as wildfires become larger, more frequent and move closer to communities, experts said it is increasingly important for people to be aware of what the blazes are belching.

“You’re not only now burning wood,” said Peter DeCarlo, an associate professor of environmental health and engineering at Johns Hopkins University. “You’re burning heavy metals, and you’re burning plastics and other things that wouldn’t burn just in a forest fire. … Those add additional chemicals, many of which we know are toxic and noxious, to what’s already bad from wildfire smoke.”

And thanks to extremely parched vegetation, fires also are burning hotter and with greater intensity, which can enable smoke to travel farther, he said.

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