Those living in polluted cities are more at risk from Covid-19, the European Public Health Alliance (EPHA) warned today.

Air pollution can cause hypertension, diabetes and respiratory diseases, conditions that doctors are starting to link to higher mortality rates for Covid-19. A 2003 study on victims of the coronavirus SARS found that patients in regions with moderate air pollution levels were 84% more likely to die than those in regions with low air pollution.

The European Respiratory Society (ERS) is an EPHA member. Dr Sara De Matteis, Associate Professor in Occupational and Environmental Medicine at Cagliari University, Italy, and member of the ERS Environmental Health Committee said: “Urban air quality has improved in the last half century, but petrol and especially diesel vehicle fumes remain a serious problem. Even the latest diesel engines emit dangerous levels of pollution. Patients with chronic lung and heart conditions caused or worsened by long-term exposure to air pollution are less able to fight off lung infections and more likely to die. This is likely also the case for Covid-19. By lowering air pollution levels we can help the most vulnerable in their fight against this and any possible future pandemics.”

Air pollution is the biggest environmental health risk in Europe, with the problem greatest in cities, according to the EEA. Particulate matter (PM), nitrogen dioxide (NO₂) and ground-level ozone (O₃) cause the most harm and lead to about 400,000 early deaths annually. One hotspot is Northern Italy, centre of Europe’s Coronavirus outbreak. Urban NO₂ pollution comes mainly from traffic, especially diesel vehicles, which are also a major source of PM. There has been a sharp rise in the proportion of diesel vehicles across Europe since the turn of the millennium, many of which have failed to comply with European air pollution standards. By December 2019, the EU had begun 71 air quality infringement procedures against member governments.

Satellite imagery has revealed a remarkable drop in NO2 pollution.

PM10 levels in Lombardy have fallen dramatically after 10 days of COVID-19 social distancing measures. NO2 levels have also dropped significantly.

“The air may be clearing in Italy, but the damage has already been done to human health and people’s ability to fight off infection. Governments should have tackled chronic air pollution long ago, but have prioritised the economy over health by going soft on the auto industry. Once this crisis is over, policymakers should speed up measures to get dirty vehicles off our roads. Science tells us that epidemics like Covid-19 will occur with increasing frequency. So cleaning up the streets is a basic investment for a healthier future,” EPHA Acting Secretary General Sascha Marschang said.