The nation is grappling with a novel coronavirus pandemic and Delhi is witnessing the acute problem of air pollution and high rate of virus transmission at the onset of the winter season. It has been claimed by the health experts and officials that stubble burning in Punjab is adding to the woes of Delhiites. But, according to Punjab, the National Capital Region must evaluate the other factors which have deteriorated the air quality.
Now, another study has come to light which states that the virus transmission rate will become more severe due to air pollution. Consequently, it will make people more vulnerable to the disease and will aggravate the Covid-19 situation, experts said. Besides this, people who have had the infection in the past might have to face new challenges.
As of Tuesday, Delhi's air quality was in the 'poor' category and the government has warned that it will turn to 'very poor' by tomorrow.
According to doctors, respiratory illnesses, such as viral influenza, increase with a spike in pollution levels as poor air quality leads to inflammation in the lungs making it more vulnerable for the virus to penetrate.
“This year, we have COVID-19. Like the common cold, the transmission of this virus is expected to increase with a rise in pollution levels. We may see a further surge in cases. It would be a taxing time for testing centers as they have to cater to people with coronavirus and also non-COVID patients with similar symptoms,” Dr Neeraj Nischal, an associate professor in the Department of Medicine at AIIMS, told 'The Tribune'.
According to experts, people of lower socioeconomic strata would be worst affected as they have no access to masks and also are vulnerable to additional risk factors such as 'chulla' smoke.
"Transmission apart, the presentation of COVID-19 like other viral respiratory illnesses will be more severe in high-pollution areas. This will burden hospitals as more patients become symptomatic, requiring admission," Dr. Nischal said.
According to Dr Neeraj Gupta, a professor in the Department of Pulmonary, Critical Care and Sleep Medicine at Safdarjung Hospital, the mortality rate is directly linked to population density, how far people are residing, and heavily industrialized or urbanized areas where pollution levels are higher than average.
Thus, these factors are anticipated to become more effective during the festive season and winters, especially in North India as stubble burning is a common practice here and this affects the air quality drastically, Dr. Gupta said.
"Italy showed a possible link between PM 2.5 concentration and excess mortality to the extent that one-unit increase is associated with a 9 percent increase in COVID-19 mortality," Dr. Gupta said, adding that pollution could also assist in the transmission of the novel coronavirus.
Divulging more details on it, Dr. Gupta added, during smog, particulate matters remain suspended in the air near the earth’s surface for a longer period making it conducive for the transmission of the virus.
Dr. Suranjit Chatterjee, senior consultant of Internal Medicine at Apollo Hospitals, said: “We really don’t know how this virus is going to behave. But we need to prepare ourselves for the worst as pollution level increases and with winter setting in. It will be a dangerous combination.”
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He warned that people with respiratory illness, such as asthma and bronchitis, were at a much higher risk of contracting coronavirus infection.
“For people who have tested positive for COVID-19, it is going to be a double whammy, with pollution making things worse,” he told the news agency.
Doctors have also cautioned those who have had tested positive for Covid-19 in the past to stay alert as they might contract the infection again.
“Post-COVID fibrosis and immunoparalysis make their lungs more susceptible to super-added bacterial pneumonia and other viral respiratory illnesses. We urge everyone to get inoculated with the influenza vaccine and pneumococcal vaccine to prevent additional infections in these times,” Dr. Nischal stressed.
According to Dr. Gupta, the number of Covid-19 survivors is increasing exponentially, a significant number is noted to be symptomatic — 43 percent with respiratory complaints — even after two months.
These individuals are particularly vulnerable to air pollution, which is known to cause chronic airway irritation and inflammation, affects mucus clearing, impairs immunity, and acutely precipitates airway disorders such as asthma, COPD, lung fibrosis, or even cancer-related conditions.
Dr. Vivek Nangia, principal director and head of pulmonology, Max Super Speciality Hospital in Delhi’s Saket said that those individuals who are considered to be in the high-risk groups, who are at extremes of ages and suffering from chronic disease, have been advised to stay indoors or at least restrict their movement to bare essential activities outdoors.
"While outdoors, wear a mask at all times and stay away from firecrackers during Diwali. Keep an inhaler handy and consult a doctor at the earliest. Even for the others, it is strongly recommended that they minimize their outdoor activities and wear a mask at all time," he said.
"The number of cases will go up. There is a study which has been published by Harvard Medical School, USA, where they have shown that with every 1 micron per metre rise in PM 2.5 particles, there’s an 8 percent increase in the mortality," he said.
Dr Gupta said, "Indeed, a tough time for post-COVID patients is in store."