Los Angeles wildfires prompted significantly more virtual medical visits, UW-led research finds

University of Washington

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When uncontrolled wildfires moved from the foothills above Los Angeles into the densely populated urban areas below in January 2025, evacuation ensued and a thick layer of toxic smoke spread across the region. Air quality plummeted. Local hospitals braced for a surge, but it never came.  

Research led by the University of Washington and Kaiser Permanente Southern California sheds new light on how the Los Angeles fires affected people’s health, and how people navigated the health care system during an emergency. In the rapid study, published Nov. 26 in JAMA Health Forum, researchers analyzed the health records of 3.7 million Kaiser Permanente members of all ages living in the region. They found that health care visits did rise above normal levels, especially virtual services.  

In the week after the fires ignited, Kaiser Permanente members made 42% more virtual visits for respiratory symptoms than expected. Those living near a burn zone or within Los Angeles County also made 44% and 40% more virtual cardiovascular visits, respectively, than expected. 

In-person outpatient visits for respiratory symptoms also increased substantially. Members who lived near a burn zone or within Los Angeles County made 27% and 31% more virtual cardiovascular visits, respectively, than expected. 

Extrapolating to all insured residents of the county, the researchers estimated an excess of 15,792 cardiovascular virtual visits, 18,489 respiratory virtual visits and 27,903 respiratory outpatient visits in the first week of the fires. 

The results suggest that people may rely more heavily on virtual health care during climate-related emergencies, and that providers should better prioritize virtual and telehealth services as they prepare for future crises. 

“We saw over 6,241 excess cardiorespiratory virtual visits in the week following the fire ignition. This represents a substantial increase in care,” said Joan Casey, a UW associate professor of environmental and occupational health sciences and of epidemiology who led the research. “While the fires clearly impacted health, virtual care likely enhanced the ability of providers to meet the health care needs of people experiencing an ongoing climate disaster.” 

In collaboration with Kaiser Permanente Southern California, an integrated health care system with millions of members across the region, researchers analyzed health records of people who were highly or moderately exposed to wildfires. They defined high exposure as living within about 12 miles (20 kilometers) of a burn zone, and moderate exposure as living within Los Angeles County but farther than 12 miles during the time of the fires.  

Researchers looked back three years to estimate how many health care visits to expect in the weeks following Jan. 7 — the first day of the fires — under typical conditions. They then estimated how many people sought care in the first week of the fires, when smoke levels were highest, evacuations took place, and Los Angeles County public schools were closed.

In addition to the spike in cardiovascular and respiratory visits, researchers found a sharp increase in the number of visits for injuries and neuropsychiatric symptoms. On Jan. 7, outpatient injury visits were 18% higher than expected among highly exposed members, and virtual injury visits were 26% and 18% higher than expected among highly and moderately exposed groups, respectively. Among those same groups, outpatient neuropsychiatric visits rose 31% and 28% above expectations, respectively.

While both groups made significantly more visits than expected, proximity to the fires mattered. When researchers zoomed in on respiratory-related virtual visits, they found that minimally exposed members made 31% more visits, moderately exposed members made 36% more, and those living in highly exposed areas made 42% more.  

“While healthcare systems often plan to increase the number of hospital beds available or clinic staffing during an emergency, this work highlights the importance of considering virtual care capacity,” said Lauren Wilner, a UW doctoral student of epidemiology and co-author on the study. “This may be particularly true for climate disasters like wildfires, during which people are advised to stay indoors or when people must evacuate — motivating them to seek care online if at all possible. As climate disasters increase in frequency and intensity, it is essential that health care systems know how to prepare for a sudden and dramatic surge in health care utilization.” 

Other authors on this study are Yuqian Gu, Gina Lee and Sara Tartof of Kaiser Permanente Southern California; Lara Schwarz of the University of California, Berkeley; Timothy Frankland of Kaiser Permanente Hawaii; Heather McBrien and Nina Flores of Columbia University; Chen Chen and Arnab Dey of the Scripps Institution of Oceanography at UC San Diego; and Tarik Benmarhnia of the Scripps Institution and the University of Rennes in France.

This research was funded by the National Institute on Aging and the National Institute for Environmental Health Sciences. 

For more information or to reach the research team, contact Alden Woods at acwoods@uw.edu.

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Journal

JAMA Health Forum

DOI

10.1001/jamahealthforum.2025.4632 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

The 2025 Los Angeles Wildfires and Outpatient Acute Health Care Utilization

Article Publication Date

26-Nov-2025

COI Statement

Dr Casey reported receiving grants from the National Institutes of Health (NIH) outside the submitted work. Mr Frankland reported receiving grants from NIH during the conduct of the study; owning stock in AstraZeneca, Regeneron Pharmaceutical, and Stryker Corp; previously owning stock in Ishares Biotechnology ETF, AbbVie, CVS, and Merck. Ms Lee reported receiving grants from the National Institute on Aging during the conduct of the study; receiving other support to her institution from Moderna and GlaxoSmithKline outside the submitted work. Dr Benmarhnia reported receiving grants from the NIH outside the submitted work. No other disclosures were reported.

