Air Pollution Worsens COVID-19, but Bay Area Emissions Limits Are Unchanged

As wildfires foul the air, research suggests particles from construction work – and wildfire smoke – can worsen COVID-19 symptoms and even carry the virus itself. Yet urging from public health experts has not moved policymakers.

Air pollution can worsen COVID-19, scientific research suggests, but Bay Area regulators haven't moved to tighten air pollution limits.

Telestar Logistics/CC-BY-SA-3.0-MIGRATED

Air pollution can worsen COVID-19, scientific research suggests, but Bay Area regulators haven't moved to tighten air pollution limits.

Throughout most of the COVID-19 lockdown this spring and summer, when Sabrina Hall left her home in San Francisco’s Bayview-Hunters Point neighborhood and walked to her car, she routinely found the vehicle — and every other car on the block — covered in a fine layer of dust.

Its source, she believes, is concrete residue from nearby road construction that’s “been going the entire time” throughout the pandemic, she said, and at higher intensity than before the stay-at-home order was imposed in March. Lately, coupled with wind and ash from wildfires, “The dust situation has been worse,” she said Thursday.

Leaotis Martin didn’t have to leave home to breathe invasive particles. On June 8, laborers and heavy equipment working for homebuilder Lennar Corp. appeared on the southern slope of the Hunters Point ridge, to resume work on the SF Shipyard mega-development project, the largest real-estate effort in the city since the 1906 earthquake. Since then, “We’ve got dust flying all over, from there to where I’m at,” several blocks away on West Point Road, Martin said in an interview this summer.

As life in San Francisco entered a state of suspended animation in the early days of the novel coronavirus pandemic, some business continued as usual. That includes construction, which after the first two weeks of the lockdown was specifically permitted as “an essential activity” under Mayor London Breed’s executive order, provided it met certain criteria.

Limits on construction activity were lifted May 17 as California reopened. Reopening presaged a summer-long spike in COVID-19 cases. As the pandemic continues through wildfire season, and San Franciscans breathe in pollution from the fires’ miles-wide blankets of smoke, public health experts and researchers contacted for this article agree that human-created sources of pollution should be limited or eliminated.

That would include slapping limits on construction. Scientists agree construction contributes to air pollution, and according to multiple studies, air pollution can predict where the disease will strike hardest and exacerbate symptoms once people fall ill. And early research out of Italy, where the pandemic struck hard in its earliest days, suggests that pollution can carry the virus itself.

Along with sheltering in place, compulsory masking, and washing hands, a sensible, comprehensive public-health response to the novel coronavirus pandemic would include mandates for cleaner air, experts say. That would be particularly welcome in Bayview. The area suffers some of the worst air quality in the region along with San Francisco’s highest rates of COVID-19, with 1,101 confirmed cases among 37,394 residents, according to the San Francisco Department of Public Health.

Despite the high likelihood that pollution controls would improve health outcomes, the coronavirus pandemic has not prompted changes to air pollution restrictions anywhere in the Bay Area, officials with the San Francisco Department of Public Health and Bay Area Air Quality Management District confirmed. That reluctance is prompting experts to question policy-makers’ actions.

“I don’t know why construction was deemed an essential activity,” said Dr. John Balmes, an air-quality expert and epidemiologist at the University of California, San Francisco, medical school. “I think that was a political-economic decision.”

The result for some San Francisco residents, like Martin and Hall, is sheltering in place in what they say and what data suggests is an unhealthy atmosphere that could make them more vulnerable to the virus.

Some research suggests air pollution link to coronavirus

In both Italy and in China, two early hotspots for COVID-19, researchers found what they call a “direct relationship” between particulate matter and cases of the virus. Building off of these findings, an article published in April in the peer-reviewed journal Challenges suggested the novel coronavirus can travel on particulate matter, fine particles small enough to be inhaled and lodge in the lungs — and that this was a clear call for regulators to cut pollution as a pandemic response.

