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Today's issue is 1,587 words, a 6-minute read.

1 big thing: The pandemic shows the problem of air pollution

New York's smoggy skyline 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.

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.

2. A digital stimulus for the post-pandemic age

Illustration: Eniola Odetunde/Axios

A new report recommends stimulus spending t0 help close the digital divide revealed by pandemic social distancing.

Why it matters: Right now many Americans can't easily access remote work or education, which leaves them behind and limits their ability to safely carry out social distancing. Stimulus spending could be diverted to address those gaps, which would also leave us better prepared to respond to the next pandemic.

Context: As painful as the pandemic lockdown has been, without the internet and digital tools like Zoom, it would be almost impossible to carry out any semblance of normal life while stuck at home. But not every American has access to those tools.

  • Over a quarter of rural Americans lack access to broadband with speeds of at least 25 Mbps download.
  • America lags behind other countries on mobile and remote payment systems, which has emerged as an obstacle to rapidly getting stimulus checks to citizens.
  • About 40% of teachers report their students lack a computer at home or the necessary access to do their homework online.

In a new report, the nonprofit Information Technology and Innovation Institute (ITIF) recommends that some of the additional stimulus funding Congress is considering should go toward public policies that can ensure every American can live, work and learn remotely.

  • "This should be a wakeup call in Congress," says Rob Atkinson, president of ITIF. "We have been relying on the private sector to do this but a lot of these problems can only be solved by public-private partnership."

Details: The full report includes more than 25 different stimulus proposals ranging from telemedicine to industrial automation to 3D printing. But the top priorities are providing true universal broadband internet and workable e-government services.

"Broadband access is particularly important for any kind of workable remote education. And for e-government, I'm just angry that people are desperately applying for unemployment and these websites keep crashing."
— Rob Atkinson

The bottom line: Never let a crisis go to waste.

3. Electric vehicle sales headed for a big drop

Illustration: Rebecca Zisser/Axios

Global sales of electric vehicles are projected to drop by 43% this year as the technology faces a series of overlapping problems, the consultancy Wood Mackenzie finds in a new analysis, my Axios colleague Ben Geman reports.

Driving the news: "The coronavirus outbreak, potential delays to fleet purchasing due to lower oil price and a wait-and-see approach to buying new models have all contributed to this decrease in projected sales," Wood Mackenzie writes.

  • They see worldwide sales of battery electric and plug-in hybrids at 1.3 million vehicles this year, compared to 2.2 million last year.

Why it matters: EVs remain a niche market, and the Wood Mackenzie report shows why COVID-19 means even more speed bumps on the path to the technology becoming mainstream — and for multiple reasons.

  • "The automakers’ response to the pandemic — suspending car manufacturing to focus on making medical equipment — is only going to delay model launches further," Wood Mackenzie analyst Ram Chandrasekaran notes in the report.

But, but, but: Chandrasekaran also says pent-up demand is expected to help a bounce back in sales later in the year, and the long-term trend is slated to remain upward.

  • He points out that automakers have become more interested in climate-friendly product lines due to government policies and investor attitudes.
  • "The shift towards sustainability is the driving force behind the electrification of transport. Uncertainty caused by the oil price war and global catastrophes will only serve to strengthen that resolve, not deter it," Chandrasekaran says.
4. Citing pandemic, lawmakers call for the closure of wet markets

A wet market in Hong Kong. Photo: Anthony Kwan/Getty Images

A rare bipartisan group of lawmakers is calling on global health organizations to permanently ban buying and selling of live wildlife, which is likely the root cause of the novel coronavirus outbreak, my Axios colleague Amy Harder writes.

Driving the news: Nearly 70 Democrats and Republicans from both chambers of Congress are sending a letter on Wednesday calling on top officials at the World Health Organization, United Nations and World Organization for Animal Health to do just that.

The big picture: Zoonotic diseases — those spread from animals to humans — are increasing and are more virulent, experts say. The lawmakers write that in the last 45 years, at least five pandemics have been traced to bats. This coronavirus likely came from bats or pangolins, an anteater-like mammal.

Where it stands: The UN biodiversity chief just called for the permanent ban on live wildlife markets, known as “wet” markets, and China moved to ban such markets in late February. The lawmakers want more aggressive and permanent moves.

What they’re saying: China’s ban has “significant loopholes,” the lawmakers write in the letter, organized by Sens. Cory Booker (D-N.J.) and Lindsay Graham (R-S.C.).

  • China took similar steps after a far less widespread outbreak of another coronavirus in 2003 but “ultimately lifted the restrictions after the outbreak came under control and perceived risk decreased,” the lawmakers write.

Go deeper: The wildlife and climate change influence on coronavirus

5. Worthy of your time

Days without name: On time in the time of coronavirus (Heidi Pitlor — LitHub)

  • Even writers who are used to working from home are flummoxed by our unmarked lockdown days.

The quest for a pandemic pill (Matthew Hutson — The New Yorker)

  • Antivirals, not a vaccine, ultimately stemmed the AIDS pandemic. Could we create something similar for COVID-19 — and the next outbreak?

The Black Death radically changed the course of history (Steve LeVine — Gen)

  • A familiar name for Axios Future subscribers applies his brain to the many historical lessons to an epidemic that left its mark on humanity.

A Google plan to wipe our mosquitoes appears to be working (Kristen V Brown — Bloomberg)

  • In the department of good, if creepy, news, Google has had success in wiping out disease-causing mosquitoes through genetic engineering.
6. 1 bathroom thing: Smart toilets

Where did this person get two rolls of toilet paper? Photo: George Mdivanian/EyeEm/Getty Images

A new study made the case for personalized diagnostic toilets capable of tracking health data from feces and urine.

Why it matters: Don't laugh — what comes out of your body can be very revealing about the state of your health. Smart toilets would enable us to track that health data at home, which suddenly seems more useful.

In a paper published in Nature Biomedical Engineering, researchers at Stanford University sketched out how such a diagnostic toilet would work and what it would be able to do. Features would include:

  • A fingerprint-sending handle so the toilet would personalize to the user.
  • Four cameras including an "anus camera."
  • A urinalysis strip that would monitor urine for biomarkers including protein and nitrates, which are linked to kidney health.

How it works: The toilet would send data and images to a secure, cloud-based portal.

  • Lest you think this is a joke, doctors are very excited about the potential health benefits of such smart toilets. "If we could collect data from the general population in a controlled clinical trial, it’s possible that you could use the existing platform to look for changes in urine or stool consistency associated with COVID-19," microbiologist Jack Gilbert told STAT.
  • Though such a toilet is only theoretical at this point, it's part of a trend toward more wearable and at-home diagnostics that is likely to be accelerated by the pandemic.

The catch: First you need to find toilet paper.