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Studies link COVID-19 deaths to air pollution, raising questions about EPA’s ‘acceptable risk’

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PhD Candidate and Research Fellow, State University of New York College of Environmental Science and Forestry
Michael Petroni receives funding from State University of New York Discovery Challenge Fund.
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The pandemic is putting America’s air pollution standards to the test as the COVID-19 death toll rises.
The U.S. government sets limits on hazardous air pollutants to try to protect public health, but it can be difficult to determine where to draw the line for what is considered “acceptable risk.” Power plants, factories and other pollution sources release hundreds of million pounds of hazardous pollutants into the air every year.
As the coronavirus spreads, the pattern of deaths suggests there are serious weaknesses in the current public safeguards.
Several studies have explored connections between air pollution and severe cases of the respiratory illnesses. The latest, published on Oct. 26, estimates that about 15% of people who died from COVID-19 worldwide had had long-term exposure to fine particulate air pollution.
My research as an environmental health scientist looks closer at individual hazardous air pollutants and shows how higher rates of COVID-19 deaths across the U.S. – particularly in the South – have been associated with higher levels of pollutants, particularly diesel exhaust and acetaldehyde, a compound widely used in industry.
The delivery boxes piled up in my living room offer a snapshot of how pervasive hazardous air pollutants can be. Toxic gases like acetaldehyde are exhaled by the paper mill that manufactured the boxes in Louisiana, the diesel trucks that delivered them, and even the gas furnace that keeps me warm as I open them. The Environmental Protection Agency regulates acetaldehyde, in part because in 1986 Dutch scientists found that it damages the respiratory system of rodents.
Acetaldehyde is quite common. In addition to being used in industry, it’s found in decaying vegetation, alcohol and cigarette smoke.
I generally don’t think about the toxic emissions resulting from my consumer behavior, but I can’t help but think about health risks now, and how to reduce them.
In the early days of the pandemic, I isolated myself. I dusted off my bicycle. I identified the contaminants in my water system and installed a reverse osmosis filter. To put it bluntly, I was afraid. Overweight men were not faring well against the virus, according to an early study, so I tried to modify my risk.
But what can I do about the air I breathe? I cannot stop the trucks from driving past my house, or the steel mill down the street from releasing emissions from its smokestack.
Harvard University and Emory University have investigated the role of particulate matter, ozone and nitrogen oxides in COVID-19 deaths by comparing county death rates to pollution levels and other potential factors. Similar studies have been done in Italy, England and China.
All of these studies found an association between higher death rates from COVID-19 and long-term pollution exposure.
While the causal factors are still unclear, the association may be related to air pollution exposure weakening the respiratory, immune and cardiovascular systems. Exposed populations have greater vulnerability and less resistance to the virus.
My colleagues and I investigated specific hazardous air pollutants, including acetaldehyde, that are elevated in Southern rural areas that have been hit hard by the virus.
In states such as Mississippi, Alabama, Georgia and Louisiana, high COVID-19 death rates have been attributed in part to an older population that’s more likely to have chronic illnesses and live in poverty. We controlled for these factors, as well as population health and preventive behaviors, and found that long-term hazardous air pollutant exposure is putting pressure on COVID-19 patients in these areas.

While federal standards suggest that the pollution levels in these areas aren’t harmful, our findings suggest officials need to reevaluate some of those standards.
In 1991, the EPA extrapolated from rodents to humans to set the safety limit for acetaldehyde at 9 micrograms per cubic meter of air – similar in volume to a cup of water in an Olympic-size swimming pool. This standard assumes contaminated air below this level will not lead to any harm, excluding cancer.
But even acceptable exposures to these chemicals may be contributing to COVID-19 mortality rates. There is still a lot that scientists don’t know about the impact of hazardous air pollutants on humans.
There are some reasons we might observe effects below the threshold. First, animal reactions to toxins do not always predict human reactions. Second, hazardous air pollutants do not act alone, and exposure to multiple toxins can have cascading impacts. Third, methods of monitoring and estimating exposures to air toxins are not adequate for characterizing risks to human health, especially for vulnerable populations.
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The Toxics Substance Control Act is responsible for addressing risks from chemicals and limiting use of such substances as PCBs and asbestos. A 2016 amendment increased the government’s authority to review risks for communities living near high-emissions sources. But these risks have yet to take a major role in the assessment process. The government in recent years has also cut funding for the Integrated Risk Information Service, which identifies health hazards.
More research is needed into effective pollution limits to address multiple chemical exposures and their effect on vulnerable populations.
Limits, along with funding for pollution prevention and control technology, could provide incentives for cleaner production practices and cleaner vehicles. These can be important strategies for strengthening the nation’s defenses against this and future respiratory disease pandemics.
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Your corner pharmacy – joining the front lines of the COVID-19 fight

