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New York City's skyline on a smoggy day in May 2019. Photo: Drew Angerer/Getty Images

COVID-19 is underscoring the connection between air pollution and dire outcomes from respiratory diseases.

Why it matters: Old-fashioned air pollution is almost certainly the single biggest environmental health threat, contributing to the deaths of some 7 million people a year according to the WHO, making it comparable to deaths from smoking.

How deadly COVID-19 might be is a function of a number of variables, from the age of a patient to viral load to how overwhelmed a hospital system might be. But a growing body of research is a reminder of the hidden health consequences of living with serious air pollution.

Driving the news: A new study by researchers at Harvard T.H. Chan School of Public Health examined more than 3,000 counties in the U.S. and found that higher levels of the small particulate matter known as PM2.5 were associated with higher rates of death from COVID-19.

  • Some of the results were startling: A person who had lived for decades in areas with high levels of PM2.5 was 15% more likely to die from COVID-19.
  • On the whole, the paper showed a clear statistical relationship between air pollution and dire outcomes from COVID-19.

Other early studies have shown a similar relationship in countries hit hard by COVID-19.

  • One analysis published in Environmental Pollution found a connection between the high rates of death from the pandemic in northern Italy, where as many as 12% of patients have died from the disease, and the region's air pollution, which is some of the worst in Europe.

Flashback: In 2003, researchers found that SARS patients in the most polluted parts of China were twice as likely to die from the virus as those living in low pollution areas. And a study of the 1918 flu pandemic found American cities that burned more coal for electricity experienced more excess deaths than cities that didn't use as much coal.

How it works: None of the studies tried to answer why exposure to air pollution might worsen outcomes for COVID-19, but many doctors believe fine air particulate matter and ozone will damage the lungs just as smoking would, causing inflammation and leaving them less able to fight off infection of any sort — including from the novel coronavirus.

  • Hospitals frequently experience an increase in admissions for pneumonia a few days after air pollution alerts.
  • "It absolutely makes sense that we would see a synergistic effect between air pollution exposure and worse outcomes for COVID-19," says Jack Caravanos, a clinical professor of environmental health sciences at New York University.
  • Air pollution could also be one factor in another statistical anomaly emerging from the COVID-19 pandemic: unusually high death rates for African Americans, who are more likely to live in counties with persistent air pollution problems.

The big picture: While many countries, including the U.S., have generally experienced improvements in air quality over recent decades, scientists are learning that even lower levels of air pollution are still a threat.

Yes, but: The irony is the near-global shutdown triggered in response to the pandemic has helped lead to a marked improvement in air quality in polluted cities like Los Angeles and New Delhi. But that's only temporary — and a few weeks of cleaner air won't make up for decades of smog.

The bottom line: If COVID-19 has taught us anything, it's this: Our lungs matter. Perhaps when the economy restarts post-pandemic, we'll take greater care of the air around us.

Go deeper

"Atmospheric river" swings Northern California from drought to flood

Satellite view of the bomb cyclone swirling off the coast of the Pacific Northwest and the atmospheric river affecting California on Oct. 24. Photo: CIRA/RAMMB

A series of powerful "atmospheric river" storms are delivering historic amounts of rainfall across parts of drought-stricken California and the Pacific Northwest — triggering widespread power outages and flooding.

Why it matters: The strong atmospheric river, packing large amounts of moisture, is causing Northern California to whiplash from drought to flood.

Updated 2 hours ago - World

Saudi dissident claims MBS said he could get "poison ring" to kill king

Saudi Crown Prince Mohammed bin Salman attending the Saudi Green Initiative Forum, via video link, in Riyadh, Saudi Arabia on Saturday. Photo: Royal Court of Saudi Arabia/Handout/Anadolu Agency via Getty Images

A former senior Saudi intelligence official who worked with the U.S. on counterterrorism alleged to "60 Minutes" in an interview broadcast Sunday that Crown Prince Mohammed bin Salman discussed in 2014 killing the kingdom's then-monarch.

Why it matters: The claim by the exiled Saad al-Jabri, whom Saudi authorities describe as "a discredited former government official," that the crown prince, known as "MBS," allegedly said he could obtain a "ring from Russia" to carry out the attack, is one of several serious but unproven allegations he made on the CBS show.

“You blew it”: GOP activist turns on corporations over vaccine mandates

The chairman of the American Conservative Union said on "Axios on HBO" he accepts "Joe Biden is my president, and I want him to succeed," but predicted Republicans retake the House and Senate in 2022 — with greater than 50% odds Donald Trump runs in 2024.

The big picture: In a joint interview with his wife, Mercedes, Matt Schlapp also refused to share their vaccination status. And he told corporate America "you blew it" by embracing vaccine mandates and liberal social stances that have alienated GOP voters and politicians.