The dangers of pollution are often overlooked, as many people value making money over being concerned and worried about their environment. The coronavirus pandemic has affected millions and destroyed economies, but it has not slowed down climate change with rising temperatures, increasing green house gases and sea levels, and natural disasters threatening people’s health, jobs and safety. Pollution therefore is an everlasting pandemic.

According to a World Health Organisation study, 14 of the 30 most-polluted cities in the world are in India. Delhi, Kanpur , Patna, Agra, Muzaffarpur, Srinagar, Gurgaon, Jaipur, Gaya,Varanasi are the worst affected cities.Pollution (mainly air ,water, occupational ) contributed to 8.3 million annual deaths globally in 2019. India faced 2.3 million deaths due to pollution, notes a Global Alliance on Health and Pollution(GAPH ) report.

In simple terms, pollution is killing around 23000 people every day. Every day, around 6300 Indians are dying due to pollution.

Air pollution is the fourth highest cause of death surpassed only by high blood pressure, tobacco use and hunger. It caused 1.6 million deaths in India out of which 1,16,000 were neonates, data by the State of Global Air 2020 notes.

Over two million children—half the children in Delhi—have abnormalities in their lung function, according to the Delhi Heart and Lung Institute.

Pollution is defined as the addition of any substance (solid, liquid, or gas) or any form of energy (such as heat, sound, or radioactivity) to the environment at a rate faster than it can be dispersed, diluted, decomposed and recycled. There are different types of air pollutants, such as gases (Ammonia NH3 ,Carbon monoxide CO, Carbon Dioxide CO2, Methane CH4 , Sulfur dioxide SO2 , Nitrous oxide NO and Chlorofluorocarbons CFCs and HCFCs), Particulates(Especially PM2.5 and PM10 ), Metals (Ex-lead Pb )and Biological molecules like pollens.

Ozone high up in our atmosphere is a good thing. It helps block harmful energy from the Sun, called radiation. Bad ozone is ground level ozone, created when sunlight reacts with certain chemicals that come from sources of burning fossil fuels, such as factories or car exhaust. When particles in the air combine with ozone, they create smog.

The National Air Quality Index ( AQI) is an index for reporting daily air quality, calculation is based on 8 pollutants (PM10, PM2.5, NO2, SO2, CO, O3, NH3, and Pb) . Think of the AQI as a yardstick that runs from 0 to 500. The higher the AQI value, the greater the level of air pollution and the greater the health concern. AQI is divided into 6 categories indicated a with particular color code ; Green -Good (0-50 ) , Light Green -Satisfactory (51–100), Purple - Moderately polluted (101–200), Yellow -Poor(201–300), Red-Very Poor(301–400), Maroon - Severe (401-500). PM10 is Particulate Matter with a diameter less than 10 micrometers and PM2.5 is Particulate Matter with a diameter of less than 2.5 micrometers.

Major sources of air pollution include burning of fossil fuels, unregulated industrial emission , indoor Air Pollution, burning crop residue, unregulated construction and demolition activities, pesticides and fertilizers spraying, increased number of vehicles in cities with outdated vehicles on the road, improper waste disposal, deforestation, disturbing biogeochemical cycles and most importantly lack of awareness of environmental issues.

51% of pollution is caused by industrial pollution, 27 % by vehicles, 17% by burning crop residue and 5% by other means.

The effect of pollution on health is enormous. It has a long lasting effect; it's a vicious cycle starting with the direct outcomes of mothers' exposure to air pollution during pregnancy leading to infants born with complications such as prematurity, low birth weight and poor lung capacity. For the babies that survive infancy, they remain at a higher risk of respiratory infections and other infectious diseases throughout early childhood, and grow into adults with increased chances of lifelong chronic diseases.

Air pollution can cause health problems, like bronchial asthma, lung carcinoma, heart attacks, strokes, diabetes, high blood pressure, chronic lung/liver/kidney diseases, leukemia ,skin diseases, eye diseases and neonatal diseases. Many have been identified as the pre-existing medical conditions that raise the chances of death from COVID-19 infection.

Emerging research has now suggested that breathing more polluted air over many years may itself worsen the effects of COVID-19 (8% increase in mortality from COVID-19 infection for every 1 microgram/cubic meter increase in air pollution ). The Doctors For Clean Air (DFCA) has warned that compromised lung function due to air pollution could lead to a serious complication in patients affected by the Covid-19.

Air pollution may also exacerbate symptoms of “long Covid”, which is a term used to describe symptoms of COVID-19 persisting weeks and months after recovery - with symptoms of cough, fatigue, diarrhea, joint pain, muscle aches, and lungs, heart, and kidney damage.

The Coronavirus pandemic compelled many countries to resort to a lockdown, and as a result, daily average AQI value drastically reduced to more than half in March-April 2020 in parts of India as the country went into lockdown. This had a positive impact on the environment, but sadly the effect was reversed as soon as we opened up.

The government has taken measures like pushing reforms in industrial sectors, power plants, highways, construction industry to reduce carbon emission but has failed to reduce pollution because of poor enforcement of the laws. In 2019, India launched 'The National Clean Air Program with a tentative national target of 20%-30% reduction in PM2.5 and PM10 concentrations by 2024.

Recently, the Central Government issued an ordinance to deal with rising air pollution in Delhi and the National Capital Region. Measures such as that Pradhan Mantri Ujjwala Yojana - providing farmers with a machine called a Happy Seeder which converts agricultural residue to fertilizer, increasing electric public transport, etc have started showing benefits but there is lot that has to be done.

Conserving energy is the first step towards a better future with clean air to breathe. Understanding the concept and imbibing the habit of reducing, reusing, and recycling is crucial.

The wider public also has to understand and contribute to reduce pollution. Falling in love with your surroundings, with nature, will save you, your family, your future generations. Make good choices about transportation. When you can, walk, ride a bike, or take public transportation. Do not burn leaves, vehicle tyres and electrical equipment. Avoid leaving the house when the air is polluted. Most importantly -- support leaders who push for clean air and water and responsible steps on climate change. There is a respiratory virus that kills people out there – this is the right time to build a healthy and clean environment, and reimagine the future of our world.

“Everyone has the right to an environment that is not harmful to their health or well-being; and to have that environment protected, for the benefit of present and future generations" - Nelson Mandela.

And meanwhile, wear a mask - it will give you protection from both deadly factors -- air pollution and COVID-19.

Dr Kafeel Khan is at the Department of Pediatrics, BRD Medical College, Gorakhpur, U.P