Thanks to COVID-19, a lot more than previously thought.
Nobody but the oil companies and a few carmakers are happy with the Trump administration's rollback of fuel efficiency standards, which were agreed to by the manufacturers in exchange for the 2009 bailout by President Obama. The point of the exercise was to reduce CO2 emissions, and we know Trump doesn't care much about that.
But CO2 isn't the only thing that comes out of a tailpipe. There are also nitrogen oxides, particulate matter, nitrous oxide, and unburnt hydrocarbons. All of this is bad for breathing; as Paul Billings, senior vice-president of advocacy for the American Lung Association, said in the Guardian:
“This will mean there will be more pollution associated with oil extraction, transport, refining – sort of all the way from the well to the pump,” Billings said. “This will mean high levels of smog, more coughing, wheezing, shortness of breath, asthma attacks, COPD (chronic obstructive pulmonary disease) exacerbations and also more particulate pollution.”
Even the EPA admits that the rollback will cause increases in premature deaths from pollution, according to the Washington Post: "The rule projects between 440 and 990 premature deaths would occur due to air pollution during that same period, though Environmental Protection Agency officials said the number may be slightly lower."
The 23 states and the District of Columbia, which sued to stop the rule change, said the numbers would be much higher: "They said weakening the standards would kill about 2,000 more people and cause 50,000 more cases of respiratory illnesses while making the climate crisis worse."
But that was all before COVID-19.
COVID-19 is a respiratory disease. According to Professor Peter Wark, writing in the Conversation, "The virus first invades our bodies by attaching to a protein called ACE2 on cells in the mouth, nose and airways." For many people, the symptoms are mild, but for many, it gets much worse, requiring hospital care and supplementary oxygen. Some deteriorate further and require high-flow humidified oxygen, or worse yet, intubation on a ventilator. Some die, but many more recover. What happens to them?
In these diseases, collectively called acute respiratory distress syndromes (ARDS), the fragile small airways and air sacs become damaged by inflammation, can become blocked by fluid and blood, and are replaced by scar tissue as they heal. This can stiffen the lungs – at first from fluid and then from scar tissue – impairing their ability to transfer oxygen and making breathing more laboured.
Another study published in the Journal of the American Medical Association noted that "lingering health consequences among people who contract severe respiratory diseases are common." From ABC News:
"It’s the same general thing that you have with any type of phenomena that's severe enough to land you in the ICU," said Dr. Amesh Adalja, an infectious disease and critical care expert at Johns Hopkins Bloomberg School of Public Health. "There’s a lot in common with what we do for non-COVID respiratory failure that’s going to be applicable here," Adalja said.
The imagery shows extensive damage to the lungs of a generally healthy 59-year-old male with high blood pressure. Since becoming seriously ill, the patient requires a ventilator to help him breathe, but even on the highest setting, it's not enough.
According to the South China Morning Post, people who recover from the disease still are suffering from reduced lung capacity.
Dr Owen Tsang Tak-yin, medical director of the authority’s Infectious Disease Centre at Princess Margaret Hospital in Kwai Chung, said doctors had already seen around a dozen discharged patients in follow-up appointments. Two to three were unable to do things as they had in the past. “They gasp if they walk a bit more quickly,” Tsang told a media briefing on Thursday. “Some patients might have around a drop of 20 to 30 percent in lung function [after recovery].”
Which brings us back to North America, where the rollback in fuel efficiency standards means that drivers will burn 80 billion more gallons of gas. The government has already canceled the switch to summer gas because all the storage tanks are still full of winter gas, even though the change to low volatility gas is done to reduce evaporation and air pollution. And of course, they are doing everything they can to promote the coal industry. Basically, it is doing everything it can do to increase air pollution.
Every single person who comes out of this crisis will be more susceptible to COPD or respiratory infections, all made worse by smog, hydrocarbons, particulates and ozone, all of which the American government seems to be doing everything they can to increase.
Think of what this means to the possibly millions of people trying to recover from COVID-19. Here we are, rolling back fuel efficiency standards when what a sensible government would be doing now, with all these compromised citizens, is tightening the pollution standards even further, promoting emission-free transportation like electric cars, bikes and electrified public transit. This government just has it backward.