As the novel coronavirus sweeps across the U.S. and the number of people who have tested positive for COVID-19 climbs by the hour, the Americans at greatest risk are the elderly and those with underlying health conditions.

The Centers for Disease Control and Prevention says the highest-risk group includes people who suffer from heart and lung disease and asthma – all conditions that can be caused or made worse by moderate to heavy air pollution. And the European Public Health Alliance, or EPHA, warns that people “living in polluted cities are more at risk from Covid-19.”

“Patients with chronic lung and heart conditions caused or worsened by long-term exposure to air pollution are less able to fight off lung infections and more likely to die” from COVID-19, said Dr. Sara De Matteis, associate professor of occupational and environmental medicine at Cagliari University, in Italy, and a member of EPHA.

That’s especially troubling in light of the rise in U.S. air pollution levels, and the weakening of air pollution regulations, during the Trump administration.

Trump’s Assault on Air Pollution Regulations

On Tuesday, the Trump administration released its final rule rolling back President Obama’s fuel efficiency standards for automobiles, which will allow cars and light trucks to cumulatively emit nearly 1 billion more tons of lung-damaging carbon dioxide over the lifetime of the vehicle fleet than under the standards put in place during the Obama administration, The New York Times reported.

“The new rule, which is expected to be implemented by late spring, will roll back a 2012 rule that required automakers’ fleets to average about 54 miles per gallon by 2025. Instead, the fleets would have to average about 40 miles per gallon,” the Times said.

Since taking office, President Trump and his administration have overseen an unprecedented assault on federal policies aimed at reducing industrial pollution from power plants, tail pipes and coal, oil and natural gas extraction operations, including carbon dioxide, nitrogen oxide, mercury and methane.

The administration has or is in the process of repealing at least 95 different environmental rules, with 25 having a direct and adverse impact on the nation’s air quality, and dozens of others that will indirectly increase air pollution.

Among the 16 rules Trump has officially repealed are the Clean Power Plan, President Obama’s signature climate change initiative. The plan set strict limits on carbon emissions coal-fired power plants, which contribute to the health issues that increase susceptibility to COVID-19.

The administration has repealed a rule requiring the oil and gas industry to report methane emissions. It is seeking to revoke California’s ability to set its own stringent auto emissions standards, and has abolished a requirement that each state track emissions from cars, light trucks and other vehicles traveling on federal highways.

On Tuesday, the Trump administration released its final rule rolling back President Obama’s fuel efficiency standards for automobiles, which will allow cars and light trucks to emit nearly 1 billion more tones of carbon dioxide over the lifetime of the vehicle fleet than under the standards put in place during the Obama administration, the New York Times reported.

The Environmental Protection Agency is poised to make significant changes to a 2011 rule that drove a 70 percent reduction in mercury emissions from coal-fired power plants, which could cause mercury emissions to go back up. Regular exposure to mercury can impair brain and nervous system development in babies and children, and damage the lungs and immune systems in adults and people of advanced age, putting them at greater risk of contracting COVID-19.

And last week the EPA said it will let the fossil fuel, chemical, electricity utilities and other industries use “enforcement discretion” to determine for themselves whether they should be required to monitor and report air and water pollution discharges.

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Air Pollution on the Rise Under Trump

Economists at Carnegie Mellon recently published research showing an increase in one form of air pollution by 5.5 percent between 2016 and 2018 after it declined by 24 percent between 2009 and 2016.

Among the reasons the researchers suspect for the rise in annual average fine particulate matter, or PM2.5, are likely policies adopted by the Trump EPA, including significant decreases in Clean Air Act enforcement actions. PM2.5 most notably comes from coal mining and the burning of fossil fuels, including from power plants and combustible engines. The authors of the study estimate an additional 9,700 premature deaths in 2018 alone due to the spike in air pollution

In addition, EPA air emissions data published in June of last year showed a significant increase in bad air days between 2017 and 2019.

In Wake of Coronavirus, Worldwide Emissions Plummet – But Will Return

New satellite data show steep reductions in air pollution in the U.S., as major cities and states have ordered millions of Americans to shelter in place and many businesses to close.

But the damage from increased air pollution has already been done, leaving many people who suffer from underlying health problems and who live or work in dense urban areas or near big sources of emissions such as power plants, refineries and chemical plants at greater risk of contracting COVID-19.

During the 2003 SARS outbreak in China, caused by a similar coronavirus, residents of areas with the highest levels of air pollution were twice as likely to die as those who lived in places with lower levels, according to a study conducted by a team of scientists from China and the U.S.

To make up for lost production time, China is now easing restrictions on manufacturing and other industrial operations that have idled since the pandemic first exploded.

That will eventually happen in the U.S., when these unprecedented efforts to quell the coronavirus and flatten the curve of infection takes hold. Entire industries will ramp back up, and hundreds of millions of Americans will return to their daily commutes to work and school, producing a surge of tailpipe and factory emissions.

The lesson to be learned is that protecting public health does not depend solely on the response to an emergency or the regulation of a specific pollutant. Public health is the sum product of many interrelated policies and practices. Protections targeting a single industrial sector or geographic region have profound ripple effects throughout society.

Congress Must Act to Reduce Air Pollution Through Clean Energy Incentives

Key tax credits for renewable energy have helped spark a revolution in the wind, solar, battery storage and electric vehicle industries, and created more than 3.3 million clean energy jobs. Now those credits are expiring, and Congress failed to reinstate these incentives in the latest coronavirus stimulus package.

The next round of aid lawmakers consider must extend and expand these tax credits and take additional steps to bolster the clean energy industry. This will simultaneously address the three great crises confronting the nation: the pandemic, the economic collapse and climate change.