“If it is true that the novel coronavirus remains active from some hours to several days on various surfaces, it is logical to postulate that the same can occur when it is adsorbed or absorbed by the atmospheric particulate matter, which may also help carry the virus into the human respiratory system,” wrote lead researcher Luigi Sanita di Toppi, a biologist at the University of Pisa.

Once inhaled, those particles — virus-laden or not — can trigger lung inflammation.

Common sources of particulate matter include carbon emissions from industry and automobiles, wood smoke and dust from building and other construction activities, according to the U.S. Environmental Protection Agency.

Such pollution is well-known to increase the likelihood of respiratory infections and mortality. And links between construction pollution and lung disease have been suggested well before the pandemic.

“As the Earth presents us with a very high bill to pay, governments and other authorities need to take prompt action to counter excessive pollution levels,” di Toppi wrote.

Bayview Hunters Point has already paid a very high bill. According to one survey of elementary-school students at George Washington Carver Elementary School, near the Hunters Point shipyard, as many as 85 percent of first-graders have symptoms of asthma, a public-health crisis that researchers have suggested is connected to an influx of new construction.

“Given this, there are public health reasons to institute stronger controls on pollution right now,” said Dr. Claudia Persico, an applied-policy scholar and professor at American University in Washington, D.C. 

Persico  is the lead author of a recent discussion paper that suggested a link between air pollution and COVID-19 infections and deaths. Researchers at Harvard University’s T.H. Chan School of Public Health found a similar link between long-term exposure to air pollution and higher rates of COVID-19 death rates.

The pandemic adds a layer of urgency to revived community concerns around the Bayview-Hunters Point shipyard redevelopment project. In 2008, Lennar Corp. paid a $515,000 fine for failing to control construction dust laden with naturally occurring serpentine asbestos, present in the Hunters Point hill where the first few hundred condos were built.

More recently, the shipyard project has been delayed for years by a fraud scandal in which a contractor hired to clean pollution allegedly faked its work. The weight of these developments, along with recent research suggesting toxic material from the shipyard may have been absorbed by local residents and workers, and  fears that the work that began in June raised more asbestos-laden dust, has led to renewed calls for government to step in.

“Once again, Lennar Corporation is making a loud statement that Black Lives do not matter,” attorney Charles Bonner wrote in a petition filed in early July with the state attorney general’s office. Bonner alleged that construction dust is entering into nearby homes and asked authorities to halt the construction, a claim repeated by Martin and other litigants in a class-action lawsuit.

Officials with the Bay Area Air Quality Management District stressed that the Lennar construction project has not  violated any pollution limits, including the controls on dust containing naturally occurring serpentine asbestos imposed more than a decade ago. An inspector with the district visited the site on July 1 and did not observe any emissions at all, according to a site-visit report obtained via a public records request.

Danielle Tocco, a spokeswoman for Lennar, did not respond to several email messages and phone calls seeking comment.

And, at least for now, that work is over. The work Lennar did in June is pre-construction work called “grubbing,” the removal of roots and vegetation from the hillside so heavier building work can begin.

Once that construction starts, particulate-matter emissions will continue to be monitored, district spokesman Ralph Borrmann said in an email. Emissions will also be subject to limits hashed out as part of the settlement agreement reached about a decade ago.

Should construction be shut down?

But merely monitoring dust is  not good enough for some public-health experts. Some believe pollution controls in place before the pandemic are too lax — and that allowable levels of pollution contribute to asthma, chronic bronchitis and other lung illnesses that render the sufferers more likely to become seriously ill with COVID-19.

“In general, air pollution cutoff criteria should be tightened, irrespective of COVID,” said Dr. Mary Prunicki, a physician and research scientist at Stanford University School of Medicine, where she is the Director of Air Pollution and Health Research at the Sean N. Parker Center for Allergy Research.

Even areas with poor health outcomes and widespread chronic breathing problems connected to long-term air pollution experience near-immediate improvements when pollution levels are cut, she said. Pollution concerns underscore complaints from earlier in the pandemic that argue there’s little justification for construction to be considered an “essential activity” during a respiratory-disease pandemic.

