OSCEs Parlamentariske Forsamling 2020-21
OSCE Alm.del Bilag 7
Offentligt
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Vienna, 18 November 2020
Dear Members of the OSCE Parliamentary Assembly,
It is widely known that long-term exposure to high levels of particulate matter (PM)
chronically impairs human health and influences the clinical course of infections acquired by
already debilitated individuals, especially in the most vulnerable age groups. According to the
Annual Report on Air Quality by the European Environment Agency, pollution is causing
almost a half-million preventable deaths in Europe. Among other things, inhaling polluted air
increases the risk of heart attack, pneumonia and, if infected by COVID-19, death.
Against the backdrop of increasing SARS-CoV-2 infection rates throughout the OSCE
region, the Bureau of the General Committee on Economic Affairs, Science Technology and
Environment and the Special Representative on Arctic Issues are pleased to
share with your
national delegations some interesting findings which have been presented by the Italian
Society of Environmental Medicine (SIMA) during an informative briefing
held on 23
October 2020.
Over the last few
years, SIMA’s scientists
- in consultation and co-operation with a wide
network of academic institutions from across the OSCE region - conducted extensive
research on the impact of pollution on public health and, most recently, on the correlation
between the high concentration of atmospheric particulate matter and COVID-19 infections,
both in terms of airborne diffusion and health outcomes. Notably, such a correlation has been
signalled by various research institutes, including the Max Planck Institute for Chemistry in
Mainz and the Harvard T.H. Chan School of Public Health. To learn more about these
developments, we plan to host a roundtable policy debate with the contribution of pertinent
experts from across the region in the framework of our 2
nd
Committee work.
At this critical juncture, we are especially convinced that policymakers should respond to
citizens’
security needs through timely and well-calibrated environmental protection policies
based on the latest scientific evidence. The far-fetched health and security implications of the
ongoing crisis have, in fact, restated the urgency to effectively limit the detrimental effects of
 OSCE, Alm.del - 2020-21 - Bilag 7: Open Letter from the Bureau of the General Committee on Economic Affairs, Science Technology and Environment, Ms. Barnett, Mr. Gerasymov and Ms. Hoxha, and from the Special Representative on Arctic Issues, Ms. Eidsheim
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pollution on human well-being and climate through strict regulations, both during and after
the crisis.
We therefore
invite you to consider the annexed findings in your policymaking efforts
aimed at mitigating the security impact of the current health crisis.
You may also
circulate them among your respective parliaments, governments and scientific communities,
as appropriate.
In conclusion, rest assured that we will continue to advocate for a more holistic and
interdisciplinary approach to environmental security, whereby the protection of the
environment becomes the precondition to effectively address both the public and the planet’s
health crisis. Our goal is to achieve a more balanced and forward-looking development
strategy in response to growing public health concerns, as well as to the security expectations
of current and future generations.
Yours sincerely,
Ms. Doris Barnett,
Chair of the OSCE PA General Committee on Economic Affairs,
Science, Technology and Environment
Vice-Chair of the OSCE PA General Committee on Economic
Affairs, Science, Technology and Environment
Ms. Elona Gjebrea-Hoxha,
Rapporteur of the OSCE PA General Committee on Economic
Affairs, Science, Technology and Environment
Ms. Torill Eidsheim,
OSCE PA Special Representative on Arctic Issues
 OSCE, Alm.del - 2020-21 - Bilag 7: Open Letter from the Bureau of the General Committee on Economic Affairs, Science Technology and Environment, Ms. Barnett, Mr. Gerasymov and Ms. Hoxha, and from the Special Representative on Arctic Issues, Ms. Eidsheim
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Practical implications of the SIMA studies on COVID-19 containment
for the attention of the OSCE Parliamentary Assembly
18 November 2020
This document outlines the recent scientific findings of the Italian Society of Environmental
Medicine (SIMA) on the correlation between the high concentration of atmospheric particulate
matter and SARS-CoV-2 virus transmission, presented to the Bureau of the OSCE PA General
Committee on Economic Affairs, Science, Technology and Environment during an Informative
Briefing on 23 October 2020. As such, the OSCE PA makes no claims nor warranties of any kind,
expressed or implied, about the completeness and reliability of the data presented.
KEY FINDINGS
•
Particulate matter (e.g. PM2.5 and
PM10) serve as “carriers” for
several chemical and biological
pollutants,
including
viruses,
allowing long-term survival of
viruses in the atmosphere for hours or
even days. Thus, like many other
micro-organisms and viruses,
the
new coronavirus Sars-Cov-2 can
also spread through the air over
large distances
(the so-called
airborne route transmission
1
).
