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COVID-19 & Air Pollution

Medically reviewed by Pulmonologist Kelly Fan, MD, Susan Kerrigan, MD and Marianne Madsen on January 8, 2023

There’s a murky relationship between air pollution and coronaviruses, which may mean that tackling air pollution will be a crucial part of easing lockdown and tackling this virus that seems to have taken the entire world by storm. Global lockdowns do seem to have left a more clear, blue mark on the skies of many of the world’s megacities. This article explores the relationship between COVID-19 and air pollution.


Besides the 4.2 million deaths resulting from air pollution annually, researchers in the US are building a case that suggests that air pollution has significantly worsened the COVID-19 outbreak and led to more deaths than if pollution-free skies were the norm. In addition, it seems that people who had been living surrounded by high levels of air pollution are predisposed to COVID-19. Even further, scientists are suggesting that air pollution particles may be acting as vehicles for viral transmission. These new findings may have a meaningful impact on how governments choose to ease lockdowns in the coming months, as scientists say that improving air quality could play an important role in overcoming the pandemic.

Facilitating spread of the virus


The assumption that air pollution conditions facilitate the spread of the virus was shown and supported by a study conducted by Cui et al. during the SARS outbreak in mainland China in November 2002. This study analyzed the correlation between the API (Air Pollution Index) and the rate of death as a result of SARS across 5 regions in China.

The regions were selected according to their elevated Air Pollution Index and took into consideration that an API less than 100 is thought to be healthy for the general population. The study demonstrated a positive association between air pollution and SARS case fatality in the Chinese population.


One recent study found that even small increases in fine particulate matter, known as PM2.5, have had an outsized effect in the US. An increase of just 1 microgram per cubic metre corresponded to a 15% increase in COVID-19 deaths, according to the researchers at the Harvard University T.H. Chan School of Public Health. Another recent study from the SIMA (Società Italiana di Medicina Ambientale) reported that the specificity of the high spread of the contagious virus in some areas of Northern Italy is likely to be linked to air pollution conditions.


The particulars of particulate matter


Particulate matter is like a virus: It seems containable in small doses until one day, it’s not. Described by the Environmental Protection Agency (EPA) as a complicated mixture of small particles and liquid droplets, it’s made up of the soot created by our industrial world. Particle pollution includes “acids (such as nitrates and sulfates), organic chemicals, metals, and soil or dust particles.” Particulate matter is created from factories and cars but also through natural events like forest fires and dust storms.

What particulate matter does to us


Particles that are 10 micrometers in diameter or smaller are the key because these are the particles that make their way through your nostrils, into your lungs, and even into the bloodstream. The impact that these particles have on the human body can be aggravated asthma, irregular heartbeats, decreased lung function, increased coughing, nonfatal heart attacks, and premature death, according to the EPA.


SARS virus and other respiratory diseases such as COPD (chronic obstructive pulmonary disease) seem to find fertile “territory” in air pollutant particles, and they appear to survive longer and become more aggressive in an immune system already aggravated by these harmful substances. This hypothesis needs to be further validated by additional future studies in more geographic regions that have been affected by the COVID-19 pandemic.


Evidence is clear


“The evidence we have is pretty clear that people who have been living in places that are more polluted over time, that they are more likely to die from coronavirus,” says Aaron Bernstein, the director of the Center for Climate, Health, and Global Environment at Harvard University. Scientists warn that pollution levels must be limited as much as possible to minimize the effects of a second wave of coronavirus. Maria Neira, director of environment, climate change and health at the World Health Organization advocates for a green recovery from the crisis. She urges governments to take this into account when easing lockdowns. The global response to COVID-19 should be harnessed to create a healthier society, one that is better prepared for emergencies, according to Neira. “After the masks are gone, we will breathe cleaner,” she says.

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