Covid is not Pakistan’s deadliest ‘pandemic’

What is the biggest public health emergency in the world today? Unless you have been living under a rock for the last year, it is of course the Covid-19 pandemic with about two million deaths in 2020 alone. What if there was another global ‘pandemic’ which was causing four times the number of casualties yearly compared to Covid? Yes, it exists and it is the biggest public health issue according to WHO and World Economic Forum. Air pollution is causing the death of over eight million people globally which is about one in five deaths each year.

Pakistan handled the Covid threat impressively and it shows that the country can be surprisingly resilient when its top policymakers lead a joint, professional effort which led to change in public behaviour. To combat an even bigger ongoing threat of air pollution, we have to be just as creative in our local setting. We need to identity which population is the most susceptible to a public health threat. Covid is a good example: vaccinations were prioritised in the first phase to the most vulnerable segment; the frontline health workers and elderly people. Air pollution by contrast affects infants to teenagers disproportionally as lungs continue to develop till the age of adolescence. We need to focus on protecting the young to avoid a huge toll on our healthcare in the future. Air pollution unlike Covid is a slow killer and its effects will not be manifested until years down the road.

What is the emergency solution to protect our youth from the air pollution ‘pandemic’? My radical proposition is that we change our school calendar as an emergency measure to protect our youth from outdoor air pollution. Pakistan is ranked as the one of the most polluted countries in the world by air quality. Air pollution is highest in our country during winter and lowest during the summer monsoon season. The months of November, December and January have the highest concentration of PM2.5 which can cross 10 to 20 times the legal limit for ambient air. In contrast, the summer months have the lowest concentration of PM2.5 compared to the rest of the year. We need to close schools during the toxic winter months and open them during the summer to ensure a ‘smart’ school year which lowers the exposure of deadly air to our youth. This will also lead to secondary benefit; lower transportation during winter smog season which is the biggest contributor of air pollution.

Air pollution like Covid is a multi-faceted public health issue which needs a long-term, evidence-based approach. The government has implemented changing fuel standards to Euro-5, reducing stubble burning by Happy Seeders, and approving the national electric vehicle policy. These will show their fruits in the long term with better health outcomes for Pakistan’s citizens. However, given the enormity of the issue, innovative steps will need to be taken to protect the population from this threat. A ‘smart’ school calendar may have its critiques about the high summer temperatures but this can easily be resolved by changing school timings to an earlier start and finish. Once our winter and summer air quality matches in the future, we can switch the school calendar back to the traditional year.

Covid has shown we can take unprecedented steps to manage the pandemic. Air pollution and its deadly effects will remain with us for decades. We can choose to be passive about this and see millions of our children go through limited lung growth and increased cardiopulmonary mortalities. Or we can be proactive and change the school calendar to mitigate the immediate effects of air pollution on our youth.

Published in The Express Tribune, March 14^th, 2021.

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