Every morning Pu wakes up to the loud sounds of the city. Putting on her orange vest, she revves her motorbike and rides out to begin a long day of carrying passengers to their destinations with speed. She has become one with the motion of the Thai metropolis. But the city’s toxic air has not been kind to her. “When my motorcycle is behind buses with black smoke, I often shudder at the thought of the dangerous dust particles in the air I am breathing,” Pu told Thai Enquirer from Phahonyothin Soi 8.
She is worried about the health hazards that come with PM2.5, but there is very little she can do to avoid exposing herself to the pollution levels rising in Thailand’s capital. “Thankfully, I am wearing a mask, but what happens if I take it off for just a short second? The thought makes me very worried. I just can’t take it off as it’s so dangerous.”
To decrease her chance of illness, she invests in high-quality masks in an attempt to keep herself safe, but this necessity has taken a financial strain. She says that long hours of riding through the smog has made her fatigued.
“Unlike those who can work from home, people in my profession experience exhaustion on a daily basis, and we need to keep on our mask for hours,” Pu said. “I do realize this [the pollution] has taken a toll on my health. And I don’t know how contaminated my blood is by now.”
On top of the pollution, the pandemic has made life even more burdensome.
The toxic air pollution has become an annual crisis afflicting Thais during the cooler months from October to February. Now, some experts are warning that when COVID and air pollution collide, people could be even more at risk.
Although the noxious particles do not cause sudden illness or death, the tiny atmospheric dust can be detrimental to our respiratory systems over time, compounding risks of COVID-19, doctors say.
Dr. Nitipat Jiarakul, the chief of Siriraj Hospital’s respiratory disease division, told Thai Enquirer that PM 2.5 could fundamentally weaken a respiratory system because it can sabotage cell membranes, making it easier to be affected by diseases, including coronaviruses.
“Even without cigarettes or PM 2.5, the COVID-19’s virus SARS-CoV-2, can invade our lungs easily,” Dr. Nitipat said. “So, if we constantly smoke or inhale PM 2.5, the virus will affect us more easily. Simply put, we [those living in polluted areas] are prone to catch SARS-CoV-2 and have more severe symptoms than others, more critical pneumonia leading to more dangerous symptoms and a higher death risk.”
He added that tiny particles can travel through the lung’s alveoli and bloodstream, increasing risks of chronic diseases, lung cancer, and cardiovascular disease among them.
While it is a known fact that spending time indoors lessens the exposure to PM2.5, not everyone in Thai society has the luxury of doing so. And it’s particularly dangerous for daily wagers who spend most of their time outdoors in order to feed their families.
Just a short drive north from where Pu drives her motorcycle, Liu, a vegetable merchant who works near a bus stop at Bang Khen Market, brushes aside multiple fears to get through the day.
To make ends meet the 62-year-old copes with the thought of catching COVID-19 frequently. But before the virus hit Thailand, he was already grappling with a familiar hazard perpetuating his city – toxic air pollution.
Rain or shine, Liu’s shop has become a permanent fixture at Bang Khen’s busy marketplace for over three decades. Yet despite high levels of hazardous particulate matter in the air, known as PM.2.5, he works a solid six hours a day.
“I just got used to the smoke and dust emissions from buses,” Liu said. “I just have to protect myself.”
He soldiers on everyday in Bangkok’s heat, but has not always been in good health. In 2017, Liu developed tuberculosis. It took him around six months to recover. While smoking could have been one reason for the disease, it’s possible that the polluted air from passing vehicles contributed to his condition as well, he explained.
But still, he doesn’t wish to dwell on the haze, and he only monitors the PM2.5 levels when it happens to be in the news. He doesn’t need reporters or websites to tell him when the pollution begins to get bad. He sees the air’s worsening condition with his own eyes everyday.
While the world is battling COVID-19, some studies suggest that there might be correlations between polluted air and getting sick from COVID-19.
One recent study published in April 2020 in the journal Science Advances, found that an increase in PM2.5 by 1 microgram per cubic meter, was associated with an increase of an 8% death rate from COVID-19.
The researchers discovered that people living in places with a high level of PM 2.5 for long periods of time could be at greater risk of death from COVID-19 than those living in areas with clean air. The study said that the results “were statistically significant,” and that “a small increase in long-term exposure to PM2.5 leads to a large increase in the COVID-19 death rate.”
Some experts say the study has limitations and suggest that more research is needed, but the researchers warn that it’s important to solve air pollution around the world while still combatting the pandemic.
But it’s not the only study that’s causing some concern. Many experts who have looked at the effects of air pollution are now flagging that it’s worth looking into. They add that low income workers are even more at risk of the disease.
