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?:abstract
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It has been posited that populations being exposed to long-term air pollution are more susceptible to COVID-19 Evidence is emerging that long-term exposure to ambient PM2 5 (particulate matter with aerodynamic diameter 2 5 mum or less) associates with higher COVID-19 mortality rates, but whether it also associates with the speed at which the disease is capable of spreading in a population is unknown Here, we establish the association between long-term exposure to ambient PM2 5 in the United States (US) and COVID-19 basic reproduction ratio R0- a dimensionless epidemic measure of the rapidity of disease spread through a population We inferred state-level R0 values using a state-of-the-art susceptible, exposed, infected, and recovered (SEIR) model initialized with COVID-19 epidemiological data corresponding to the period March 2-April 30 This period was characterized by a rapid surge in COVID-19 cases across the US states, implementation of strict social distancing measures, and a significant drop in outdoor air pollution We find that an increase of 1 mug/m3 in PM2 5 levels below current national ambient air quality standards associates with an increase of 0 25 in R0 (95% CI: 0 048-0 447) A 10% increase in secondary inorganic composition, sulfate-nitrate-ammonium, in PM2 5 associates with =10% increase in R0 by 0 22 (95% CI: 0 083-0 352), and presence of black carbon (soot) in the ambient environment moderates this relationship We considered several potential confounding factors in our analysis, including gaseous air pollutants and socio-economical and meteorological conditions Our results underscore two policy implications - first, regulatory standards need to be better guided by exploring the concentration-response relationships near the lower end of the PM2 5 air quality distribution;and second, pollution regulations need to be continually enforced for combustion emissions that largely determine secondary inorganic aerosol formation
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