I am a lung doctor who cares for patients in the clinic and ICU when they are sickened from diseases caused or worsened by air pollution. Air pollution causes diseases in may organs, including the heart and blood vessels, as my podcast guest Dr. Thomas Muenzel today knows too well. He is a heart doctor who can help intervene to open up arteries on patients who are suffering from blockages that cause heart attacks and other damage. For both of us, having a patient come to need our intervention already indicates that person is very sick, and we would both like to prevent them getting that ill in the first place. Dr. Muenzel has studied how air pollution actually damages the blood vessels in our body and around our heart. COVID19 has been consuming communities around the world, and is currently raging out of control in the United States at the time of this post. Dr. Muenzel and his group have worked to define how many of the deaths from COVID19 may be related to its interaction with air pollution.
From the first SARS pandemic, researchers in 2003 determined that breathing polluted air increased the risk of dying from SARS. The link between particulate matter and infectious illness is significant; for example, we know that the flu season following a severe wildfire season and heavy particulate matter burden can be more severe (prior post). The H1N1 pandemic had a similar relationship with particulate matter and mortality.
Similar trends have been seen with SARS-CoV-2, aka COVID19. We all recall how severe the initial devastation from COVID19 was in China and then in Northern Italy. Researchers quickly determined that the severity in both those countries often correlated with PM2.5 exposure. A large analysis in the United States has shown that for each 1ug/m3 in long-term PM2.5 there was an 8% increase in mortality from COVID-19. This was adjusted for population. PM2.5 exposure alone has a 0.73% increase in all-cause mortality for Medicare beneficiaries per 1ug/m3 increase, therefore this is a dramatic synergy with the impact of COVID-19.
Using that analysis and working with atmospheric chemists to determine global PM2.5 exposure, Professor Muenzel and his colleagues determined how much air pollution was contributing to the COVID19 deaths around the world. They found that around 15% of the deaths from COVID19 worldwide may have been caused due to the interaction w/ air pollution. That percentage is around 17% in North American, and higher in areas with a higher burden of air pollution (ie 27% in East Asia). Around half of the excess deaths around the world are due to fossil fuel use, up to 70-80% of the extra deaths in the West are likely due to fossil fuel use.
On the one hand, this is really sad to know that air pollution we create is contributing to the already devastating tragedy of COVID19. On the other hand, it is hopeful to know that there are concrete steps we could take to make the next pandemic less severe by working to decrease air pollution.
One of the devastating cruelties of this pandemic is how much it is hitting some communities harder than others. We have discussed the unfair burden of air pollution on communities of color in other podcasts, but this has been multiplied here. We see it in the ICUs of Oregon, where our Hispanic community has been hit at a higher rate than other communities. Black Americans are dying at 2-3 times the rate as white Americans. There are many reasons for this, but I think a significant component is likely related to breathing more polluted air on average.
As always, so much of our wealth comes from our health. The analysis that Europe alone is paying over one trillion Euros from the health effects of air pollution is staggering. Conversely, the wealth, health and lives that could be saved from cleaning up the air is also a ray of hope. It is in line with what the American Lung Association has found about the benefits of transitioning to a zero emission transportation sector for our own country (read more here).
The analogies to our inaction on climate change and our poor response to both the problem of air pollution and the COVID19 pandemic are sadly congruous. The scientific information has been inconvenient, and therefore ignored, with devastating losses of life and economic stability, when listening and understanding the science and investing intelligently early on would have saved countless lives, money, and jobs. I hope that we all decide to face these interlocking challenges, because pandemics will keep coming and air pollution will keep killing unless we decide to take responsibility and leave a better planet to our children.
TLDR= Don't Light Things on Fire and Breathe them into your Lungs- especially in a pandemic!
What to Do:
1- Follow public health guidance on decreasing COVID19 pandemic so we can get through this sooner.
2- Pay attention to the absolute PM2.5 level where you live and AQI to help determine when it is safe to exercise.
3- Do your part to decrease air pollution in your own life and encourage your community and country to do the same.
4- Consider a donation to the American Lung Association or spreading the word about the importance of healthy air by wearing an Air Health Our Health T-shirt or using a mug or tote (proceeds also go to supporting healthy air).
References:
AP June 2020- Coronavirus ravages Latino communities in U.S.
APM Research lab- “The Color of Coronavirus”- accessed November 2020
