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Air pollution and coronavirus, a perfect symbiosis.

“We provide evidence that people living in an area with high levels of pollutant are more prone to develop chronic respiratory conditions and suitable to any infective agent. Moreover, a prolonged exposure to air pollution leads to a chronic inflammatory stimulus, even in young and healthy subjects. We conclude that the high level of pollution in Northern Italy should be considered an additional co-factor of the high level of lethality recorded in that area”.

Thus begins the article "Can air pollution be considered a co-factor in the extremely high level of lethality of SARS-CoV-2 in northern Italy?", signed by researchers Edoardo Conticini, Bruno Frediani and Dario Caro, published on 24 March in the scientific journal “Environmental Pollution”. The Covid-19 pandemic has stimulated the production of academic articles, focused on analyzing the different aspects of a total phenomenon, spread out over every aspect of living. Shaken by the need for an emergency, various disciplines are chasing a quick and evasive enemy, relying on literature in an attempt to find in similarities with the past the props of a new knowledge.

The study of the three Italian scholars tries to explain the appalling lethality shown by the virus in northern Italy, but rests solidly on the analyzes conducted for other coronavirus infections, such as SARS (2002-2003) and MERS (2012). In "Air pollution and case fatality of SARS in the People's Republic of China: an ecologic study", published in Environmental Health in 2003, a group of Chinese researchers demonstrated how SARS patients living in particularly polluted regions have 84% more likely to face death than inhabitants of areas where air pollution has less incidence.

The Po Valley is the most polluted region on the European continent, surrounded by a thicker layer of fine dust than Wuhan, the metropolis of ten million inhabitants where Covid-19 first developed. In Lombardy, Veneto and Emilia Romagna, explained Caro, “many people live with previous diseases, including respiratory diseases, due to pollution. We know that Covid-19-related deaths are mostly caused by serious pneumonia, the so-called acute respiratory distress syndrome, which in turn is caused by a massive release of inflammatory cytokines. From a medical point of view we noticed that in populations subjected to high levels of pollution these inflammatory cytokines are persistently high, even in healthy and young subjects".

For the Italian trio it was enough to overlap some data, such as those on mortality provided by the Civil Protection, the analyzes on health conditions and respiratory diseases, and finally the numbers of the Air Quality Index elaborated by the European Environment Agency. To confirm the intuition of Conticini, Frediani and Caro then came a study from Harvard University, commented and broadcast by newspapers such as the New York Times and the Guardian. In "Exposure to air pollution and COVID-19 mortality in the United States", it is shown that an increase of one microgram per cubic meter in PM2.5 (extremely fine dust) causes an increase in lethality given by Covid-19 of 15 %. The long exposure to conditions where the presence of fine particles (PM2.5 are those capable of getting deeper into the respiratory system) has undergone a growth, even minimal, increases the mortality rate of coronavirus by twenty times. The conclusions reiterate "the importance of continuing the implementation of the PM2.5 air pollution regrticles, focused on analyzing an health during and after the Covid-19 crisis".

A note definitely needed in a country where the government, under the pressure of the economic and financial sectors, accepted the quarantine measures only when the virus hit New York, where today the possibility of creating mass graves in public parks to host the dead is contemplated . The neoliberalism of predation does not give up even in the face of scientific evidence, tempting rulers with pre-scientific, medieval positions. The perfect geometry of the pandemic process is not enough: deforestation puts men in contact with viruses otherwise imprisoned in other animal species, political and economic interests prevent or slow down the implementation of health protocols, the virus proliferates in the regions with the highest industrialization, where movement and profit prevail over collective responsibilities, where air pollution makes the bodies fragile, and the pathways for the disease spread faster and lasting.

Leonardo Setti of the University of Bologna and Gianluigi and Gennaro of the University of Bari, both belonging to the Italian Society of Environmental Medicine (Sima), together with other colleagues monitored and cross-referenced the data from the ARPA detection units (Regional Agency for Environmental Protection) and those on contagion provided by the Civil Protection. Once again the scientific literature provided the basis for a conclusion that organically links pollution to contagion: as for other types of pneumonia and for measles, there exist a strong relationship between the exceeding of the legal limits of the concentrations of Pm10 and PM2.5 and the number of cases infected with Covid-19. The virus binds in a coagulation process to the fine particles, which become a highly efficient disease carrier, increasing its persistence and its ability to cover distances wider than the canonic “safety meter”. “The more fine particles there are, the more highways are created for infection. We need to minimize emissions", said De Gennaro.

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