“There’s a difference in opinion, but based on the science, I would say it should be limited or stopped,” Prunicki said. “It would stand to reason that if you can improve air quality, or at least not make it worse, it may have some impact on COVID rates.”

As elsewhere in the country, air quality improved dramatically in March and April, when all but essential workers were told to stay at home and traffic disappeared from Bay Area freeways. Since then, pollution levels have slowly returned to normal — before worsening to some of the most hazardous air quality in the world following wildfires that struck last week.

With that in mind, and with the pandemic still stifling the economy, travel, and normal activities, more radical measures may be needed to smash the virus.

“Given the current increase in coronavirus infections, we should be considering a much more intensive lockdown and shelter-in-place, and in my view, that would include” limits on particulate-matter emitting activities like construction, Balmes of UCSF said.

Construction also poses risks to workers laboring in a dust-laden environment. Inhaling dust can weaken their immune systems thus increasing the likelihood of contracting COVID-19, which could then be spread to family or friends back home.

Little political will for halting or limiting construction

So far, the coronavirus pandemic does not appear to have triggered even a discussion of restricting polluting activities, or re-examining market-rate residential construction’s essential status. In fact, elected officials contacted for this article declined to even discuss the concept.

Before District 10 Supervisor Shamann Walton’s election to represent the Bayview two years ago, he was executive director of Young Community Developers, a job-training nonprofit that’s also involved in affordable-housing construction.

“Right now we are addressing the negative impacts of COVID-19,” he wrote in response to a text message asking if he would tackle the issue of air pollution. “We are providing food, basic needs, PPE and monetary resources.”

Asked directly if he would explore stricter pollution controls, Walton, who also sits on the air-quality district board, did not respond.

Mayor London Breed, through city spokesman Joseph Sweiss, acknowledged “the relationship between poor air quality and COVID-19.” Asked about the link between Bayview’s poor air quality and its COVID rates, and what can be done in response, Sweiss said the pandemic has “disproportionately impacted the most vulnerable among us.”

Part of San Francisco’s climate-action plan to become a “zero emissions” city by 2050 includes pending legislation that would mandate “zero-emission homes” through bans on natural-gas heaters and stoves in new construction, he pointed out. Asked why construction was deemed an “essential activity” during the pandemic and whether Breed would revisit this designation or impose tougher pollution controls, Sweiss did not respond by the time of publication.

No good options

Pollution may present public officials a menu filled with bad options, not unlike the dilemma of how to reopen schools.

Keep pollution limits where they are and health risks are exacerbated. Cut pollution limits, and industrial and construction jobs may vanish. The better air quality seen in the Bay Area this spring “occurred hand in hand with devastating social and economic challenges which will continue to impact communities, particularly the most vulnerable and the most susceptible, for the foreseeable future,” said Dr. Sumi Mehta, a senior epidemiologist at Vital Strategies, a global public health organization that advises governments.

Such considerations won’t satisfy some critics, for whom the COVID-19 pandemic represents a crisis on top of a crisis — and for whom public health concerns outweigh economic indicators.

“I don’t think we need to discuss it any further,” said Dr. Mark Alexander, an epidemiologist and research scientist retired from Kaiser Permanente Northern California, who grew up in the Bayview and now works as a health equity advocate and adviser.

“I would argue that the 38,000 residents of Bayview-Hunters Point are not and will not significantly benefit from development going on in Bayview-Hunters Point,” he said. “This work, and the lack of interest in the health of the community, was happening well before the pandemic hit.”

“The development must stop, certainly during this era of the COVID-19 pandemic,” he added. “It would be the humane thing to do at minimum.”

Until then, residents like Hall and Martin are instructed by public health officials to stay at home to stop the spread of the virus — in an environment that experts say is unhealthy and grows worse as the wildfires rage.

Hall suffers from lung disease and worries about damage from the dust being spread from construction and other elective work. Even if the city insisted that work must go on, there are preventative measures that could protect or save lives that simply have not been offered.

“They haven’t offered us humidifiers or air purifiers,” she said. “There’s no dust control, and no regard to our health.”