The Effects of Outdoor Air Pollution Concentrations and Lockdowns on Covid-19 Infections in Wuhan and Other Provincial Capitals in China

Abstract

Background: Covid-19 was first reported in Wuhan, China in Dec 2019. Since then, it has been transmitted rapidly in China and the rest of the world. While Covid-19 transmission rate has been declining in China, it is increasing exponentially in Europe and America. Although there are numerous studies examining Covid-19 infection, including an archived paper looking into the meteorological effect, the role of outdoor air pollution has yet to be explored rigorously. It has been shown that air pollution will weaken the immune system, and increase the rate of respiratory virus infection. We postulate that outdoor air pollution concentrations will have a negative effect on Covid-19 infections in China, whilst lockdowns, characterized by strong social distancing and home isolation measures, will help to moderate such negative effect. Methods: We will collect the number of daily confirmed Covid-19 cases in 31 provincial capital cities in China during the period of 1 Dec 2019 to 20 Mar 2020 (from a popular Chinese online platform which aggregates all cases reported by the Chinese national/provincial health authorities). We will also collect daily air pollution and meteorology data at the city-level (from the Chinese National Environmental Monitoring Center and the US National Climatic Data Center), daily inter-city migration flows and intra-city movements (from Baidu). City-level demographics including age distribution and gender, education, and median household income can be obtained from the statistical yearbooks. City-level co-morbidity indicators including rates of chronic disease and co-infection can be obtained from related research articles. A regression model is developed to model the relationship between the infection rate of Covid-19 (number of confirmed cases/population at the city level) and outdoor air pollution at the city level, after taking into account confounding factors such as meteorology, inter- and intra-city movements, demographics, and co-morbidity and co-infection rates. In particular, we shall study how air pollution affects infection rates across different cities, including Wuhan. Our model will also study air pollution would affect infection rates in Wuhan before and after the lockdown. Expected findings: We expect there be a correlation between Covid-19 infection rate and outdoor air pollution. We also expect that reduced intra-city movement after the lockdowns in Wuhan and the rest of China will play an important role in reducing the infection rate. Interpretation: Infection rate is growing exponentially in major cities worldwide. We expect Covid-19 infection rate is related to the air pollution concentration, and is strongly dependent on inter- and intra-city movements. To reduce the infection rate, the international community may deploy effective air pollution reduction plans and social distancing policies.

Estimating COVID-19 Prevalence in the United States: A Sample Selection Model Approach

“…Nevertheless, because these models 'scale up' observed deaths to estimate population infections, small differences in the assumed case fatality will have substantial effects on the results. This poses a challenge for estimation, given that there is considerable uncertainty regarding the case fatality rate, which may vary widely across regions due to local demographics and environmental conditions [27][28][29][30][31]. Moreover, to the extent that there is significant undercounting in the number of COVID-19 related deaths [32,33], these estimates may fail to capture the full extent of population infection.…”

Estimating COVID-19 Prevalence in the United States: A Sample Selection Model Approach

“…Nevertheless, because these models 'scale up' observed deaths to estimate population infections, small differences in the assumed case fatality will have substantial effects on the results. This poses a challenge for estimation, given that there is considerable uncertainty regarding the case fatality rate, which may vary widely across regions due to local demographics and environmental conditions [27][28][29][30][31]. Moreover, to the extent that there is significant undercounting in the number of COVID-19 related deaths [32,33], these estimates may fail to capture the full extent of population infection.…”

Environmental pollution and COVID-19 outbreak: insights from Germany

“…Environmental quality index serves as a comprehensive indicator to analyze the impact of environmental quality on human health. Based on Chinese provincial dataset from December 01, 2019, to March 20, 2020, Han et al (2020) concluded that lower environmental quality is negatively correlated with human immune system and as a consequence, it is contributing towards COVID-19 pandemic in countries with poor environmental quality. Similarly, Venter et al (2020) reinforced comparable discoveries and recommended that better environmental quality lowers the risk of getting infected from COVID-19.…”