Dr. Mitchel Rosen was across the country for a work conference when Sandy slammed his New Jersey home. He remembers watching TV reports on the damage as he waited for intermittent phone calls from his family back home in Middlesex County.

When they finally did get in touch, they had one request.

“Batteries,” said Rosen, director of the Center for Public Health Workforce Development at Rutgers University. The widespread power outages meant those little canisters of electric charge were in high demand.

“So, I bought a lot of batteries and put them in my suitcase and flew home,” he added.

Rosen knows better than most how critical it is to get power back after a destructive storm like Sandy. He’s trained hundreds of people on how to beat back one of the most tenacious consequences: mold.

Creeping, furry fungus colonized tens of thousands of homes in the areas hardest hit by Sandy, according to estimates from community groups. Storm recovery cost billions of dollars, and an individual home with a major mold problem may have cost as much $25,000 to remediate, according to a report by New York City advocacy group ALIGN. Homeowners and renters alike endured long waits and headaches over red tape as they navigated the remediation process.

A handful of buildings still bear the scars — from a Bronx firehouse with mold-damaged walls and ceilings to a Brooklyn NYCHA development where residents have filed hundreds of mold-related lawsuits. Many more sat unremediated for months or even years after Sandy, posing health risks to children, elderly residents, people with asthma, and the immunocompromised.

In the weeks and months after the storm, doctors, residents, and contemporaneous news coverage all reported a smattering of respiratory symptoms among storm survivors, called “Sandy cough,” “Coney cough,” or “Rockaway cough,” depending on who you asked and where they lived. Because these symptoms often weren’t severe enough to send people to the hospital, data on the phenomenon is hard to come by — but health officials acknowledged it was a problem at the time.

“Providers in the Rockaways have identified patients with respiratory symptoms that they have attributed to viral respiratory infections, exposure to respiratory irritants due to cleanup work or exacerbations of asthma and chronic obstructive pulmonary disease [COPD],” the health department’s Dr. Jay Varma told the Amsterdam News, adding that many of those affected had pre-existing respiratory issues.

As New York City continues to confront a changing climate and the prospect of more frequent intense storms, are we better prepared to fight off fungal invaders? Experts say yes, sort of, pointing to recent changes to the law and to homeowners’ understanding of the seriousness of mold. But they add that the city needs to do more to protect its most vulnerable residents against the ravages of flooding and the mold that follows.

“We learned a bit from Sandy,” said Michael Schmeltz, an assistant professor of public health at Cal State East Bay who studied the city’s response to the storm as a graduate student in New York City. “We have the recovery and the emergency response down. But we really need to focus on that preparation.”

'The phone wouldn’t stop ringing'

In Sandy’s immediate aftermath, tens of thousands of New Yorkers had to vacate their homes because of the floodwaters and the damage left behind. Others struggled through days and weeks without power, heat, and hot water. Months after the storm, thousands were still living in damaged homes, or else in temporary emergency housing, according to a 2013 state Senate report.

These absences left a window of opportunity for mold, which thrives in damp conditions. And without power, it was difficult for residents to start the process of drying out their homes to curb the fungal spread.

“They like the same living conditions that we do,” Dr. Howard Waksman, a pulmonologist at Deborah Heart and Lung Center, said of fungi. “It’s no wonder that you’re going to see more mold and mildew. The dampness will support the mold.”

Even upon returning to their homes, residents struggled to get a handle on mold’s growth — which typically starts within 24 to 48 hours of water exposure. Contractors were completely overwhelmed with inquiries, and there weren’t enough skilled workers to go around.

We could not get enough people. The phone wouldn’t stop ringing.
Oren Saar, owner of Indoor Mold Specialist

“The first few months after the storm, it was literally insane,” said Oren Saar, who worked for a mold remediation company after Sandy and has since started his own inspection firm, Indoor Mold Specialist, in Bergen Beach. “We could not get enough people. The phone wouldn’t stop ringing.”

News outlets reported that some homeowners were scammed by underqualified contractors, who rebuilt homes without properly drying them out first — leading to yet more mold growth.

Paying for the repairs through insurance and federal aid programs also posed a serious problem for many survivors. Contemporaneous news reports describe delayed inspections, bogus denials, and insufficient payouts.

November 6, 2013: Far Rockaway residents clear out a home that flooded following Hurricane Sandy. Mold growth typically starts within 24, to 48 hours of water exposure, according to the U.S. Environmental Protection Agency.

The city’s offerings were limited, too. Its Rapid Repairs effort restored more than 11,000 homes to livable condition, but the program didn’t include the intensive repairs needed to curb mold growth. A small mold remediation program, funded by private donations, treated about 2,000 homes in hard-hit areas.

All together, these delays and obstacles gave mold the time and conditions it needed to take hold, experts told Gothamist.

“The combination of things — not having power and then not being able to purchase and utilize dehumidifiers, not having enough contractors, not hanging enough homeowners understanding what needs to be done — all these things are ripple effects that caused greater destruction,” Rosen said. “It was such a high amount of devastation that it overtook the system.”

