Those living in polluted cities are more at risk from Covid-19, health and environmental groups are warning.

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.

Graph 1: The Correlation and Association between Short-term Exposure to Ambient Air Pollution and Case Fatality of SARS in People’s Republic of China. From the Journal Environmental Health.

Italian associate professor in occupational and environmental medicine, Dr Sara De Matteis, said: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.

From left to right: The same view of Porta Nuova, a business district in Milan on January 8, February 8, March 8 this year. (Images from a webcam).

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. Industry, household heating and agriculture are all also responsible for dangerous levels of pollution in the air we breath.

By December 2019, the EU had begun 71 air quality infringement procedures against member governments.

Campaign groups have backed local and European action to tackle pollution but have often criticised national governments for their lack of action. Italy was one of ten governments criticised last year for being more than six months late in publishing plans for how it hopes to improve air quality.

Satellite imagery has revealed a remarkable drop in NO2 pollution in the weeks since Italians restricted their movements following the Covid-19 outbreak.


NO₂ pollution, mainly from traffic fumes, has dropped sharply during the Covid-19 outbreak

European Public Health Alliance acting secretary general Sascha Marschang said: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.”

Anna Gerometta, President of EEB Member Cittadini per l’aria wrote last week about the link between the outbreak of Corona in Lombardy and the poor air quality recorded in the region.

Germoetta stresses that it is too soon to draw conclusions but wrote: For over two months, from the beginning of December to the first week of February 2020, the concentrations of particulate matter, PM10 and PM2.5, and NO2, nitrogen dioxide, in Lombardy have been almost constantly well beyond the legal limits.”

NOx reacts in the environment to become NO₂. Graphic from the EU NOx Atlas 2019.
NO₂ drop decline in Northern Italy

PM10 levels in Lombardy have also fallen dramatically
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