The problem is exacerbated by a worsening economic situation where lockdowns, travel restrictions, and other economic circumstances are putting low income people into vulnerable scenarios.
Thorn Pitidol, an associate professor at Thammasat University and director of the Center of Research on Inequality and Social Policy (CRISP), told Thai Enquirer that the two issues are putting a huge burden on lower to middle class people, particularly those living in poverty.
“On the issue of PM 2.5, it is more obvious that low-income people cause less pollutant emission, but they have to bear a higher cost,” Thorn said. “ People who tend to face more [financial] burdens, higher [health] risks, and have lower self-defense [in coping with the crisis] are the ones with lower incomes.”
Thorn said that if an outbreak happens in the slums of Bangkok, it would be hard for its residents to self-isolate since they reside in squalid conditions where a confined living space makes it easier for the virus to spread. Thorn then noted that this raises questions over whether the government is doing enough to curb the pollution alongside COVID-19.
“The Thai government still lacks effort on this aspect because the government thinks that exercising regulated power is more effective,” Thorn said. “When the government uses power to control people’s actions, it will overlook inequality. However, if the government includes inequality in the analysis, it will clearly see that low-income people, the group of people who must bear a higher cost of a crisis, need more supporting measures.”
Thorn has offered some solutions, however. He said that authorities could design and implement incentive measures to stop excessive crop burning and limit carbon emission from vehicles. But the bureaucratic nature of the Thai government bulwarks potential solutions, as officials have difficulty coming together to make concerted plans, he added. In 2019, the Thai government declared tackling air pollution as a national goal, but not enough has been done.
He added that everyone will have to chip in to make a difference. From civil society and private organizations, to government agencies, citizens must also learn to cut down fossil fuels and carbon emissions as well. It’s a multifaceted issue that requires a multi-layered approach.
“The best way to solve this problem is changing the ‘mindset’ of the elected,” Thorn said. “Are they being pressured enough to take a stance on such matters?”
“The question is how to make this a big deal? How to get the public excited about it?”
There are signs that Thailand might tighten it’s PM2.5 threshold to fall in line with international standards.
Athapol Charoenchansa, director-general of Pollution Control Department [PCD], revealed that all relevant government agencies are attempting to find solutions to improve Thailand’s air quality.
“We are discussing lowering the thresholds to be in line with the new measures,” Athapol said.”
“It is no use to set a stricter standard without considering the measures involved. When it shows a red level alert, it will cause public panic. This scenario will make it hard to solve problems and difficult for officials to work because there should be certain ground rules laid which include raising measures for each area for instance, first.”
He added that when tackling air pollution was made a national goal two years ago, they made progress in the following year, claiming that targeted hotspots of PM2.5 decreased pollution levels by 52%. But he also admitted that their operations faced some obstacles.
“Traffic problems in urban areas is an example, to ban driving is a way to minimize pollutants emitted by vehicles, but it has negative effects,” Athapol said. “ If pollution levels start to rise above a normal level and we shut down activities, we need to consider the effects of that decision.”
He noted other ways to regulate the pollution levels include, enforcing stricter laws in punishing owners of cars with black exhaust smoke, petitioning the public to voluntarily work from home or use public transport when PM2.5 levels are high, and imposing burning restrictions.
Even with potential solutions up in the air, solving the problem is complex. And it’s going to take a lot of time.
The CRISP researcher, Thorn, stressed that if the PM2.5 issue is examined alongside social inequality, those who cause the least amount of pollution have the most to lose.
He broke down the three dominant sources of air pollution: biomass burnings, fuels used for cars and other vehicles, and electrical power generation. All these sources are closely linked to economic progress, he noted.
“On car and fuel use, it is found that most people who can afford personal cars are higher-income groups, while low-income groups are those who tend to use public transportation.”
“Lastly, slash-and-burn agriculture farming is a relatively complicated practice,” Thorn said. “ If you ask if burning is done by farmers, the answer is yes. Yet, it is also linked to the agricultural market structure and its big agriculture companies. That is why it doesn’t come as a surprise that they benefit the most from it.”
He warns that those at the bottom will bear the brunt of pollution, climate change, and now the pandemic.
Back on the busy roads of Paholyothin, Pu understands this message more than most. She keeps pushing through the haze. Aware that moto riders like her are indispensable in a city of at least 10 million, she knows the health risks of her work, and doesn’t have the luxury of quitting.
“When I heard on the news there were high levels of particles in the air and that it was very dangerous, I was scared,” Pu said. “This did have an effect [on me]. However, I cannot stop my work, this is how I must earn my daily income.”