'Coney cough' and other maladies

Studies show that breathing in mold can cause allergic reactions in some people. Coughing, sneezing, wheezing, runny nose, and congestion are all typical symptoms. Mold exposure can also exacerbate symptoms for people with asthma or other respiratory illnesses.

Emergency room visits ticked up slightly in the storm's aftermath, but went back to normal shortly after. Officials in New York and New Jersey told the New York Times they saw no lasting trends in post-Sandy respiratory illness.

But some residents remember differently.

“For well over a year after Sandy, everybody had the Coney cough, and we had it in Brighton Beach, too,” said Ida Sanoff, an environmental advocate whose Brooklyn neighborhood was devastated by Sandy. “We all attributed it to the mold.”

A 2015 study of 1,000 New Jerseyans affected by Sandy found that people exposed to mold were more likely than their peers to report both asthma symptoms and emotional distress.

Invasive mold infections are uncommon but can be fatal.

New Jersey’s Deborah Heart and Lung Center screened more than 1,300 people in Ocean and Monmouth counties in the months after Sandy. Of those, about 200 were referred for additional testing or treatment for their respiratory symptoms. Referral rates were higher among those who lived in the most heavily damaged areas, Deborah’s John Hill, a registered respiratory therapist, said in a 2013 interview with the American Association of Respiratory Care. But he warned that the finding is far from establishing cause and effect.

“At this point we are not speculating at all that these referrals are Sandy-related,” Hill added at the time.

In storm-stricken Coney Island, residents asked the city's health department to study the phenomenon as recently as 2019, but they haven’t heard anything back. In a statement to Gothamist, health department spokesperson Shari Logan said that the agency monitors air quality across the city and posts neighborhood-specific information online.

For immunocompromised New Yorkers, mold poses an even greater risk. Invasive mold infections are uncommon but can be fatal. People with weakened immune systems are advised to stay away from moldy environments. Children and elderly people are also more sensitive.

Overwhelmed homeowners, contractors and volunteers all faced these risks firsthand during Sandy's aftermath. In a mold remediation training a few months after landfall, Randy Creamer, a volunteer with Southern Baptist Disaster Relief, told a roomful of people that “the greatest risk and the greatest danger for you are the things that you can't see. You will start to pick up odors. You'll start to have a lot more of this stuff” — he cleared his throat and coughed for effect — “going on.” He and other experts urged the use of masks, gloves, and other personal protective equipment for anyone involved in mold remediation.

The health risks of mold were particularly acute for New Yorkers living in poverty, who experience higher rates of asthma-related hospitalizations and emergency department visits than their peers in wealthier neighborhoods. For many residents of NYCHA buildings, the storm only exacerbated a pre-existing mold problem. A 2014 study of NYCHA residents found that a third of those surveyed were dealing with mold prior to Sandy. After the storm, that number jumped to 45%. More than half of respondents dealing with mold said it was adversely affecting their health.

“Poverty is the biggest indicator of whether people have the coping capacity to confront a climate challenge,” said Kizzy Charles-Guzman, executive director of the Mayor’s Office of Climate and Environmental Justice. “Can they get up and go? Can they seek refuge? Can they get primary care? All of these are things that, when a storm comes, really affect whether you live or die.”

The present and future of fighting mold

Experts said that a decade after Sandy, New Yorkers and New Jerseyans have learned a thing or two about fungus-fighting.

The fallout inspired some clever rebuilding strategies. Community groups deployed squads of volunteers and used charitable donations to hire contractors for batch jobs, pushing down the cost per home.

Volunteers and officials also trained homeowners, building inspectors, and others on how to safely spot, treat, and protect against mold.

Saar, the mold remediator, said his clients are much more aware of the risks posed by mold than they were before the storm.

“People are a little more cognizant of their situation at home or in their office,” he said. “If they see a small problem, they’ll call a professional right away.”

Laws changed, too. In an effort to curb unscrupulous contractors, New York now requires all mold remediators to be licensed. State law also says that, in order to avoid a conflict of interest, mold inspections and remediations must be conducted by different firms.

But subsequent storms have shown that there’s still much to be done. Last year, the remnants of Hurricane Ida flooded homes, overwhelmed infrastructure and killed dozens of people in New York and New Jersey. Mold remediation companies were overwhelmed by demand — one business owner told Curbed he was booked for weeks.

And that’s just for the people who had the funds to start cleaning up. Close to 30,000 households in Brooklyn and Queens applied for relief money from the federal government, but only half of them actually received it. Even residents who did receive funding from FEMA found that it fell far short of what they needed to repair their homes. Some New Yorkers in coastal communities still feel just as vulnerable to the next big storm.

“There's been a million plans, a million projects,” Sanoff, the environmental activist, said of the work that’s been done since Sandy. “A lot of these projects don't seem to have anything to do with each other. And we are all sitting ducks here.”