With deteriorating AQI in the Capital, people are flocking to hospitals complaining of respiratory illnesses. The problem is especially acute in patients who have battled the Coronavirus

As smog stifles the national capital, the Delhi government is mulling restricting many activities, while some have already been restricted. The Supreme Court has also raised concerns over the prevalent pollution in Delhi-NCR. And even though covid cases have gone down considerably, the high levels of pollution in the air are creating problems now just for Covid patients but also for those who have recovered from the virus. 

Hospitals in the national capital are facing an influx of patients complaining of respiratory illnesses and cardiac problems. Dr Ishan Gupta, Senior Registrar, Pulmonary Medicine, Apollo Hospital  says that since pollution increased in the capital, people are flocking to the doctors with complications and a  large number of these are Covid recovered patients.

Researchers find that an increase in exposure to hazardous air pollutants is associated with a 9% increase in death among patients with Covid-19. Essentially, the higher the air pollution index, the more it correlated to poor health outcomes due to Covid-19. The likely reason: these pollutants cause respiratory stress, thereby increasing vulnerability to severe illness from Covid-19.

In December 2020, another study tried to determine the effects on  mortality  from Covid-19 increased with long-term exposure to fine particle pollution; the researchers estimated that, on average, 15% of worldwide deaths from Covid-19 may be linked to chronic exposure to air pollution.

Air pollution thus has a detrimental effect on health, contributing to respiratory and cardiovascular diseases and increasing mortality rate. The main culprits for this effect comes from hazardous particulates or particulate matter (PM2.5, PM10), carbon monoxide (CO), nitrogen oxides (NOx), and sulphur-oxides (SOx).

Dr Dilshad, a doctor in Delhi, says that the pollution in Delhi has been constant for many years, thanks to traffic and other human activities. It affects everyone from paediatrics to people with geriatric problems, no one is immune to it. Its severity depends on the size of the suspended particulate matter i.e., PM2.5 and PM10, and the smaller they get the more harmful they become. For a majority of the year, the Air Quality Index (AQI) remains in the poor to the very poor category, with the current average being AQI 462, the worst in 5 years.

The price of laxity

According to the Central Pollution Control Board (CPCB), this year on the night of Diwali, the level of PM2.5 in Delhi ranged from 348-484 microgram per cubic metre and 439 micrograms per cubic metre on average. It was 8780% more than the permissible limit defined by WHO, and 731.6%  more than the limit prescribed by India`s NAAQs.

Avinash Chanchal,  senior climate campaigner from Greenpeace India, said “There is abundant evidence that exposure to air pollution increases our vulnerability to respiratory viral infections both in terms of transmission and the severity. Researchers have linked air pollution with mechanisms that may reduce our immune defences such as damage to human airways, cilia and epithelial barriers. In the case of Covid-19, current evidence indicates that chronic exposure to air pollutants is associated with more severe infections and higher mortality”. 

“People are already paying a huge price for air pollution. Polluted air increases the likelihood of deaths owing to cancer and stroke, the spike in asthma attacks, and worsens the severity of Covid-19 symptoms”. 

Shobha Suri, a senior fellow with ORF`s Health Initiative Air quality echoes the same thoughts saying that “pollution also increases the susceptibility to Coronavirus, by affecting the body’s immune defence, making an individual more susceptible to respiratory and other infections. Children will be at high risk—they have already been affected by lack of adequate physical activity and social interaction due to prolonged stay at home due to Covid-19”.

Dr Ishan Gupta, Senior Registrar, Pulmonary Medicine, Apollo Hospital said that the hospitals are now running full due to exacerbation in COPD and other respiratory illnesses. We are also seeing respiratory complications in paediatrics patients, who don’t even have any family history of such diseases, he further said. PM2.5 is more dangerous because it settles down deep inside the lungs, thus it becomes difficult to remove it from the body as compared to PM10.

Tanushree Ganguly, Program Lead at CEEW, says the reasons for this year`s pollution remains the same, despite precautionary steps from the governments. She says, “Delhi itself is responsible roughly 60% and the rest 40% is due to the neighbouring states”. She also stresses on the need to look for alternative fuels sources to minimise air pollution. We now have to take this menace very seriously and governments should be proactive in execution as well as in implementation.

Experts thus recommend that patients who are already suffering from COPD or any other respiratory related illness, should start taking their medications and precautions beforehand, and should adhere to the routine as suggested by their consultants. 

Measures only on paper?

The Central Pollution Control Board (CPCB) shows that out of the total complaints they have received from 15 Oct 2021 to 5 Nov 2021, they were able to resolve only 16% of the complaints. CPCB in their Winter Inspections reports of 25 Oct 2021-5 Nov 2021 and 20 Oct 2021-4 Nov 2021 neither mentioned that crackers have been busted illegally nor did they recognise them as the source of air pollution. Whereas, many mainstream media outlets reported that people in Delhi flouted the cracker ban by the government.

Although, the government of India has launched many schemes and programs like the National Clean Air Program, National Air Quality Monitoring Program, National Ambient Air Quality Standards, National Air Quality Index, Forty-two Action Points, Environment Pollution (Prevention and Control) Authority, Graded Response Action Plan to combat Air Pollution which seem to have failed, having no considerable impact on the levels of air pollution in the capital. 

In January 2019, The Central Government launched the National Clean Air Programme (NCAP) with targets to achieve a 20% to 30% reduction in Particulate Matter concentrations by 2024. The NCAP had set the timeline for the creation of a National Emission Inventory as 2020. But India is yet to formalise one, according to CEEW findings, Tanushree informed.

The Delhi government also installed a smog tower in Delhi’s Connaught Place to give breathable air to residents. However, its impact has so far been limited.  

Sunil Dahiya of the Centre for Research on Energy and Clean Air says that environmentalists and scientists are of the opinion that there is no proven record or global data that establishes that smog towers are effective. “This experiment at Connaught Place has shown that smog towers can never be a solution to the problem of air pollution. Any further wastage of money on such structures should be stopped immediately. The money should be utilised to reduce pollution at source,” he adds.

(Cover: Getty images)