Virus particles can piggyback on PM 2.5 pollutants, leading to a deadly cocktail of toxic air in winter, says Dr Arvind Kumar of Sir Gangaram Hospital.
The record-high number of new Covid-19 cases being reported in Delhi is a “direct effect of air pollution”, says Arvind Kumar, chairperson, Centre for Chest Surgery at Sir Gangaram Hospital, New Delhi. Virus particles piggyback on particulate matter in the air, and enter the lungs, Kumar explains, adding that pollution is also related to heart disease, hypertension, etc, all of which increase the risk of mortality from Covid-19. “If this deadly cocktail – the festivities which will occur over the next few days, coupled with the steep rise in pollution – has an effect on Covid and we see a massive spike, it will be disastrous for the people as well as for the healthcare sector because the ICUs are almost choked, at least in all Delhi hospitals,” Kumar says, emphasising the need to wear masks, maintain physical distance and practice hand hygiene, in addition to doing everything we can to reduce pollution. Kumar is also the director of the Institute of Robotic Surgery at the Sir Gangaram Hospital, and founder of the Lung Care Foundation. Excerpts from the interview: In our earlier conversation, you had correlated higher deaths in parts of Italy with pollution. What was it like then, and what are we seeing today in Delhi and potentially in other parts of the country where pollution levels are rising? What is common between the two? What I had said back then is now being seen in Delhi. At the time, I had quoted a study from Italy, which had correlated the incidence of Covid-19 cases with PM 2.5 levels across Italy. [PM 2.5 refers to airborne particles 30 times finer than a human hair that can sicken or kill people by entering the lungs.] When they plotted heat maps of Covid-19 cases and PM 2.5, they found the two maps to be replicas of each other – areas with a higher concentration of PM 2.5 reported a much higher incidence of Covid-19 cases per 100,000 population. A couple of months later came another report from Harvard, which looked at the mortality correlating to PM 2.5: For every 1 microgram rise in chronic PM 2.5 exposure, they noted an 8% increase in mortality. This was pooled data from over 3,000 counties in the US. This was evidence that Covid is increasing in incidence and causing more mortality in communities that are affected by pollution. And now, what we are seeing for the last two weeks in Delhi has confirmed that. Till a few weeks back, there was a decline in the number of cases across the country and also in Delhi. But as soon as there was a spike in pollution levels in Delhi, the decline converted into a steep incline, and today we are seeing the highest number of cases per day being reported in the city. This is directly an effect of air pollution. Why do Covid-19 cases rise specifically at a time like this, assuming all other factors are constant? There are many theories. One is that the virus particle piggybacks on the PM 2.5 [particle]. It gets adsorbed on the surface of PM 2.5 and when we inhale a large number of particles adsorbed on their surface, the virus particle also goes deep down into the chest, thereby increasing the total dose delivered and total duration for which the virus stays there. But that is not the only cause. We know that pollution badly affects the lungs. It causes inflammation of the lining of the windpipe and lungs, which reduces their immunity and increases their vulnerability to infection. When you have an injured and inflamed lung and you have a certain dose of virus entering into the lung, that injured, inflamed lung will be more prone to infection than a healthy lung. [This is] common sense. Plus, these people may otherwise also have low immunity because of various other toxins which go in the pollution. So overall, you have low body immunity, low lung immunity, and on top of that, you have the same dose of virus going.