Figure 1. How Big Are Coronavirus Particles?
Smart Air Filters, 4 February 2020,
https://smartairfilters.com/en/blog/can-masks-capture-coronavirus/.
•
SIMA’s
innovative research
on the correlation between SARS-COV-2 virus transmission and
the concentration of atmospheric particulate matter
suggests that PM should be regarded as
a contributing factor to COVID-19 infections,
both in terms of airborne diffusion and health
outcomes. A
positive correlation between exposure to significant levels of air pollution
and higher fatality rates
has been signalled by various scientific efforts around the globe
2
.
As COVID-19 related deaths and the further spread of the coronavirus have been found to be
associated with excess PM10 and PM2.5,
the abundance of particulate matter in the air
represents a significant predictor of COVID-19 infection
- which reveals how the virus
spreads more quickly in polluted areas, even when accounting for population density and the
average number of daily travellers and tourists.
•
At the end of September 2020, the Centre for Disease Control in the USA have recognized the “Airborne
Route”
as
another way of COVID-19 spreading in addition to direct interpersonal contagion.
2
For instance,
a recent nationwide study from Harvard T.H. Chan School of Public Health
found that 1 unit increase in
long-term average exposure to PM2.5 is associated with an 8% increase in the COVID-19 mortality rate in the USA.
Moreover, an international research effort which included
the Max Planck Institute for Chemistry in Mainz
found that 15%
of worldwide COVID-19 deaths can be traced back to long-term exposure to PM2.5
1
1
 OSCE, Alm.del - 2020-21 - Bilag 7: Open Letter from the Bureau of the General Committee on Economic Affairs, Science Technology and Environment, Ms. Barnett, Mr. Gerasymov and Ms. Hoxha, and from the Special Representative on Arctic Issues, Ms. Eidsheim
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•
In particular,
super-spread
(or “high-way”) effects
are observable when, under stable
weather conditions, the PM10 exceedances are repeated over time with frequencies beyond
three consecutive days.
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This is a typical condition in many European cities where the
temperature is around 5-10 degrees, the relative humidity is over 80% and the presence of
emissions is high due to fossil or biomass combustion caused by vehicular traffic or domestic
heating. In such conditions,
the virus may cover distances up to 10 meters from the
emission source.
Notably, while one person can normally infect two individuals, in this
“super-
spread scenario,” one person
may infect up to five individuals.
Sars-Cov-2 can also rapidly diffuse in any
indoor environment
in the presence of one
or more infected people, but there are
different technologies that can be useful in
reducing the risk of virus diffusion in indoor
environments (e.g. schools, offices, and
restaurants) to near zero. For instance, air
conditioning systems play a decisive role in
controlling the dispersion of droplets and
aerosols produced by breathing in closed
environments. Notably,
doubling the air
conditioning flow rate inside a closed
room reduces the concentration of
contaminated particles by 99.6%.
•
Figure 2. The difference between droplet and airborne transmission.
BBC News, 8 July 2020,
https://www.bbc.com/news/world-53329946.
•
Air exchange is fundamental in the dilution of the virus
and its transfer to the outside. The
reduction of airborne biological pollutants present in the droplets significantly decreases the
concentration of the pathogen in the air. This, together with the today's use of barrier means
(wearing face masks, social distancing and hand washing), represents the main tool in reducing
the risk of contagion in closed environments.
KEY RECOMMENDATIONS
•
In order to
prevent the
“super-spreading”
effect induced by heavy air pollution
during the
next European winter (when climatic conditions, humidity and temperature will be ideal for
viral spreading), it is critical to reduce the levels of particulate matter by:
o
In the short-term: Temporarily halting all vehicular traffic and reducing heating
combustion in cities experiencing more than two consecutive days of PM exceedances
during a COVID-19 emergency context.
o
In the mid-term: Reducing the use of fossil fuels and biomass combustion while
favouring the transition to renewable energy sources.
To
avoid the detrimental impact of
“super-spread”
events
in the presence of prolonged PM
exceedances, it is critical to:
o
Increase the interpersonal safety distance beyond two meters.
o
Close all windows and doors to avoid high concentrations of PM indoors.
o
Make the use of FFP2 face masks compulsory, both indoors and outdoors.
Monitoring the presence of Sars-COV-2 RNA on particulate matter,
both indoors and
outdoors, should be used
as an early indicator of COVID-19
local epidemic recurrences
4
.
