COVID, Fossil Fuels, & Health

Few subjects – individually – are more vexed and vital than the Coronavirus pandemic, the fate of the fossil fuel industry (bound up in climate change and the future of the entire planet) and the economics of the vast healthcare industry (or, outside the USA, the health care services sector). And yet, in our pandemic world, they are tied together, and their convoluted ties provide intriguing lessons that can be digested without anger:

  • We need a vibrant economy.
  • We are spending trillions to keep the economy alive as the pandemic’s damage expands.
  • We are already spending vast sums – worldwide these are also trillions of dollars – to prop up the fossil fuel industries.
  • We are spending trillions of dollars on health care – amounts that are expanding due to COVID.

Too many trillions. Too much pain. Too expensive.

One particular thread to pull on is this: the world spends trillions of dollars per year to deal with the health damage caused by fossil fuel use. The health consequences of fossil fuel use are adding to the scope of human suffering, and to the cost of dealing with it – and the mandated shutdowns have resulted in similarly vast potential long-term savings.

We are at a place where rebalancing the economy becomes imperative. Here’s one way to not waste trillions of dollars AND have a healthier populace AND have a more vibrant economy.

The other costs of fossil fuels

Marine Photobank

Our relationship with fossil fuels is one in which we give vast subsidies – hundreds of billions of dollars each year – and it gives us back cheap oil – and a grim toll of death and disease. We get to pick up the tab for the hospitals and funerals as well, another few hundred billion dollars. It’s time to rethink the balance.

Explicitly, this must include adding in the costs of death and diseases to the balance sheets of fossil fuels. It must include thinking of the great monies being spent here and looking to use them to build a cleaner, post-COVID future.

The IMF (and, separately, this author and others) have estimated the total health costs of use of fossil fuels. The IMF estimates that the worldwide, annual health-associated costs of air pollution from fossil fuel use exceed $2.3 Trillion dollars. (My estimates, and some others, are higher – as much as $2.9 Trillion per year.) These costs are external to the fossil fuel industry – they are borne instead by you and me and the rest of the world in pulmonary diseases and syndromes, and in loss of life and diminished vitality.

The data are already in: we can save money and lives

One sad consequence of the COVID pandemic is that it is already so vast, and covers such numbers of people, countries, industries, lands, that – alas – some statistical analyses are already instructive. The health consequences go far beyond sitting at home and losing jobs and reducing the contagion of COVID. Here are two important ideas:

  • The worst instances of COVID infection occur in areas with lowest air quality – with fossil fuel use atop the list of culprits.
  • The close-down of industry in Wuhan to deal with COVID resulted in air quality improvements so vast that the lives saved by improved air quality likely greatly exceed the death toll from COVID.

We’ve found ourselves in an unholy, nay, terrible, cycle in which our addiction to heavily subsidized fossil fuels both worsens our health problems and limits our ability to pay to solve those health problems. The inevitable outcome must be cutting this knot, by driving to a place where we rebalance our economy. So, while this piece is not about how or when we get to a post-COVID economy, it is about what that economy must look like.

Note: the rest of this note deals with the death toll and costs of COVID and other problems without empathic consideration of the human misery it has brought, sickness, job losses, bankruptcies and more. Each death and severe sickness and job loss and company failure is a tale of suffering. I mourn for those, and yearn for a world in which we can solve problems, and that is what this note is about.

COVID and health quality

Urban pollution ,Photo by Holger Link on Unsplash

Wuhan has achieved notoriety as the point of origin of COVID. I’ve been there, a decade or more ago. It already had the worst air I’d ever experienced; I’m sure it’s become worse since. My meetings ended in mid-afternoon and we emerged from the building we’d been in and … you could stare, safely, at the sun – a blood-red disk in a yellow-brown haze.

At a primitive level (I’m not a medical doctor), it makes sense the air pollution or heavy smoking (also prevalent in Wuhan) would make for worse COVID outcomes – they both cause persistent and grave challenges to lung function: the inhabitants of Wuhan already had lungs that daily suffered significant injury. But it’s not just in China. We now have the first statistically-significant analyses of COVID and air pollution in the USA – a Harvard-led analysis of the correlations between air pollution and COVID outcomes, looking at the known air quality in over 3,000 US counties. Key takeaways (the following are direct quotes):

  • The majority of the pre-existing conditions that increase the risk of death for COVID-19 are the same diseases that are affected by long-term exposure to air pollution
  • … an increase of only 1 μg/m3 in PM2.5 is associated with a 15% increase in the COVID-19 death rate, 95% confidence interval
  • A small increase in long-term exposure to PM2.5 leads to a large increase in COVID-19 death rate, with the magnitude of increase 20 times that observed for PM2.5 and all-cause mortality.

