Stalking the efforts of the government and the private sector to revive the economy in the time of COVID-19 are two dangers to people’s health — air pollution and greenhouse gases — and a weak public health system. The respite from the air pollution that blankets Indian cities is transitory. India must heed scientists’ warnings tying health disasters to air pollution as well as greenhouse gas (GHG) emissions causing global warming.
A noxious cocktail
Strikingly, the avoided number of early deaths from dirty air quality in recent months in China is estimated to have exceeded the number of those who have died from COVID-19. In Europe, 11,000 air-pollution related deaths were estimated to have been averted since the start of lockdowns. There is an association between pollution levels in cities (despite the improvements during the pandemic) and COVID-19 infections and death rates, a link observed in New York City and the northern provinces of Italy. Delhi, Maharashtra, Gujarat, and Tamil Nadu, in the top tier of pollution concentration, have also seen high deaths and infections per thousand people.
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Of course, other factors too decide morbidity and mortality. COVID-19’s toll has differed considerably across States — Kerala and Tamil Nadu, for example, have a lower COVID-19 mortality rate. These States stand out with good healthcare systems.
Globally some 9 million premature deaths a year are associated with air pollutants, such as fine particulate matter, known as PM 2.5. Regrettably, 14 of the world’s 20 most polluted cities are in India. The air in Ghaziabad, Delhi, and Noida is particularly hazardous. Last year, a public health emergency was declared as post-Diwali New Delhi’s air quality index approached 500, the “severe plus emergency” category.
Adding to this noxious cocktail are GHGs like carbon dioxide, causing global warming and damaging health. Despite the plunge during the lockdown, atmospheric carbon emissions are a record high because of past accumulation. Ranked as the world’s fifth most vulnerable country to climate change, India must respond to alerts on communicable diseases linked to GHGs. Global warming intensifies heat waves and worsens respiratory illnesses. Locust swarms in Jaipur and Gurugram have been linked to climate change. Evidence is also emerging on a link between global warming and the emergence of diseases. Mosquito-borne diseases in India have been connected to global warming through both increased rainfall and heat waves. Europe reported its first local transmissions of dengue in 2010.
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Need for a new plan
So, India must not scramble to return to bad old ways of boosting short-term growth at any cost but capitalise on the tantalising glimpse of a healthier and cleaner world. Spending on reducing air pollution and GHGs provides estimated health benefits of 1.4 to 2.5 times more than the cost of the actions. Delhi, set to overtake Tokyo as the most populous city by 2030, needs to deal with transport, responsible for two-fifth of the PM 2.5 in the skies. Reforms should encourage public transportation in place of the 10 million vehicles, expand electric vehicles, and provide inter-connectivity between the metro and buses.
In managing health risks, emission reduction should be coupled with a stronger public health system. Right now, government spending on health is just 1.6% of GDP, low for a lower middle-income country. Most countries, including India, fail the test of readiness for health disasters, according to the 2019 Global Health Security Index. The cleaner air the country is still breathing during the pandemic should be a powerful motivation. Scientific warnings do not indicate the time and place of calamities but do call for confronting air pollution and global warming and strengthening health systems before the next health emergency that is surely going to happen.
Vinod Thomas is Visiting Professor at the National University of Singapore and a former senior vice president at the World Bank.@vthomas14