Air Pollution and Covid-19 Mortality: Considerations for Southeast Asia

Thursday, April 23, 2020

As the world struggles to contain the coronavirus pandemic, preliminary research findings highlight how air quality and Covid-19 death rates may be linked, says Helena Varkkey of the University of Malaya. While this correlation may seem tenuous at first, it is not entirely surprising: After all, acute respiratory distress syndrome, which has long been linked to polluted air, has been a major cause of Covid-19-related deaths. The new information on air quality could inform the response to the Covid-19 pandemic, especially in Southeast Asia, now and in the future.

Air Pollution and Covid-19 Mortality: Considerations for Southeast Asia

Haze over Kuala Lumpur, September 2019: Studies show that air pollution from agricultural fires across Southeast Asia lead to over 100,000 more deaths in the region (Credit: yusuf madi / Shutterstock.com)

The significantly higher Covid-19 infection and death rates in Western countries have enabled researchers to make conclusive findings that validate the link between mortality and air pollution. Across the US, an increase in concentrations of the fine particulate matter known as PM2.5 of just 1 microgram per cubic meter was associated with a 15 percent increase in Covid-19 deaths. And in Italy, the more industrial northern regions have seen higher death rates of 12 percent compared with about 4.5 percent in other parts of the country.

These results are especially concerning, considering that they are from countries that are not known for poor air quality. A 2019 global report on annual air pollution levels found that 99 out of 100 cities with the most polluted air were in Asia. While the relatively smaller numbers of Covid-19-related deaths in Asian countries do not lend themselves to meaningful data analysis for the time being, past research in China found that death rates from SARS, Covid-19’s closest relative, were twice as high in highly polluted areas.

While China and other parts of Northeast Asia might now be slowly coming out of the grip of Covid-19, Southeast Asia is firmly in the thick of things. Singapore (as of April 23) has the highest infection rates in the region, followed by Indonesia, the Philippines, Malaysia, and Thailand. While Singapore, the Philippines, Malaysia and Thailand have been lauded for their quick reaction in containing the virus (though as in the case of Singapore early success may not have been sustained), Indonesia has been criticized for not being transparent in its Covid-19 reporting and its ability to handle the outbreak.

Air quality and health in Southeast Asia

In 2019, all ASEAN countries save Brunei made it into the list of top 60 countries with the worst air pollution. Much of this is due to baseline pollution caused by a mix of urban and industrial emissions. In addition, Southeast Asia also suffers from seasonal air pollution in the form of transboundary haze caused by forest and land fires mainly related to agribusiness activity.

Clear and present health danger: Satellite image shows smoke blanketing Sumatra and Borneo in 2015 (Credit: Jeff Schmaltz/LANCE EOSDIS Rapid Response/NASA)

Clear and present health danger: Satellite image shows smoke blanketing Sumatra and Borneo in 2015 (Credit: Jeff Schmaltz/LANCE EOSDIS Rapid Response/NASA)

Last year saw serious transboundary haze episodes across the region. The Golden Triangle area where the borders of Thailand, Laos and Myanmar meet suffered unprecedented haze levels from March to April. And from September to October, haze in the southern ASEAN sub-region caused air quality indexes to skyrocket and thousands of schools to close across Indonesia and Malaysia.

Despite being a seasonal occurrence, these periodic pollutant spikes have severe and long-term health consequences. A 2016 study estimated that more than 100,000 additional deaths would have occurred in the southern ASEAN sub-region, both during and after the 2015 haze season, as a result of breathing in toxic haze particles.

One notable finding from the recent US study is that the high rates of Covid-19-related deaths do not only correlate to current air pollution conditions but also to prolonged exposure to bad air over time. For example, those living in US counties that have experienced worsening air pollution over the past 15 to 20 years have a substantially higher mortality rate.

PM2.5 particles, the particles in air pollution that are small enough to be inhaled into the lungs and even enter the bloodstream, have the long-term effect of weakening one’s respiratory, cardiovascular and immune systems. In the context of Covid-19, someone with already weakened lungs and respiratory tracts has a higher risk of not just getting infected and but also suffering worse symptoms.

Cleaner air thanks to Covid-19?

One of the oft-cited silver linings of the various coronavirus-related movement restrictions all over the world is the almost immediate improvement of environmental conditions. There have been reports of lower CO2 emissions as the world uses less fossil fuel, better air and water quality and visibility, and a return of wildlife to open spaces. During the shutdown months in China, the proportion of days with good air quality was up 11.4 percent in 337 cities compared to the same time last year. As China begins to reemerge from the pandemic, with people traveling again and industries restarting, air pollution levels are quickly bouncing back.

Similar trends are discernible in Southeast Asia. The Malaysian Department of Environment reported an improvement in air quality in major cities a mere two weeks into the Movement Control Order due to reduced vehicle emissions, industrial stack emissions, and open burning. Likewise in Jakarta, the capital of Indonesia, air quality has improved markedly as people commute less.

