Supposedly fresh air would be taken care of by a unit that brings in fresh air, exhausts house air, and eliminates energy loss by using a heat exchanger. How well this works in practice, though, is another question. But it does seem like a good idea--every place I've ever lived is closed up in winter--everything stays shut as much as possible (windows, doors, etc). This has, unfortunately, included places that had air quality issues. Given the cost of heating, I have a hard time flinging open a window for fresh air. (Except, of course, in the case of an emergency, like a huge plume of smoke from a failed cooking experiment.)