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Super-spread events are generally observed also for the seasonal flu, resulting in high healthcare-related costs each year.
In this context, SIMA has a specific project proposal which can be presented to interested OSCE PA delegations.
2
 OSCE, Alm.del - 2020-21 - Bilag 7: Open Letter from the Bureau of the General Committee on Economic Affairs, Science Technology and Environment, Ms. Barnett, Mr. Gerasymov and Ms. Hoxha, and from the Special Representative on Arctic Issues, Ms. Eidsheim
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•
•
The use of air purification, or mechanical ventilation, should be actively implemented
to
enhance safety in any indoor environment.
The interpersonal safety distance should be increased to at least two metres
to better
protect citizens’ health amid the coronavirus pandemic. In parallel,
it is critical to
require all
citizens to use face masks in every public place.
Figure 3 . SIMA’s s he e of possi le e ha e e t of viral tra s issio
through stabilized human exhalation on PM.
•
The capacity of healthcare systems should be immediately boosted
by re-opening closed
hospitals and making use of military infrastructures to efficiently manage the expected surge
in COVID-19-related admissions. Simultaneously,
outpatient medical services
(those that can
isolate and closely follow patients and direct contacts at home)
must be urgently reinforced.
References to SIMA Publications
•
Setti L, Passarini F, De Gennaro G, Barbieri P, Perrone MG, Borelli M, Palmisani J, Di Gilio A, Torboli V, Fontana F,
Clemente L.
SARS-Cov-2RNA Found on Particulate Matter of Bergamo in Northern Italy: First Evidence.
Environmental
Research. 2020 May 30:109754.
Setti L, Passarini F, De Gennaro G, Barbieri P, Licen S, Perrone MG, Piazzalunga A, Borelli M, Palmisani J, Di Gilio A, Rizzo
E.
Potential role of particulate matter in the spreading of COVID-19 in Northern Italy: first observational study based on
initial epidemic diffusion.
British Medical Journal Open (BMJ Open). 2020 Sep 1;10(9): e039338.
Borro L, Mazzei L, Raponi M, Piscitelli P, Miani A, Secinaro A.
The Role of Air Conditioning in the Diffusion of Sars-CoV-
2 in Indoor Environments: a First Computational Fluid Dynamic Model, based on Investigations performed at the Vatican
State Children’s Hospital.
Environmental Research. 2020 Oct 15:110343.
Distante C, Piscitelli P, Miani A.
Covid-19 outbreak progression in Italian regions: Approaching the peak by the end of March
in northern Italy and first week of April in Southern Italy.
International Journal of Environmental Research and Public Health.
2020 Jan;17(9):3025.
Setti L, Passarini F, De Gennaro G, Baribieri P, Perrone MG, Borelli M, Palmisano J, Di Gilio A, Piscitelli P, Miani A.
Airborne Transmission Route of COVID19: Why 2 Meters/6 Feet of Inter-Personal Distance Could Not Be Enough.
Int. J.
Environ. Res. Public Health2020, 17, 2932.
Leonardo Setti, Fabrizio Passarini, Gianluigi de Gennaro, Pierluigi Barbieri, Alberto Pallavicini, Maurizio Ruscio, Prisco
Piscitelli, Annamaria Colao, Alessandro Miani.
Searching for SARS-COV-2 on Particulate Matter: A Possible Early Indicator
of COVID-19 Epidemic Recurrence?
Int. J. Environ. Res. Public Health, 23 April 2020.
Miani A, Burgio E, Piscitelli P, Lauro R, Colao A.
The Italian war-like measures to fight coronavirus spreading: Re-open
closed hospitals now.
Lancet EClinical Medicine. 2020 Apr 1; 21.
Piscitelli P, Miani A, Mazza A, Triassi M, De Donno A, Scala A, Pulimeno M, Distante A, Pollice F, Colao A.
Health-care
inequalities in Italy: challenges for the Government.
Lancet Public Health. 2019 Dec 1;4(12): e605.
Anelli F, Leoni G, Monaco R, Nume C, Rossi RC, Marinoni G, Spata G, De Giorgi D, Peccarisi L, Miani A, Burgio E.
Italian
doctors call for protecting healthcare workers and boosting community surveillance during covid-19 outbreak.
British Medical
Journal BMJ. 2020 Mar 26;368:m1254.
Colao A, Piscitelli P, Pulimeno M, Colazzo S, Miani A, Giannini S.
Rethinking the role of the school after COVID-19.
Lancet
Public Health. 2020 May 25.
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