The Latest Findings: Is There a Connection Between COVID-19 Mortality Rate and Air Pollution?

COVID-19 has been at the forefront of the news since January. It seems that, with every subsequent day, we’re finding out new information about this ever-developing virus. And, as death tolls continue to rise, research on the virus and factors that increase death rates are increasingly important.

We might be as much as a year away from a vaccine, but there are undoubtedly outside factors that we can address to help decrease the severity of the disease until we can generate a vaccine. One of those outside factors might be from the literal outside world -; our environment itself.

We all know that pollution and global warming are major issues on their own, but could they affect COVID-19 as well?

What We Know about COVID

There are a few things that we’ve known about this disease from the beginning.

Airborne and droplet transmission spreads the virus

Anyone who has the virus can spread it through coughing or breathing. If others inhale their exhalations, they catch COVID. This explains how the virus can enter the body -; through the nose and mouth. Health officials encourage wearing masks to cover the lower portion of your face and therefore block the spread.

COVID-19 enters cells through the receptor ACE2

ACE2 is a protein on the surface of certain types of cells in your body that are responsible for cleaving angiotensin II. Angiotensin is a different protein that is associated with increased blood pressure and inflammation.

Functional ACE2 receptors decrease inflammation. COVID-19 can bind to ACE2 through a spike-like protein it has (think of it as a key inserted into a lock) and, from there, enter your cells. It can then replicate and spread to other cells. ACE2 itself is found in several different tissues, such as the lungs, heart, blood vessels, pancreas, kidneys, and gastrointestinal tract.

COVID-19 and the lungs

One of the hardest-hit organs by COVID-19 is the lungs, because COVID is airborne-spread, and therefore the lungs are the first organ to encounter it. As mentioned earlier, the lungs have ACE2 receptors, and as the ACE2 receptors are “kept busy” with the COVID binding to it, they cannot break down angiotensin II, leading to inflammation and lung damage. This explains why people with COVID often have difficulties breathing and have to be hooked up to respirators when their condition worsens.

Looking at Environmental Factors and COVID

With this knowledge in mind, a highly researched topic surrounding COVID-19 has been what external factors influence death rates, specifically those associated with preexisting health conditions concerning the lungs. If COVID-19 is damaging to the lungs, it makes sense that environmental conditions that also damage the lungs might increase death rates.

There are many ways to tackle a problem and ease it. Even if we do not yet have a vaccine for the virus, by moderating those external conditions, we could do everything possible to decrease the severity of the disease and lower death rates. As such, scientists have been researching COVID-19 and air pollution.

Pollution and PM2.5

Air pollution is one such environmental factor that contributes to lung health. PM2.5 are particles whose diameter is less than 2.5 micrometers. These are tiny and need microscopes with a strong focus for us to even see them. PM2.5 are considered fine particles, as they’re smaller than most other pollutants.

They come from power plants, burning gas, dust storms -; sources both man-made and natural -; but the amount of PM2.5 in the air has increased with our steadily increasing carbon emissions. These are especially dangerous because they’re so fine and light that they can hang in the air for longer than other particles. Humans are therefore more likely to inhale them and inhale them deeply since they’re small enough to squeeze through some of our natural body filters.

Scientists have done research showing that increased exposure to PM2.5 correlates with increased heart and lung disease-related deaths. PM2.5 worsens heart and lung-related problems. They have even found that for every 10 micrograms per cubic meter increase in airborne PM2.5, there’s an 8% increase in lung cancer deaths. High PM2.5 levels can additionally weaken the immune system, making your body even more susceptible to infection.

Other studies have found that PM2.5 increases inflammatory responses in the immune system. All of this information points to the same conclusion: PM2.5 is bad news for our health.

COVID-19 and Pollution

To summarize so far, PM2.5 and pollution can cause inflammation in the lungs and increase the risk of infection by bacteria or viruses. COVID-19 is an airborne virus that causes significant damage to the lungs, so scientists have hypothesized that COVID-19 symptoms and deaths might be worse in areas with high pollution. Several papers have been published to corroborate this hypothesis.

The Netherlands Study

One study examined the rates of COVID-19 in 355 different regions of the Netherlands and found that the southeast regions of the country had the highest numbers. The southeast regions were rural areas with lower populations. This seemed counter-intuitive for an airborne virus that spreads primarily from person to person. Some news sources suggested festivals bringing high volumes of people into the area as the likely culprit but, if this were true, COVID case rates should only peak during times surrounding the events.

Further analysis then revealed that the southeast Netherlands house over 50% of the country’s livestock. And, with livestock, comes high levels of pollution because of the large amounts of excrement these animals produce. Ammonia is a large proportion of PM2.5 particles. And, sure enough, the southeast Netherlands was found to have the highest concentrations of ammonia in the air.

This study concluded that for every 20% increase in air pollution, COVID rates nearly doubled. Pollution was the culprit.

The China Study

Researchers in China examined 72 different cities in China, looking at 25,000 COVID-19 cases and the PM2.5 concentrations in the air. By tracing COVID cases and the PM2.5 levels over a series of weeks, they could find links between rises in pollution and infection rates.

When the levels of PM2.5 increased by 10 micrograms per meter cubed, the number of COVID-19 reported illnesses and deaths increased for the next couple of weeks. This was found even if the PM2.5 increase was seen for as little as a day, meaning that even short pollution spikes can have long-term effects on COVID-related cases.

We must note that this study did not take into account preexisting health conditions or socioeconomic levels, meaning the effects of PM2.5 on COVID could be even worse than the study reports. It also did not consider the impact of living in areas with consistently high PM2.5 as opposed to living in areas with small spikes every once in a while.

COVID and Pollution Around the World

The results from these studies have been echoed by researchers around the world. In Italy, they found that in Northern Italy, where PM2.5 levels are highest, the death rate was three times as high as other regions in Italy. Similar findings were seen in Denmark. The World Bank even released a study finding a significant correlation between COVID-19 and air pollution.

While more experiments need to be done under different conditions to see full the effects of pollution, there is powerful evidence for a detrimental correlation between pollution and the viral disease.

What Does This Mean for Us?

Pollution itself is already an enormous problem. Global warming is one of the biggest battles that our world is facing.  Though some countries are bringing down their PM2.5 levels, in others, it’s still high. The United States has seen a 23% decrease in PM2.5 air concentration in the last 10 years.  These puts them at less than 10 micrograms per meter cubed, but China remains above 40 micrograms per meter cubed. Change is happening, but it’s gradual and not enough.

We already know that pollution is damaging to our health.  However, the prevalence of pollution is also higher in areas of lower socioeconomic standing. This leads to increased health disparity in communities that already have a harder time paying for health care. Adding COVID-19 into the equation means increasing those health differences in different communities. Pollution and COVID-19 are not only health problems, but social and economic ones. Every single person has a stake in this, as it’s a humanitarian problem.

Taking Action

Across the world, we need to do our part in decreasing carbon emissions and air pollution. We keep seeing the effects of pollution play out on our health, our happiness, and our well-being.  It’s time to put a stop to it.

The emergence of COVID-19 is just another reminder that pollution hurts us on every level, and we can’t let it continue. If we want to do our part in the world, we need to take action. Most of us might not be researchers or healthcare workers, but we can all help fight COVID-19 and improve the environment at the same time by decreasing our carbon footprint. Saving the world doesn’t always have to be dramatic -; sometimes it’s taking one step at a time to use less gas or recycle a little more.