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Director of Skills Education and Clinical Assistant Professor of Pharmacy Practice, Binghamton University, State University of New York
Assistant Professor, Department of Pharmacy Practice, Jefferson College of Pharmacy, Thomas Jefferson University
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

Binghamton University, State University of New York provides funding as a founding partner of The Conversation US.
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The new year has brought the deadliest weeks of the U.S. COVID-19 epidemic thus far, with thousands of deaths every day. It’s been several weeks since the U.S. Food and Drug Administration issued the first of two emergency use authorizations for COVID-19 vaccines, but getting one isn’t easy.
There are no available appointments to get a vaccine in many communities. Wait times at California’s Dodger Stadium, the nation’s largest distribution site, reached five hours earlier this month. At the current rate, it could take until 2022 for all adult Americans to be vaccinated, according to some estimates.
The Biden administration is trying to change that. The national strategy President Biden rolled out in his first week in office includes a target of injecting 100 million vaccines during his first 100 days as president and strengthening distribution to high-risk communities.
A key component of the president’s five-step vaccine plan, he said, is to “fully activate the pharmacies across the country.” This will greatly expand the number of providers to administer vaccines – and expand the role of pharmacists in the pandemic in the weeks and months ahead.
As pharmacists who work in both rural and urban settings, we are among those who are preparing to meet this challenge.
With the slow rollout, community pharmacies are being brought on board much sooner than anticipated. They’ve been an underutilized resource: U.S. pharmacies have experience storing and administering many types of vaccines. In 2018, they gave about one-third of all flu shots, up from 18% in 2012. They are now preparing to handle the new Pfizer-BioNTech and Moderna COVID-19 vaccines.
These messenger RNA (mRNA) vaccines have a new, but not unknown, mechanism. The Moderna vaccine can be kept in a traditional freezer, but the Pfizer vaccine requires ultra-cold storage at -112 to -76 F before being thawed and administered. Health systems and federal partner pharmacies equipped with these specialized freezers are key hubs for distribution.
It’s not just the vaccine that needs to be protected. Pharmacies are stockpiling personal protective equipment to keep staff safe. They have also established safety protocols for patients – social distancing, disinfection and observation for 15 to 30 minutes after vaccination.
There are also administrative requirements, issuing immunization cards to those who have been immunized and reporting the number of administered doses to state and federal officials.
Pharmacies are registering with the searchable Vaccine Finder website – where people will be able to search for participating pharmacies. The vaccine is free: Insurance companies will be billed an administration fee, though a national relief fund covers that cost for the uninsured.
Under a U.S. Department of Health and Human Services mandate, pharmacists and pharmacist interns who have completed a minimum of 20 hours of accredited training are authorized to administer COVID-19 vaccines.
While health departments and local officials are working to share information, many people are calling their local pharmacies with questions. Because the vaccine was produced, tested and approved in record time, some are questioning its safety. It was produced quickly because government funding fast-tracked various phases of development, allowing them to be conducted simultaneously rather than sequentially. Thousands of volunteers signed up for clinical trials, speeding the process, and emergency FDA approval allowed for rollout while some phase 3 studies are completed.
People are also concerned about contracting coronavirus from the vaccine, which is impossible. Neither mRNA vaccine contains live virus; they simply teach the body to recognize the unique spike protein on the outside of the COVID-19 virus to create a faster immune response to the invader if exposed. Two doses must be spaced 21 to 28 days apart, and it takes another few weeks after the second dose to reach full immunity.
Some who have called us are worried about possible side effects. The most commonly reported aftereffect is pain and swelling at the injection site; some individuals have also reported chills, fever, headache or fatigue. While this may be uncomfortable, it’s not alarming: These are all signs that the immune system is doing its job.
We have also helped explain to people why all are monitored after their shot. A few people have had serious allergic reactions – anaphylactic shock, which is why there is an established observation period after the vaccine that is longer for anyone with a history of allergies. Pharmacists are trained to respond to these rare reactions should they occur.
There have also been reports of individuals who have died within days or weeks of receiving the vaccine. Researchers are investigating these rare events, but so far, there is no evidence that the vaccine is responsible. Unrelated or “incidental” illness seems to be the culprit, which is unsurprising given the demographics – many of those vaccinated in the early rollout are elderly people who are in frail health.
Vaccines have the power to bring this pandemic under control. They could possibly even end it, but only after some 70% of humanity is inoculated. Almost 90% of Americans live within five miles of a local pharmacy where, starting in February, many will be able to get vaccinated against this virus.
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How to stay safe with a fast-spreading new coronavirus variant on the loose

