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. 2022 Mar 1:305:114316.
doi: 10.1016/j.jenvman.2021.114316. Epub 2021 Dec 29.

Understanding the heterogeneity of COVID-19 deaths and contagions: The role of air pollution and lockdown decisions

Leonardo Becchetti  1 , Gianluigi Conzo  1 , Pierluigi Conzo  2 , Francesco Salustri  3
Affiliations

Understanding the heterogeneity of COVID-19 deaths and contagions: The role of air pollution and lockdown decisions

Leonardo Becchetti et al. J Environ Manage. .

Abstract

The uneven geographical distribution of the novel coronavirus epidemic (COVID-19) in Italy is a puzzle given the intense flow of movements among the different geographical areas before lockdown decisions. To shed light on it, we test the effect of the quality of air (as measured by particulate matter and nitrogen dioxide) and lockdown restrictions on daily adverse COVID-19 outcomes during the first pandemic wave in the country. We find that air pollution is positively correlated with adverse outcomes of the pandemic, with lockdown being strongly significant and more effective in reducing deceases in more polluted areas. Results are robust to different methods including cross-section, pooled and fixed-effect panel regressions (controlling for spatial correlation), instrumental variable regressions, and difference-in-differences estimates of lockdown decisions through predicted counterfactual trends. They are consistent with the consolidated body of literature in previous medical studies suggesting that poor quality of air creates chronic exposure to adverse outcomes from respiratory diseases. The estimated correlation does not change when accounting for other factors such as temperature, commuting flows, quality of regional health systems, share of public transport users, population density, the presence of Chinese community, and proxies for industry breakdown such as the share of small (artisan) firms. Our findings provide suggestions for investigating uneven geographical distribution patterns in other countries, and have implications for environmental and lockdown policies.

Keywords: COVID-19 pandemic; Economic activity; Lockdown; Particulate matter.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

We declare we have no conflicts of interest.

Figures

Fig. 1
Fig. 1
COVID-19 contagion, mortality and pre-existing pollution levels.
Fig. 2
Fig. 2
COVID-19 mortality: real and counterfactual trend.
Fig. 3
Fig. 3
COVID-19 mortality: difference between real and counterfactual trend.
Fig. 4
Fig. 4
The positive coefficient of the interaction, if interpreted jointly with the trends plotted in Figure 4, suggests that without lockdown mortality would have grown more in the highly polluted cities.
Fig. A1
Fig. A1
COVID-19 mortality: real and counterfactual trend.
Fig. A2
Fig. A2
COVID-19 mortality: mortality trends by lockdown and pollution.
Fig. B1
Fig. B1
Pollutants, contagions, and mortality in Italian provinces (average during the period 24 February – April 15, 2020, observed and linear fitted values).
Fig. B2
Fig. B2
Leverages and studentised residuals.
Fig. B3
Fig. B3
DFBETA.
See this image and copyright information in PMC

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