Now, correlation is not causation. We all know that the poorest people live in the dirtiest places and have the worst diets and the weakest access to healthcare. EPA researchers have previously linked PM2.5 counts to a variety of health concerns including: premature death in people with heart or lung disease, non-fatal heart attacks, irregular heartbeats, aggravated asthma, decreased lung function, and increased respiratory symptoms such as inflammation, airway irritations, coughing, or difficulty breathing

But, the authors claim, they were able to correct for the background – it’s a large data set and so, in principle, you can do that. From the paper: “We adjust by population size, hospital beds, number of individuals tested, weather, and socioeconomic and behavioral variables including, but not limited to obesity and smoking.” Insofar as these adjustments are accurate, in important conclusion of immediate value: COVID illness and death rates are significantly exacerbated by pre-existing bad air quality.

COVID shutdowns and improved longevity

Back to Wuhan. This is a vast city in central China, home to over 11 million people. According to government statistics, 81,000 people were sickened and over 3,300 died. (Note: the only data from China are “official”, and their accuracy cannot be verified. One noted source,, is maintained by a tiny company based in Shanghai.)

Only through aggressive tactics did the Chinese government succeed in preventing the death toll from soaring to hundreds of thousands. Factories closed, roads were empty. Satellite images from NASA show a fast and truly stunning decrease in air particulates across China. The best current estimate is that the improved air quality saved far more lives than were lost to COVID. Literally – Chinese official statistics initially asserted that COVID claimed over 3,000 lives; improved air quality may have saved as many as 73,000 lives.

From the paper: “2 months of 10µg/m3 reductions in PM2.5 likely has saved the lives of 4,000 kids under 5 and 73,000 adults over 70 in China.”

Much of this is due specifically to lowered fossil fuel use. The specific gas tracked in the NASA images shown here is nitrous oxide – also a major contributor to climate change – and not specifically PM2.5. But nitrous oxide has the same sources, so it allows the deduction of improved longevity due to the shutdown caused by COVID. 

NASA images of pollution. (Beijing and some other cities continued to have bad air during the COVID shut downs, likely because of use of coal-fired power plants for electricity generation.) Images from NASA observatory; their site also has specific images of air quality improvements in the Wuhan area.

What is PM2.5?

PM2.5 is a term used to describe particulates in the atmosphere that are smaller than 2.5 microns. (For a reference, the COVID virus itself is less than 100 nanometers in size – one 30th of the size of the particles at the upper range of  PM2.5; there’s a wide range of sizes of aerosol droplets from someone coughing or sneezing – from less than 1 micron to 100 microns). There’s a good, lay discussion at THIS SITE.

There are lots of particles in the air. Anything smaller than about 10microns (one hundredths of a millimeter) can be easily brought into our lungs. Those between 2.5 micron and 10 microns tend to deposit in the larger passages. These include ash from fires or the ground-up grit from roads; these are in the PM10 category. Much smaller ones can travel further into the many fine channels in the lung. Diesel particulates particularly, and many other fine soots from cars fit into these categories. These are particularly damaging – and their damage to the fine structures of the lung are especially nefarious in the context of COVID.

What is absolutely true:

  • COVID death rates are significantly increased by PM2.5 (as is true for many diseases)
  • The leading cause of PM2.5 particulates is the fossil fuels we burn

Now what?

COVID pandemic illustrates many societal ills. High on that list is that the costs of fossil fuels include extraordinarily high health costs. Countries – like the USA – that don’t have a national health system, see these costs as extraneous to those businesses. That conception was breaking under strain due to fossil fuels’ health consequences before COVID. It’s clearly a bankrupt idea now.

It’s high time to rebalance our economy, and it’s over time to bring the external costs to the table as we do that and as we build a cleaner economy for our future.

Photo by Zbynek Burival on Unsplash

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