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Bayard D. Clarkson Distinguished Professor of Mechanical and Aeronautical Engineering, Clarkson University
Associate Professor of Mechanical Engineering, Clarkson University
Suresh Dhaniyala receives funding from National Science Foundation and NY State Energy Research and Development Authority.
Byron Erath receives funding from the National Institutes of Health, the National Science Foundation, and the Empire State Development's Division of Science, Technology and Innovation (NYSTAR)

Clarkson University provides funding as a member of The Conversation US.
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A fast-spreading variant of the coronavirus that causes COVID-19 has been found in at least 20 states, and people are wondering: How do I protect myself now?
We saw what the new variant, known as B.1.1.7, can do as it spread quickly through southeastern England in December, causing case numbers to spike and triggering stricter lockdown measures.
The new variant has been estimated to be 50% more easily transmitted than common variants, though it appears to affect people’s health in the same way. The increased transmissibility is believed to arise from a change in the virus’s spike protein that can allow the virus to more easily enter cells. These and other studies on the new variant were released before peer review to share their findings quickly.
Additionally, there is some evidence that patients infected with the new B.1.1.7 variant may have a higher viral load. That means they may expel more virus-containing particles when they breathe, talk or sneeze.
As professors who study fluid dynamics and aerosols, we investigate how airborne particles carrying viruses spread. There is still a lot that scientists and doctors don’t know about the coronavirus and its mutations, but there are some clear strategies people can use to protect themselves.

The SARS-CoV-2 variants are believed to spread primarily through the air rather than on surfaces.
When someone with the coronavirus in their respiratory tract coughs, talks, sings or even just breathes, infectious respiratory droplets can be expelled into the air. These droplets are tiny, predominantly in the range of 1-100 micrometers. For comparison, a human hair is about 70 micrometers in diameter.
The larger droplets fall to the ground quickly, rarely traveling farther than 6 feet from the source. The bigger problem for disease transmission is the tiniest droplets – those less than 10 micrometers in diameter – which can remain suspended in the air as aerosols for hours at a time.
With people possibly having more virus in their bodies and the virus being more infectious, everyone should take extra care and precautions. Wearing face masks and social distancing are essential.
Spaces and activities that were previously deemed “safe,” such as some indoor work environments, may present an elevated infection risk as the variant spreads.
The concentration of aerosol particles is usually highest right next to the individual emitting the particles and decreases with distance from the source. However, in indoor environments, aerosol concentration levels can quickly build up, similar to how cigarette smoke accumulates within enclosed spaces. This is particularly problematic in spaces that have poor ventilation.
With the new variant, aerosol concentration levels that might not have previously posed a risk could now lead to infection.

1) Pay attention to the type of face mask you use, and how it fits.
Most off-the-shelf face coverings are not 100% effective at preventing droplet emission. With the new variant spreading more easily and likely infectious at lower concentrations, it’s important to select coverings with materials that are most effective at stopping droplet spread.
When available, N95 and surgical masks consistently perform the best. Otherwise, face coverings that use multiple layers of material are preferable. Ideally, the material should be a tight weave. High thread count cotton sheets are an example. Proper fit is also crucial, as gaps around the nose and mouth can decrease the effectiveness by 50%.
2) Follow social distancing guidelines.
While the current social distancing guidelines are not perfect – 6 feet isn’t always enough – they do offer a useful starting point. Because aerosol concentrations levels and infectivity are highest in the space immediately surrounding anyone with the virus, increasing physical distancing can help reduce risk. Remember that people are infectious before they start showing symptoms, and they many never show symptoms, so don’t count on seeing signs of illness.
3) Think carefully about the environment when entering an enclosed area, both the ventilation and how people interact.
Limiting the size of gatherings helps reduce the potential for exposure. Controlling indoor environments in other ways can also be a highly effective strategy for reducing risk. This includes increasing ventilation rates to bring in fresh air and filtering existing air to dilute aerosol concentrations.
On a personal level, it is helpful to pay attention to the types of interactions that are taking place. For example, many individuals shouting can create a higher risk than one individual speaking. In all cases, it’s important to minimize the amount of time spent indoors with others.
The CDC has warned that B.1.1.7 could become the dominant SARS-CoV-2 variant in the U.S. by March. Other fast-spreading variants have also been found in Brazil and South Africa. Increased vigilance and complying with health guidelines should continue to be of highest priority.
[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]
This story was updated Jan. 18 with latest CDC count and map showing B.1.1.7 cases now found in 20 states.
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Copyright © 2010–2021, The Conversation US, Inc.

