When Massachusetts released town-by-town coronavirus infection rates earlier this month, those that topped the list made alarming sense to environmental activists and public health experts.
That’s because the six communities that have been hardest hit by the virus — Chelsea, Brockton, Everett, Lynn, Randolph, and Lawrence — were all previously designated by the state as “environmental justice" communities. Each has a high percentage of minority, low-income residents, and each has high rates of asthma and other environmentally-related respiratory diseases, in part because of pollution.
Researchers are beginning to see clear correlations between long-term exposure to air pollution and COVID mortality rates — a nationwide study from Harvard researchers this month found that long-term exposure to air pollution increases the risk of dying from the coronavirus.
Because researchers are still learning how the coronavirus attacks the body and why some people are seriously affected while others are not, some of its connections with pollution remain mysterious. They don’t know, for example, whether air pollution affects who gets infected in the first place.
But as the virus pummels certain cities and leaves others relatively unscathed, experts and activists are examining how environmental burdens combine with other factors such as overcrowded housing, working essential jobs, and relying on public transit to tighten the virus’s grip.
“Being in a highly polluted city is not going to by itself give you COVID," said Jonathan Levy, a professor of environmental health at Boston University who is involved in an effort to map COVID vulnerabilities across the state. But, he said, “There are these important combinations of factors at play."
In Chelsea, for example, the coronavirus has ravaged the community, making it the statewide epicenter, with 5,217 infections per 100,000 people. The city shoulders a large environmental burden as well: Thousands of trucks fan out from the New England Produce Center, the largest of its kind in North America, to distribute produce to millions of people up and down the coast. In total, 85,000 vehicles, plus ships and planes, pass over and under the Tobin Bridge every day, releasing emissions into the densely packed city of 40,000.
“All of these industrial impacts for years have led us to have some of the worst public health statistics in the state," said Roseann Bongiovanni, the executive director of GreenRoots, an environmental justice group in Chelsea. “Our community was already predisposed to having a higher impact from COVID-19."
The Harvard study, which has not yet been published, found that someone who lived for decades in a neighborhood with high levels of fine particulate matter would be 8 percent more likely to die of the coronavirus than someone who lived in a neighborhood with just one unit less of the pollution, even if the two lived in adjoining zip codes.
“In many ways, these serve as ecological sacrifice zones," said Daniel Faber, a professor at Northeastern and director of the Northeastern Environmental Justice Research Collaborative. People who live outside of these communities — but who might commute in cars across the Tobin or get produce from one of the thousands of trucks that trundle through Chelsea — benefit from the unequal distribution of pollution in the state.
Some of the families that are now fighting COVID have already been devastated by asthma, another respiratory illness exacerbated by pollutants.
Brunilda Cordero, who is 67 and lives in Chelsea, is recovering from COVID-19; she spent 14 days in the hospital, short of breath and with a spiking fever.
Her friends and family prayed for her to get through it, especially after all that she had already survived. Her adult daughter had died from an asthma attack more than a decade earlier.
“I never thought she was going to die of that," Cordero said. “After that, I heard of so many cases.”
Now Cordero is home and feeling better — but five more members of her extended family have tested positive for the virus. And she is terrified for her granddaughter, who has had chronic asthma all her life. Research on how asthma interacts with the coronavirus is still in its early stages, but the CDC warns that “people with moderate to severe asthma may be at higher risk of getting very sick from COVID-19.” Brockton, Chelsea, Lawrence, and Lynn have some of the highest asthma rates in the state.
Particulate pollution, called PM 2.5 because the matter is 2.5 micrometers in size, is made up of very small, dangerous particles that can be inhaled and enter the bloodstream. It comes from a combination of the chemicals that are emitted by fires, diesel trucks and buses, and power plants. Francesca Dominici, the lead author of the Harvard study, noted that COVID-19 seems to assault the very same areas of the body that these particles do.
“COVID is causing death pretty much by attacking our lungs and our cardiovascular systems. Any environmental factor that increases the susceptibility and makes your lungs more inflamed, clearly you’re going to get sicker," Dominici said.
Her team of researchers worked to disentangle air pollution from other possible factors such as socioeconomic status, population density, and smoking that could affect mortality in COVID-19 cases.
Dominici said the data could be used by policy makers in Massachusetts to combat the coronavirus by focusing resources and testing in communities that have historically been exposed to more air pollution.
Although the Harvard study did not examine indoor pollution, experts say that could be another important factor, especially now that people are supposed to be sheltering in place. Older and smaller apartments tend to have higher indoor pollution, caused by things such as cooking with gas stoves or smoking. Levy and his colleagues at BU found that houses with higher outdoor air pollution and greater infiltration of outdoor air were located in neighborhoods with higher Hispanic populations, more people making less than $20,000 a year, and more people without a high school degree.
“Living in crowded housing that is not well ventilated is a bad thing for COVID transmission, and it’s also a bad thing for indoor air pollution exposure,” Levy said. Taken together, “that can be an even larger risk factor.”
Experts and activists say it’s no coincidence that communities contending with higher pollution in the first place tend to have many Black and brown residents.
“Because of the historical redlining and the designation of many of those communities as hazardous, people took the opportunity to concentrate the hazard in those communities," said Reann Gibson, a senior research fellow at the Conservation Law Foundation, referring to the federal government’s practice of deeming minority communities hazardous on maps and refusing to insure mortgages there. In turn, Gibson said, highways and bus lots, major sources of dangerous particulate matter, were concentrated in those communities.
Indeed, communities of color in the Northeast and Mid-Atlantic on average breathe 66 percent more air pollution from vehicles than white residents do, according to a 2019 report from the Union for Concerned Scientists.
Instead of tightening air pollution standards, the Trump administration relaxed environmental enforcement at the end of March, allowing power plants, factories, and other polluters to decide for themselves whether or not to follow federal standards.