Course material will include a discussion of clinical presentations and basic mechanisms of severe and difficult-to-treat asthma and COPD with the goal towards optimization of personalized treatment approaches. We will provide a basic overview of mechanisms of lung toxicity from environmental exposures including ambient outdoor pollutants such as traffic-related pollution, the role of the built environment in lung immunity and airway diseases, inhaled toxins from tobacco and tobacco-related products. We will discuss clinical as well as policy interventions to mitigate these exposures. Finally, we will provide an update on the interaction of asthma, COPD, and infection with the novel SARS Corona Virus-2 (COVID-19) including information on epidemiology, immune mechanisms and therapeutic interventions specific to these lung diseases and discuss environmental interventions to reduce inhaled exposure of SARS CoV-2. At the end of this symposium, the participant will have improved expertise in asthma and COPD management involving new therapeutics and environmental modifications.