Crop pests can develop ‘fighter-jet wings’ after eating specific mix of corn

North Carolina State University

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image: 

Corn earworm pests are aptly named as they feed on ears of corn.

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Credit: Photo courtesy of Steven Roberson, NC State University.

Eating a blend of non-toxic corn and genetically modified toxic corn can result in corn earworm pests (Helicoverpa zea) developing longer, more narrow and more tapered wings – shaped like the wings of a fighter jet – that can propel them long distances, increasing the chances the pests will spread resistance to the toxic corn. The findings add to knowledge about how crop diets can influence pest dispersal behavior.

The research suggests that a blend of corn that produces Bt toxin – designed to kill pests – and a small percentage of toxin-free corn can, in just one life-cycle generation, dramatically change the shape of moth wings to make them more aerodynamic, increasing the moth’s capability to fly longer distances.

“Wings from insects eating a blended toxic and non-toxic corn diet were stiffer and more able to travel in higher wind speeds,” said Dominic Reisig, professor and extension specialist of entomology at North Carolina State University and co-corresponding author of a paper describing the research. “These insects are able to get up into the winds and ride them longer distances.”

Researchers at NC State and colleagues wanted to learn if corn earworm pests growing up and eating toxic and non-toxic corn blend diets would have noticeable physical differences from pests that ate purely non-toxic corn or pests that ate purely Bt corn containing either two or three different toxins. The vast majority of corn and cotton grown in the United States contains Bt toxins to control insect pests.

Corn earworms are aptly named: they feed on corn ears. While corn yield loss is not greatly concerning, the pest also enjoys soybean, tomato and cotton plants, making it a ubiquitous pain for farmers. 

“Corn is basically like a factory for this insect,” Reisig said. “Corn earworm can overwinter in our state, slowly build up its generations early in the season, and then in July, when corn silks, those moths go in and lay eggs, Almost every single ear of corn produces at least one caterpillar that becomes a moth when it grows up. That’s a lot of bugs. All of that activity also funnels into cotton and soybeans, and that’s why they’re such a big problem.” 

The researchers compared wing shapes of moths raised on the blended corn; moths raised exclusively on non-Bt corn; moths raised exclusively on Bt corn containing two different toxins; and moths raised exclusively on Bt corn containing three different toxins.

The results showed that the wings of moths eating the three non-blended corn diets were less aerodynamic and more brittle and deformed, making those moths less apt to travel long distances.

Moreover, moths eating the blended diet showed wing shape changes after just one generation, a striking physical transformation.

“It appears that resistance occurs faster when worms eat these blends, creating individual moths that have multiple resistance mutations,” Reisig said. “This is one more piece of evidence that blending Bt and non-toxic corn pollen is really dangerous for resistance.”

Reisig adds that his program’s work continues on the effects of Bt corn and non-Bt corn diets, including on corn earworm mating success.

K M Mikac, M J Powley, S Barclay, J H Dominguez Davila and D Pezzini co-authored the paper, which appears in Environmental Entomology. 

The work received support from a Biotechnology Risk Assessment Grant, project award no. 2018-33522-28741, from the U.S. Department of Agriculture’s National Institute of Food and Agriculture. This research was also supported by a University Global Partnership Network (UGPN) grant (2022-23).

- kulikowski -

Note to editors: The abstract of the paper follows.

“Helicoverpa zea selected on Bt corn have wing shapes better suited to long distance flight”

Authors: K M Mikac, M J Powley, S Barclay, University of Wollongong; J H Dominguez Davila, South Coast Structural Engineers; D Pezzini and Dominic Reisig, NC State University

Published: Nov. 19, 2025 in Environmental Entomology

DOI: 10.1093/ee/nvaf117

Abstract: Evolution of resistance within insects to pest control has resulted in changes to the organism’s morphotype, including changes in wing shape. Both geometric morphometric and finite element method (FEM) were used to examine wing changes in Helicoverpa zea sampled from four different Bt corn treatments in North and South Carolina, USA. The four treatments were: pure-stand non-Bt corn (treatment 1), pure-stand Bt corn with two toxins (Cry1Ab and Cry1F; treatment 2); pure-stand Bt corn with three toxins (Cry1Ab, Cry1F, and Vip3A; treatment 3); and seed blended Bt corn with 80% containing three toxins (Cry1AB, Cry1F, and Vip3A) and 20% having no toxins (treatment 5). Geometric morphometric analyses revealed significant wing shape differences in both female and male moths were driven by moderately selected moths (treatments 2 and 5). Male and female moths, especially from treatment 5, had longer and more slender forewing shape conducive for longer distance flight. FEM modelling of the flight potential in both male and female H. zea, revealed that the highest wing elastic deformation values for wind speed, indicating the most impact on wing structure, occurred for treatment 2> treatment 1> treatment 3> treatment 5. Wing elastic deformation was significantly more pronounced in female than male moths. In conclusion, we found that one generation of selection on Bt corn in the field, could induce H. zea wing phenotypes more conducive for potential long-distance dispersal and should be further investigated by directly testing the impact on migratory flight. Our study contributes to the growing body of evidence that selection of H. zea on Bt crops may influence adult dispersal behavior.

