What the COVID-19 experience has taught us about tackling air pollution as a health crisis
Bhargav Krishna and K. Srinath Reddy
This commentary is part of a CCAPC series on Communicating air pollution-linked risks in India in light of COVID-19. CCAPC/2020/04 | September 2020 | Edited by Santosh Harish | Posted: September 1, 2020
The COVID-19 pandemic and its associated reduction in economic activity has resulted in vastly improved air quality across many regions of the world. These improvements, while coming at a significant economic cost and hardship, show us the potential for improvements in air quality if governments take immediate and stringent steps within a framework that preserves equity and justice. The lockdowns and the economic pain they are causing globally has also been seen by the same governments as an opportunity to relax environmental regulations on polluting industries. Viewed as low hanging fruit by policymakers in their bid to kickstart growth once lockdowns end, these actions only threaten to set back our progress on cleaning up emissions, and these moves in many cases are going to have significant long-term consequences for poor and marginalized communities. Why then does the other public health “emergency” of ambient and household air pollution not carry the same sense of urgency while being responsible for nearly 5 million premature deaths globally every year?
COVID-19 and air pollution have highlighted the same structural injustices and health inequalities that exist in both developed and developing countries with the poor, elderly and infirmed most at risk. While much remains to be learned about the biological pathways by which COVID-induced deaths occur, it is clear that both COVID-19 and air pollution affect the lungs and the heart by triggering inflammatory responses in the body. Disparities in air pollution exposure between marginalized and well-off communities have also been shown to increase the likelihood of COVID-related deaths. The parallels between the two are apparent, even if the impacts are on different time scales. To leverage these clear links between both and to drive systemic change on air pollution, there are lessons we must learn as researchers, practitioners and advocates from those that have tackled these issues during the COVID-19 pandemic.
First, we need to engage more deeply in demystifying the science around air pollution and how it affects health. Aerosol science has never been more keenly discussed than over the last few months – more has been learned by the general public about “invisible airborne particles” than through a lifetime of effort by air pollution advocates. No doubt the immediacy of the threat has influenced this, but the efforts of academics in this regard must be commended. It is worth examining why the same field of aerosol science has found it so challenging in India to communicate the threat of air pollution when the underlying principles of risk remain the same. Both are airborne and heighten risk of illness simply through the act of breathing, and this risk can be mitigated by wearing a mask. Perhaps a combination of differing risk perception among the general public, and uncertainty among scientists on the efficacy of masks to protect against air pollution has resulted in very different results.
Similarly, epidemiologists have worked under a situation of high uncertainty during the pandemic to deliver clear and concise messaging around distancing measures, masks, and other aspects of preventing the spread of disease. The importance of this effective communication cannot be understated. As with any complex issue, we must convey “simple clear messages, repeated often, by a variety of trusted sources”. Through this pandemic, scientists have appeared on television, used clever infographics, and engaged effectively on social media to communicate clear messages, dispel misinformation, and build public trust. Across all media, the messaging has been the same – the three W’s namely wear your mask, wash your hands, and watch your distance. This harmonization needs to be replicated in our messaging around air pollution with the three S’s – we know the severity of the issue, the sources that contribute to it, and the solutions we need to implement. Discourse around air pollution must also recognize that ALL sources need to be reduced and quibbling over whether one contributes 3% more to ambient loading than another is not effective in driving change.
Second, social justice and equity must be central to policymaking on air pollution. This requires moving from an urban elite-centered policymaking agenda where displacing rather than reducing pollution seems to be the norm. The only large-scale solution planned, initiated and executed successfully till date to combat air pollution in India was the Pradhan Mantri Ujjwala Yojana. While laudable, this is yet to be implemented in full measure. We must however recognize its core principles of reducing disparities of exposure, access and health outcomes if we are to make meaningful progress in changing policy.
Third, global dialogue on a post-pandemic development agenda is focused on clean energy and a “just transition” which involves phasing out fossil fuels and investing in renewables as a means of breaking down fundamental societal disparities to improve health and well-being. Adopting and advocating for this solutions-oriented approach to solving the air pollution and climate crisis would go a long way in providing policymakers a framework for holistic change. This also means moving away from piecemeal solutions for seasonal or isolated pollution events and making the debate on air pollution a year-round feature.
We need to move the dialogue beyond Delhi and empower citizens around the country to advocate for their right to clean air. Examining our own efforts in communicating the scale and impact of air pollution is critical to foster this change, and this pandemic has provided us an opportunity to reflect. Let us use this time where there is greater focus than ever on science and science communication to renew our efforts to drive lasting change on air pollution in India.
Bhargav Krishna is a Doctor of Public Health candidate at the Harvard TH Chan School of Public Health. K. Srinath Reddy is President of Public Health Foundation of India.
For the rest of this series, click here