In July 2020, three scientists from the University of Birmingham confirmed what Harvard University School of public health had suggested three months earlier: air pollution contributed to covid-19 infections, and deaths.
The research, conducted in the rural regions of Netherlands, linked 15 cases of Covid-19 and three deaths from the same disease to an increase in the concentration of fine particulate matter – better known as PM2.5 – as a result of farming activities. It also established that long term exposure to poor air quality increases covid-19 hospitalizations by ten per cent and deaths by 15 per cent.
Another research conducted between April and June identified a positive relationship between PM2.5 and covid-19 mortality in Lombardy, the then epicenter of the coronavirus pandemic in Italy. Lombardy is the most polluted city in Italy. At one point, at the height of the pandemic, eight in every ten deaths were as result of Covid-19.
China, the original global epicenter, has a long history of war on air pollution. In early 2013, PM2.5 levels had surpassed 800 on the 500-point scale. Breathing the air in Beijing, it was said, was equivalent to smoking two packs of cigarettes per day.
By late 2014, more than one million Chinese were dying from air pollution-related respiratory diseases. New environmental laws and regulations, together with traditional state-directed campaigns implemented between the 2013 and 2017 have come a long way in reducing pollution-related respiratory deaths in China. Perhaps this explains why China confirmed relatively low number of Covid-19 infections.
In the United States, people of color who succumbed to the virus in the first quarter of the pandemic were reportedly from poor neighborhoods where exposure to air pollution is high.
“40 per cent of worlds new renewable power plants are in China. In 2016 China invested $78.3 billion in renewable energy – exceeding both Europe ($59.8 billion) and the United States ($46.5 billion),”American author Elizabeth Economy writers in The Third Revolution: Xi Jinping and the New Chinese State.
Africa, where major anthropogenic air pollution sources include unclean energy and soil dust – the main source of PM2.5 – has the highest levels of particulate matter in the world after India; covid-19 cases there were nearing one million by July 2020.
First and foremost, air pollution is basically the combination of outdoor and indoor particulate matter and ozone – not the ozone layer in the stratosphere. The ozone we are talking about here is the one that is found in the lower atmosphere, close to the surface.
From available data, death rates from articulate matter tend to be higher than ozone. Since 1990, particulate matter death rates have declined from 44 to 38 deaths per 100,000 people.
For ozone, the death rate has declined from 11 to 6 deaths per 100,000 individuals. Five million people die every year from stroke, respiratory infections, lung cancer, diabetes, chronic obstructive pulmonary disease, and heart disease: the leading causes of death in the world. Air pollution is the leading risk factor in these diseases.
Air pollution (outdoor and indoor) was the fifth highest risk factor in 147.42 million disease burden – cumulative consequences of a defined disease e.g. Cancer or a range of harmful diseases with respect to disabilities in a community – after obesity, high blood sugar, smoking and high blood pressure. Disease burden is measured as Disability-Adjusted Disease Years (DALYs). One DALY is the equivalent of losing one year in good health because of either premature mortality or disability. One DALY represents one lost year of healthy life.
Out of the 56 million deaths recorded in 2017 globally, 4.9 million were caused by diseases (highlighted above) in which air pollution (outdoor and indoor) was a risk factor. Diseases attributed to indoor air pollution alone caused 1.4 million deaths in the same year.
In Kenya, air pollution was a risk factor in the diseases that killed some 18, 891 people in 2017. 14,000 of these deaths were caused by diseases in which indoor pollution is a risk factor. Note the difference: indoor air pollution “killed” more people in 2017 that outdoor pollution. More deaths were attributed to unsafe sex (42, 709), for example, in 2017 than to outdoor air pollution (4,999).
“Air pollution not only takes years from people’s lives, but also had large effects on quality of life while they are still alive,” Hannah Ritchie and Max Roser of Our World in Data observed in November 2019.
Death rates from air pollution are 100 times greater in Sub-Saharan Africa and South Asia than across much of Europe and North America. Central African Republic had the highest death rate from air pollution in 2017 (199.7 deaths per 100,000 individuals) followed by Guinea at 160.5 deaths per 100, 000 people. In Kenya, the death rate from air pollution was 90.3 deaths per 100,000 people.
That mentioned, in Kenya, as Elizabeth Economy reports, a consortium of Kenya, South Africa and Chinese energy Firms is planning to build a large coal fired power plant fifteen mile worth of a UNESCO world heritage site. It is estimated that the plant will be the country’s largest sources of pollution.
How does the death rates between indoor air pollution and outdoor pollution compare? According to Global Burden of Disease, outdoor air pollution caused 3.4 million premature deaths in 2017 alone. This was three times the number of deaths caused by HIV and more than eight times the number of homicide.
In Kenya, outdoor air pollution was attributed to just two per cent of the total deaths in 2017. The case was different in Egypt where at least 12 per cent of the total deaths were ascribed to outdoor air pollution. This is equivalent to 114 deaths per 100, 000 people; ten times the rate in Sweden, Finland and New Zealand, and the highest in the world.
Out of the six countries with more than 100 micrograms of P.M 2.5, in the world, only Saudi Arabia is not in Africa. As of 2019, Niger had the highest concentration of P.M 2.5 in the world; 203.74 (microgram per cubic meter).
It was followed by Saudi Arabia with 187.87 microgram per cubic meter, Cameroon (139.71 microgram per cubic meter), Egypt (126.03 microgram per cubic meter), Mauritania (123.63 microgram per cubic meter) and Nigeria (122.48 microgram per cubic meter). Nairobi, for example, with its sub-standard transport infrastructure and services characterized by traffic congestion, is has higher levels of PM2.5 than, say, all the major towns in Rift Valley combined.
We are able to see from this data that P.M2.5 concentration is disproportionally high in low income countries particularly in Africa and parts of South Asia. But that does not necessarily mean more deaths. Countries such as Qatar, Saudi Arabia, Omar, United Arab Emirates and Kuwait have comparably lower risk of premature deaths from air pollution despite high levels of P.M2.5 concentration.
This is primarily because these countries have higher GDP per capita than countries such as Afghanistan and Central African Republic. Higher GDP per capita means higher living standards and access to quality health care.
However, not all countries with relatively higher GDP per capita record fewer deaths from air pollution. In 2017, with a GDP per capita of $10,550 – more than three times the GD per capita of Kenya, at the time – Egypt registered 114.23 deaths per 100,000 individuals.
Kenya recorded 18.89 deaths per 100,000 people in the same year. This situation is attributed to the age factor. In 2020, more than five million Egyptians were aged above 65 years; less than 1.5 million Kenyans fell under this bracket at the time.
Globally, the death rate of outdoor air pollution among people aged above 70 years was a staggering 452.1 per 100,000 people in 2017 compared to just 6 per 100,000 people aged between15 and 49 years in 2017. In Kenya, outdoor air pollution death rates for people aged between 7 years was 218.1 per 100,000 people and 2.6 per the same number of people for individuals aged between 15 and 49 years. The burden of air pollution is more prevalent for older individuals who are most vulnerable to non-communicable diseases (NCDs).
Non-communicable diseases such as Tuberculosis are more prevalent in Africa than in most parts of the world. This explains why, despite having youthful populations, more people still die from air pollution than across Europe and the Americas.
As of 2015, approximately 44 per cent of Nigerians were aged below 15 years compared to Japan where more than 26 per cent were above 65 years of age. 114, 115 people died from air pollution in Nigeria in 2017, more than twice the number in Japan. And that is because of the GDP per capita, which, as we have seen, impacts living standards and access to quality health care. Africa’s low socio-democratic index explains why most people are at high risk of indoor air pollution-related deaths.