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Journal

Environmental Entomology

DOI

10.1093/ee/nvaf117 

Method of Research

Experimental study

Subject of Research

Animals

Article Title

Helicoverpa zea selected on Bt corn have wing shapes better suited to long distance flight

Article Publication Date

29-Nov-2025

 

Study searches for landslide clues in seismic signals from Alaska’s Barry arm

Seismological Society of America

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image: 

View of Barry Arm fjord from left to right: Cascade Glacier, Barry Glacier, and Coxe Glacier. The Barry Landslide hazard is the slope located between the Cascade and the Barry Glacier.

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Credit: Gabrielle Davy

Since 2020, the Barry Landslide in Alaska’s Prince William Sound has been outfitted with instruments monitoring seismic signals from the area, as researchers hope to catch a destructive, tsunami-generating landslide before it starts.

A team of scientists studying those signals have identified an unusual class of seismic events, characterized by impulsive, high-frequency signals that increase in rate from late summer to mid-winter, before coming to an abrupt halt in the late winter or early spring.

In Seismological Research Letters, Gabrielle Davy of the University of Alaska Fairbanks and colleagues suggest that these signals come from water freezing and thawing within microcracks in the rock located beneath nearby Cascade Glacier. The team is the first to systematically analyze these short-impulsive events near the landslide.

While these events do not correspond to movement of the landslide, they could be helpful in monitoring changes in the overall hydraulic environment behind the landslide, which in turn could be a trigger for slope movement, the researchers note.

The search for seismic precursors for a landslide at Barry Arm is a critical endeavor. The risk of landslides is high, because the landslide slope is steep and rests on a crumbly and heavily faulted bedrock. The slope has also lost an important buttress in Barry Glacier, which has been melting and retreating dramatically over the past century.

“What makes Barry Landslide especially concerning is the size of the landslide,” Davy explained. “It’s a large, slowly moving mass—on the order of about 500 million cubic meters—that has been creeping for decades.”

“If a rapid collapse were to occur, the material would fall directly into the fjord, and that could generate a tsunami with potentially high wave heights,” she added. “Barry Arm is visited by kayakers and cruise ships, and nearby communities such as Whittier could be affected, so understanding the hazard is important from both a scientific and a public-safety perspective.”

Recognizing the risks, the area of the landslide has been heavily instrumented since 2020. The SRL study by Davy and colleagues is one of the first to sort through the dataset of seismic signals captured by the instruments.

The researchers took on the massive task of manually reviewing a year’s worth of continuous seismic waveform data for their study, looking for any signals that might be useful in predicting when and where a landslide might occur.

Manually inspecting the dataset allowed Davy and colleagues to understand the diverse set of signals collected, which can be caused by slope movement, frequent earthquakes, glacier movement and other seismic “noise” from the environment.

“We needed to build a clear baseline understanding of the types of signals that routinely occur in the area, so that any unusual or previously unrecognized signals would stand out. By spending time with the raw data, you train your eye to recognize what ‘normal’ looks like” before developing classification tools and detection algorithms, Davy explained.

Once the researchers had a way of identifying these unusual short-impulsive events in the seismic records, they used weather and rainfall data and ground-based radar data to measure changes in slope deformation to analyze the pattern and location of the events.

The signals’ characteristics, locations and strong temporal patterning suggested a source of small, brittle events that occur seasonally when water freezes and thaws within rock cracks.

“Similar seismic signals have been documented in other settings, although they are not widely reported,” Davy said, citing a recent study from Norway that found comparable events near an unstable rock slope that “suggested that their signals may be linked to freeze–thaw processes acting on cracks within the bedrock.”

Co-author Ezgi Karasözen said the Alaska Earthquake Center now has a regional landslide detection system in a testing phase at the Barry Landslide, “which will alert us to any slope failures in this area.”

“As research on landslide seismology grows, there’s increasing recognition that precursor seismic activity—when it does occur—can be an important source of early warning,” said Karasözen. “That motivates broader investigations not only at Barry Arm, but also at other sites in southern Alaska where similar hazards exist.”

Researchers set up GPS-timestamped cameras above Barry Glacier in 2020. Time-lapse records from the cameras helped tie seismic signals to real motion on the glacier and the Barry Arm landslide slope.

Credit

Gabrielle Davy

Journal

Seismological Research Letters

DOI

10.1785/0220250205 

Method of Research

Observational study

Subject of Research

Not applicable

Article Title

Searching for Seismic Precursors—The Barry Landslide Hazard

Article Publication Date

19-Nov-2025