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Coronavirus

How to stay safe with a new fast-spreading coronavirus variant on the loose

Avatar

Published

on

Bayard D. Clarkson Distinguished Professor of Mechanical and Aeronautical Engineering, Clarkson University
Associate Professor of Mechanical Engineering, Clarkson University
Suresh Dhaniyala receives funding from National Science Foundation and NY State Energy Research and Development Authority.
Byron Erath receives funding from the National Institutes of Health, the National Science Foundation, and the Empire State Development's Division of Science, Technology and Innovation (NYSTAR)

Clarkson University provides funding as a member of The Conversation US.
View all partners
A fast-spreading variant of the coronavirus that causes COVID-19 has been found in at least 10 states, and people are wondering: How do I protect myself now?
We saw what the new variant, known as B.1.1.7, can do as it spread quickly through southeastern England in December, causing case numbers to spike and triggering stricter lockdown measures.
The new variant has been estimated to be 50% more easily transmitted than common variants, though it appears to affect people’s health in the same way. The increased transmissibility is believed to arise from a change in the virus’s spike protein that can allow the virus to more easily enter cells. These and other studies on the new variant were released before peer review to share their findings quickly.
Additionally, there is some evidence that patients infected with the new B.1.1.7 variant may have a higher viral load. That means they may expel more virus-containing particles when they breathe, talk or sneeze.
As professors who study fluid dynamics and aerosols, we investigate how airborne particles carrying viruses spread. There is still a lot that scientists and doctors don’t know about the coronavirus and its mutations, but there are some clear strategies people can use to protect themselves.
The SARS-CoV-2 variants are believed to spread primarily through the air rather than on surfaces.
When someone with the coronavirus in their respiratory tract coughs, talks, sings or even just breathes, infectious respiratory droplets can be expelled into the air. These droplets are tiny, predominantly in the range of 1-100 micrometers. For comparison, a human hair is about 70 micrometers in diameter.
The larger droplets fall to the ground quickly, rarely traveling farther than 6 feet from the source. The bigger problem for disease transmission is the tiniest droplets – those less than 10 micrometers in diameter – which can remain suspended in the air as aerosols for hours at a time.
With people possibly having more virus in their bodies and the virus being more infectious, everyone should take extra care and precautions. Wearing face masks and social distancing are essential.
Spaces and activities that were previously deemed “safe,” such as some indoor work environments, may present an elevated infection risk as the variant spreads.
The concentration of aerosol particles is usually highest right next to the individual emitting the particles and decreases with distance from the source. However, in indoor environments, aerosol concentration levels can quickly build up, similar to how cigarette smoke accumulates within enclosed spaces. This is particularly problematic in spaces that have poor ventilation.
With the new variant, aerosol concentration levels that might not have previously posed a risk could now lead to infection.

1) Pay attention to the type of face mask you use, and how it fits.
Most off-the-shelf face coverings are not 100% effective at preventing droplet emission. With the new variant spreading more easily and likely infectious at lower concentrations, it’s important to select coverings with materials that are most effective at stopping droplet spread.
When available, N95 and surgical masks consistently perform the best. Otherwise, face coverings that use multiple layers of material are preferable. Ideally, the material should be a tight weave. High thread count cotton sheets are an example. Proper fit is also crucial, as gaps around the nose and mouth can decrease the effectiveness by 50%.
2) Follow social distancing guidelines.
While the current social distancing guidelines are not perfect – 6 feet isn’t always enough – they do offer a useful starting point. Because aerosol concentrations levels and infectivity are highest in the space immediately surrounding anyone with the virus, increasing physical distancing can help reduce risk. Remember that people are infectious before they start showing symptoms, and they many never show symptoms, so don’t count on seeing signs of illness.
3) Think carefully about the environment when entering an enclosed area, both the ventilation and how people interact.
Limiting the size of gatherings helps reduce the potential for exposure. Controlling indoor environments in other ways can also be a highly effective strategy for reducing risk. This includes increasing ventilation rates to bring in fresh air and filtering existing air to dilute aerosol concentrations.
On a personal level, it is helpful to pay attention to the types of interactions that are taking place. For example, many individuals shouting can create a higher risk than one individual speaking. In all cases, it’s important to minimize the amount of time spent indoors with others.
The CDC has warned that B.1.1.7 could become the dominant SARS-CoV-2 variant in the U.S. by March. Other fast-spreading variants have also been found in Brazil and South Africa. Increased vigilance and complying with health guidelines should continue to be of highest priority.
[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]
Write an article and join a growing community of more than 119,500 academics and researchers from 3,844 institutions.
Register now
Copyright © 2010–2021, The Conversation US, Inc.

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