India 2nd Worst-Hit By Covid. Air Pollution Could Be Double Whammy

The number of cases in India has rapidly overtaken Brazil. The weekly average today is tens of thousands of cases more than it was on the first of August. Some expect it to cross 6 million cases by the end of this month. But that's not the only way it's going to get worse. Scientists fear a double whammy once air pollution starts spiraling.

September 7th, the first international day for blue skies day coincidentally saw clean air in Delhi and much of north India, clear enough to see the warning signs. This monsoon has been exceptionally kind to lungs here with the rain and wind removing pollutants. But peak air pollution season is just weeks away.

Pictures: Keya Bhattacharji

Research has shown that air pollution could be an important factor that turns a mild Covid-infection into one that requires acute medical care. In a paper out this month, Professor Michael Brauer of the Institute for Health Metrics and Evaluation summarises the linkages.

Short-term increases in air pollution reduces the immune response to respiratory infections. "Emerging research also suggests the air pollution may alter lung cells to increase the number of SARS-CoV-2 virus receptors and increase the likelihood of the virus binding to receptors."

Long-term exposure to air pollution can lead to permanent damage in the lung that weakens a person's defences. The study says that an infection that might have mild symptoms in a healthy person has a severe impact in those with chronic lung disease. There is also the real possibility of air pollution increasing transmission of the coronavirus: air pollution can lead to an infected person coughing or sneezing.

India has surpassed Brazil to become the second worst-hit in the world by the coronavirus pandemic 

While evidence of a direct link between Covid and air pollution is still limited, there are enough studies to establish that air pollution increases susceptibility. Scientists from the U.S.-based Health Effects Institute point to published evidence that air pollution increases susceptibility to tuberculosis and SARS. Air pollution is also linked to conditions such as diabetes, cardiovascular diseases and so on, which are now recognised as co-morbidities worsening the outcome in coronavirus patients.

Indian officials have so far not put out any advisories on the Covid-air pollution link. Although notably, the Health Ministry has put out a warning that smokers are more susceptible to Covid-19. Oddly, it says nothing about the internal damage smoking does to a person and any connection that may have to Covid infections; air pollution in places like Delhi is like smoking a pack of cigarettes a day.

#IndiaFightsCorona

Quit smoking for good. People who consume tobacco or smoke are more susceptible to COVID-19.
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— Ministry of Health (@MoHFW_INDIA) September 6, 2020

It's hard to forecast how bad the air pollution will be in the coming months. But anyone tracking this is likely to expect high levels of pollution just as in the past few years. How that will affect the coronavirus infections is not fully known (not to mention how millions who've survived Covid will be affected by rising pollution now). Air pollution is estimated to reduce life-spans by nine years in Delhi and 10 in Lucknow, and across India by a little of 5 years on an average. Now, the pandemic makes controlling air pollution far more pressing.

(Chetan Bhattacharji is Managing Editor at NDTV)

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