Medical experts have warned that the toxic pollution that envelops New Delhi annually will lead to more coronavirus deaths.
By 7am in mid-November, the air in New Delhi smells of acrid smoke and the sky is covered by a grimy brown haze. The air quality is comparable to Beijing on its most polluted days, and will deteriorate further as the temperature and winds drop, blanketing the national capital region in smog for months.
Farm stubble burning, vehicle emissions and the encroaching winter have pushed the city’s air quality index into the severe category at the same time that more than 5,000 coronavirus cases are being confirmed daily.
Doctors said that the pandemic has exposed how pollution has made populations more vulnerable to disease, warning that a flood of coronavirus patients with severe symptoms, aggravated by the hazardous air, could overwhelm India’s hospitals.
“There is a definitive association between Covid mortality and air pollution,” said Chandrakant Lahariya, an epidemiologist in New Delhi. “More people with respiratory diseases will develop symptoms.”
Long-term exposure to air pollution is linked to 15 per cent of “potentially avoidable” Covid-19 deaths, said researchers behind a new study published in the journal Cardiovascular Research.
“Air pollution is acting like a super spreader for Covid,” said Thomas Münzel, a co-author and cardiologist at Johannes Gutenberg University in Mainz, Germany. He said that particulate matter made lungs more susceptible to coronavirus infection.
India’s pollution season poses a perennial problem for authorities who have failed to develop a successful strategy to curb emissions. Every year, smog blankets north India, home to 10 of the 15 most polluted cities in the world.
Last year, when the index hit 1,000 — it should be below 50 — Delhi state chief minister Arvind Kejriwal said the capital had “turned into a gas chamber”.
Mr Kejriwal’s government last month launched a “Green War Room”, which is responsible for monitoring pollution levels in the national capital region and deploying enforcement agencies to crack down on environmental offences such as garbage burning and illegal industrial activity.
One of the war room’s early recruits was Aashima Arora. Ms Arora left her well-paid job at Citibank to join the Air Pollution Action Group, determined to tackle the toxic air that kills more than 1m Indians every year.
As a child growing up in New Delhi, Ms Arora did not even know the colour of the sky until a family holiday to the Himalayas when she was five.
“I do not remember seeing blue skies in Delhi. They are as rare as rainbows,” said the 24-year-old, who blames the thick smog that chokes the city for her asthma and severe allergies.
“In winter I’m [usually] scared to go out of my house. Now with coronavirus . . . it’s absolutely frightening,” she said.
Inside the war room, a series of giant screens display air quality indicators as well as satellite maps that identify fires.
There is also a dashboard to track complaints about pollution that could exacerbate the smog, with the public encouraged to alert the authorities to non-compliant construction sites, burning rubbish or illegal industrial work with a new app.
The pollution has also spurred entrepreneurship. Jai Dhar Gupta, chief executive of New Delhi-based mask manufacturer Nirvana Being, said sales this year had surged 3,000 per cent.
“We already have a respiratory virus [Covid-19] that we don’t understand, now we are adding tons and tons of poison in the air,” said Mr Gupta, who founded his business in 2015 after his lungs collapsed when he was training for a marathon in New Delhi.
“We are going to experience an unprecedented public health catastrophe.”
After battering big cities, coronavirus is now sweeping through India’s rural areas, where the bulk of the population lives and medical infrastructure is weak.
The nation of 1.4bn people has the world’s second-highest number of coronavirus infections with more than 8.85m cases and has recorded 130,000 deaths.
A government-appointed panel recently concluded that the country’s outbreak may have peaked, and could be under control by February. But the claim was disputed by experts who point out that testing data and deaths may be under-reported.
It is not just in the capital that fears are mounting. Puneet Singh Perhar, a pulmonologist based in Jalandhar, in the northern state of Punjab, said: “Every winter the condition of patients with respiratory diseases such as asthma, chronic obstructive pulmonary disease and bronchitis gets aggravated due to air pollution in north India.”
“This time there is the coronavirus infection as well,” he added. “The number of patients will surge. It’s scary.”