Even this temporary improvement is important in the context of the immediate Covid-19 threat. Careful policy development and implementation both during lockdowns and in the transition period after can help to ensure that air pollution levels across the region do not bounce back or worsen in Southeast Asia post Covid-19.

Air quality and policy in the context of Covid-19

Southeast Asian countries should focus on 1) normalizing clean air, 2) maintaining environmental policing and implementation, and 3) ensuring sustainable economic stimulus packages.

1. Clean air as the new normal

For decades, governments in the region have held on to the rhetoric that developing countries have every right to exploit their natural resources in order to develop. This has helped to cement a belief among the public that some environmental degradation is necessary and justifiable in the name of development and economic prosperity.

As air quality improves during the pandemic, people will experience the clean air and feel its immediate positive effects. This is a good opportunity to drive home the link between clean air and good health, as well as air quality and human behavior, both at the individual and corporate level.  

Environment and health ministries, preferably in conjunction with civil society organizations, should promote the fact that citizens have the right to always enjoy good air as part of the ‘new normal’. This will build momentum in society to dismantle the normalization of bad air, adopt good practices themselves and pressure all stakeholders to improve their practices now and beyond.

2. Environmental policing during Covid-19

While industrial emissions have fallen across the region, Covid-19 restrictions may not have the same limiting effect on pollution-causing land and forest fires as it has in industrial sectors. As most Southeast Asian states deploy their police and army personnel to urban areas to enforce lockdowns, environmentalists have raised concerns that there will be fewer enforcement personnel available to monitor protected forests and croplands and ensure that environmental regulations, especially those related to burning, are enforced.

The early effects of such reduced capacity can be seen in the fires that are currently raging in northern Thailand, causing severe haze pollution in the northern ASEAN sub-region. These fires are said to be caused by burning croplands, which is banned in principle, exacerbated by dry and windy weather. In Indonesia, there have been reports that a new project to clear massive swathes of rainforests for oil palm in Papua is currently being pushed through, despite being mired in controversy.

While governments are understandably prioritizing Covid-19 responses, the link between air quality and Covid-19 deaths should be reason enough for governments not to allow a lapse in the monitoring and enforcement of forest conservation and burning regulations during this time.   

3. Sustainable post Covid-19 stimulus packages

Post-crisis stimulus packages of the past tend to bolster nationally lucrative but polluting industries, while loosening restrictions to make it easier for these industries to bounce back. For example, the aftermath of the 2008 global financial crisis saw drastic increases in global emissions as many countries focused their stimulus packages on bailing out sectors like oil and gas, aviation and construction.

While China’s coal consumption fell by 36 percent in February 2020, its planned 50 trillion yuan Covid-19 stimulus package includes increased reliance on coal-fired power. Already there have been more permits granted for new coal plants in February and March 2020 than in the same period last year. In Southeast Asia, agribusiness and manufacturing industries are generally among the major contributors to GDP. At the same time, factors related to these sectors are a major risk to air quality.

While it will be natural for states to focus their stimulus packages on these sectors, this should not be at the expense of air quality. For example, Malaysia and Indonesia have recently implemented compulsory national Sustainable Palm Oil standards, which include stricter limitations on fire-prone peatland conversion. Any stimulus packages for this sector must not involve a rolling back of these requirements.

Clean air for ASEAN, Covid-19 and beyond

At the regional level, the ASEAN Haze-Free Roadmap was adopted by all member states in 2016, to serve as a strategic, action-oriented and time-bound framework to achieve a Transboundary Haze-Free ASEAN by 2020. While many commentators expressed doubts that ASEAN could achieve this timely vision due to a weak track record, the Covid-19 crisis just may provide the impetus needed to do so.

Research has shown that interventions tend to be more effective if they take place during moments of change, both for policy effectiveness and the adoption of new habits on the ground. Hence, prioritizing air quality and environmental sustainability in the midst of Covid-19 should not be seen as a luxury, but instead as an act of a responsible government. As the world still struggles to understand how long this global health crisis will last, a sustained cleaner environment will give the people of Southeast Asia a fighting chance to weather this pandemic and others in the future.

Opinions expressed in articles published by AsiaGlobal Online reflect only those of the authors and do not necessarily represent the views of AsiaGlobal Online or the Asia Global Institute


Helena Varkkey

Helena Varkkey

University of Malaya

Helena Varkkey is a senior lecturer in the Department of International and Strategic Studies at the University of Malaya. Her interest in sustainable development has evolved to focus on transboundary pollution in Southeast Asia, particularly the role of patronage in agribusiness (specifically the palm oil industry), and its link to peat fires and haze in the region. Her PhD monograph entitled “The Haze Problem in Southeast Asia: Palm Oil and Patronage,” was published by Routledge in 2016. She maintains an academic blog at helenavarkkey.wordpress.com.

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