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Diwali, one of the major festivals for Indians, comes with tremendous zeal and auspiciousness among people. But it is also the time when rising pollution levels become a menace for the health of the people, especially delhites.

Almost every year, shortly before the festive season, the national capital is choked by air pollution. This is mostly due to agricultural burning in neighbouring states, cracker bursting, and unfavourable weather conditions that prevent pollutants from dispersing.

This year also, the AQI of the city deteriorated to 334 on Thursday, up from 314 a day earlier, with both the readings plunging into “very poor” range.

According to Safar’s Diwali forecast, stubble burning, along with the expected bursting of firecrackers, may drive Delhi’s air quality into the’severe’ category (average AQI of 400 or over) for the first time this winter season on Diwali. It may remain in the same zone the next day as well, according to the agency, with just a little improvement forecast from November 6 forward.

Prolonged exposure to such high amounts of pollution can have hazardous affect on the health of children, elderly and patients, and an overall adverse affect on the health of all. Medically Speaking discussed the same with experts from various health institutes and akswd about how to care for one’s own health during this festive season.

Year after year the air quality index deteriorates and this time again, we see a very similar pattern. Help us really understand why we must care about reducing pollution mode. What will you say to people who haven’t been deterred from bursting firecrackers despite several regulatory actions taken by the subsequent and current government?

Dr Anant Mohan: I’ll start by answering why is it so important to reduce air pollution and it’s slowly but steadily gaining really difficult proportions. We know the health risks linked with air pollution and poor air quality and it is not restricted to lungs only. Yes, lungs and airways are the most essential parts of the body that are impacted and pollution causes a variety of problems: breathing problems, bronchitis, asthma, etc. But it also has indirect or direct impacts on other sections of the body, like the eye, skin, causes neurological disturbances in the long run, cardiovascular diseases and strokes are also linked directly.

As far as precautions are concerned, a plethora of measures must be taken, starting at the personal level, individual level, family level, possibly neighbourhood level, then community level, and finally administrative level.

It has to be a combination of education and legislation. Corona epidemic has exacerbated the problem to a big amount because it’s still present. Yes, the number of cases are minimal, but there are more than ten thousand cases every day across the country. Schools are gradually opening, holidays are approaching, and marketplaces are bustling. Please continue to maintain the covid appropriate behaviour of social distancing and wearing a mask. Apart from the vaccination, we must continue to do these two most crucial things. But keep in mind that vaccination isn’t the only Magic Bullet, and only a small percentage of the population has been fully vaccinated yet. We need to keep our behaviour appropriate.

To have everyone vaccinated is essential. Isn’t precaution, on the other hand, equally important?

Dr Sharad Joshi: So far we have propagated that prevention is better than cure because we don’t have a very effective cure for covid, therefore, Covid appropriate behaviour is essential. There is overcrowding in the markets due to Diwali and other festivities. Here we must ensure complete safety since not only Covid, a simple flu can also spread rapidly. There are multiple factors coinciding at this particular time: setting in of winters, Parali, bursting fire crackers, etc. and these are going to affect the health of everyone.

Why it is even more crucial this time around, when we have the corona pandemic lurking in the background, the positive rate was still above 10,000, it’s less than 2% of the total, but it is still high? How important is it that we keep the pollution in check?

Dr Rajesh Chawla: Pollution should be monitored throughout the year, but unfortunately at this time of year, from October to December, the pollution level rises dramatically. Now the air quality index has above 300, indicating that the air quality is quite poor. This year is no different from past years, but it has continued to open up a lot of construction activities, people are travelling a lot more as last year they were unable to celebrate Diwali as they wanted to. Winter is approaching, many people have been affected by covid, and some of them are still experiencing respiratory symptoms. Overall, if you add it all up, it has a significant influence on the air and subsequently, the health of people.

How difficult is the situation at this time for the people who caught Covid and have their lungs deteriorated?

Dr Ravi Shekhar Jha: We have a huge increase in the number of people with respiratory problems than we had 2 to 3 years back, the main reason being Covid. Therefore, Diwali air pollution affects people in two ways: First, those with healthy lungs, and then those who have already been diagnosed with illness. Those with normal lungs are exposed to higher levels of pollution than those who do not. Their respiratory system is affected in a long run, but lungs of the individuals who already have a critically poor respiratory reserve, such as asthmatics or those with Covid, get affected earlier than usual. So, when those patients come into touch with his high levels of air pollution, there’s a good chance that their recovery will be delayed.

Another myth is that fibrosis patient will be safe from Covid just by wearing masks. Charcoal masks cannot provide protection from any pollutant except for nitrous oxide only. Standard pollutant mask, which can provide some protection against PM 2.5, does not provide any protection but is comfortable in wearing. Patients with covid fibrosis are more cautious. Because the pollution level is so high, they should attempt to avoid undertaking any type of exercise.

What would be your suggestion to those who have long-haul Covid symptoms, especially lung related complications?

Dr Anant Mohan: There are two types of patients: those who have never had previously healthy lungs and are exposed to a terrible environment, and those who have sick lungs and are exposed to a bad environment. If you’re talking about the long-haul Covid, it refers to the respiratory problems that occur after three months of acute illness. Although this is not a great number in terms of percentages, it is significant due to the sheer quantity of cases, thus even a small number of people become patients. Taking precautions like having medicines on time, cutting down exhausting activities to a level and avoiding situations that may be detrimental to their health is necessary.

For the individuals who have normal lungs, the same concepts apply to a considerable part, if they could go out, would be exposed to hazardous substances on a regular basis. They will develop acute bronchitis symptoms such as breathing effort. So, in essence, it’s a matter of caution. Learn more about taking precautions and taking the right medication at the right time.

Do Air Purifiers actually work during this time?

Dr Sharad Joshi: The AQI  is almost 6 to 8 times higher than the WHO standard which is 50. Patients who already have an existing lung disease should be benefited with air purifier and they definitely have to restrict their outdoor activities. The other thing which has to be added is annual flu vaccine which must be dated timely. All preventive, respiratory infections should be prevented with vaccinations.

Where are we lacking as far as information dissemination is concerned?

Dr Rajesh Chawla: People have been inside for a long time, they are hearing it in the news that sero-positivity is high and that a lot of people have vaccinated. They believe it is safer now. Since the last week or ten days, people are not wearing mask. There’s no harm going out, keep distance as much as possible.

How reliable are sero-surveys? We spoke of all these surveys on herd immunity have not given any reliable data. Why should it be any different this time around?

Dr Ravi Shekhar Jha: I feel that it is slightly premature to comment on sero-surveys that if it is reliable or not. There are two things that we need to understand: First, vaccination or sero positivity do not prevent us from getting any new infection. It only prevents disease from getting severe. Secondly, I have noticed that people feel that covid appropriate behavior means following either hand hygiene or mask. That is not how precautions work. As far as sero-surveys are concerned. I have seen patients in my OPD whose antibodies levels remained high even after catching the infection.

What is the holistic approach to improving the situation?

Dr Anant Mohan: Though the situation continues to remain grim, I would still remain positive and hope that things approve but it will require a lot of effort at various levels may it be Pollution or Covid Pandemic.

What do you say to those who sabotaged this effort? What you have to say to people who say its intrinsic to religion?

Dr Sharad Joshi: Whenever you come out of your house, your eyes might burn. We can celebrate Diwali with green crackers and that too to an extent. But crackers are not solely responsible for this, but burning of crops, traffic, setting in of winters and existence of pollutant gases are contributing to the same.