LAHORE: Rising levels of air pollution in Pakistan’s second largest city could cause “serious” medical complications for people suffering from COVID-19, doctors say, as Lahore ranked first on Swiss firm IQAir’s list of the world’s most polluted cities on Thursday. 
Pakistan has so far reported over 349,000 infections and more than 7,000 deaths. On November 11, Pakistan recorded 34 deaths, its highest single-day coronavirus death toll in four months, according to government data. 
Recent international studies have offered links between long-term exposure to pollution and COVID-19 death rates, saying coronavirus patients in areas with high levels of air pollution are more likely to die from the infection than patients in cleaner cities.
On Thursday, Swiss firm IQAir showed Lahore, the capital of Punjab province, had an air quality index of 306, which is considered hazardous. 
“Smog affects our health adversely in so many different ways, causing allergies, exacerbation of bronchitis, asthma and other chronic airway diseases; it also lowers our overall immunity and resistance to infections and impacts our respiratory system,” Dr. Mehmood Shaukat, head of the Punjab government’s COVID-19 program, told Arab News. “The coronavirus also enters our body through the mucous membrane lining our respiratory tract, thus making things worse.” 
Indeed, one of the most common symptoms of severe coronavirus cases is breathing difficulty. And doctors say that if the ambient air suddenly becomes more toxic, as it does every year around this time in Pakistan’s Punjab province, then more people infected by the virus might end up on ventilators or die.
“Since coronavirus patients usually face breathing difficulties, smog and an unhealthy environment can endanger the lives of those suffering from COVID-19,” said Dr. Asad Aslam, head of the Punjab Corona Experts Advisory Group, adding that the number of coronavirus patients was increasing in Lahore and pollution could “aggravate the situation.”
Aslam said the biggest challenge at the moment was convincing people to comply with health care guidelines.
Air pollution in Lahore and other parts of Punjab province is caused by a combination of vehicle and industrial emissions, smoke from brick kilns, the burning of crop residue and general waste, and dust from construction sites. Other factors of air pollution include large scale losses of trees to the construction of new roads and buildings.
“Pakistan was ranked the second most polluted country in the world by the 2019 AirVisual report; it’s unfortunate that we have continued to witness crop burning, poorly maintained vehicles on roads and operational brick kilns even after the Provincial Disaster Management Authority’s order on smog,” WWF Pakistan’s Nazifa Butt said. 
“The rising air quality index can cause significant health care issues and result in respiratory illnesses,” she added. “Smog 2020 may turn out to be quite tough for COVID-19 patients.”
On its part, the provincial administration of Punjab says it is acting against environmental regulation violations.
“The Provincial Disaster Management Authority is closely monitoring the smog situation and issuing daily reports,” the organization’s director operations, Nisar Ahmad Sani, told Arab News. “Strict action is being taken against the violators of environment laws. Factories and outlets have been sealed and police reports lodged.”
“The Punjab government has also noted with concern that smog compounds the miseries of COVID-19 patients and delays their recovery,” Sani said. “Special arrangements have therefore been made to control the menace.” 
He declined to comment on what the new arrangements are.