Coronavirus: predictions and precautions

The declaration by German Chancellor Angela Merkel, earlier this week, on the possibility that between 60 and 70 per cent of the German population could eventually be infected by the Coronavirus may have shocked quite a few. That could amount to close to 38 million infected persons in Germany alone and possibly a substantial number of deaths.

I understand that Angela Merkel’s projections are a worst case scenario. This would be catastrophic, were it to ever happen. It is for this very reason that health planners in Malta have advised government, which correctly agreed, to combat the virus by playing for time and focusing on slowing its spread as much as possible, thereby reducing its overall impact on Malta and its residents. As a result of this strategy it is unlikely that there will be a large number of infected persons at any one time, thereby giving sufficient time to the health service to nurse those infected back to their normal health. On the other hand, there is a real danger that if this is not achieved the national health service will break down under the resulting strain with the number of deaths spiralling out of control. Hence the need to follow the directions given by the health authorities.

In order that the combat against Coronavirus be successful everyone has an important role to play to obstruct its spreading. At times it will be very inconvenient, but it has to be done. In the absence of a known cure, so far, slowing down the spread of Coronavirus is the only way of ensuring that the numbers infected as well as its impacts are reduced. All of us have to bear part of the brunt. If successful, this will, in the long term save lives. It will also reduce the suffering of those who are most vulnerable through shielding them and consequently reducing their risk of exposure.

The suspension of air and sea traffic to Italy, France, Spain, Germany and Switzerland together with compulsory quarantine procedures for all those returning to Malta from affected areas and localities are aimed at containing and preventing the spreading of the Coronavirus. A deep sense of responsibility is essential if the measures in hand are to be effective. In this respect it is shocking to learn, from electronic comments posted by an emergency doctor that some patients were not forthright when replying to questions on their travel history and consequently on identifying their exposure to the risk of being infected. This, it is understood, was being done in order to try and avoid precautionary compulsory quarantine procedures.

At the time of writing 12 cases have been identified and tested positive. What is very worrying is that it was reported that two of the persons identified as being infected did not self-quarantine. They went to their workplace before their attention was drawn on the need to take some sensible action!

Quarantine procedures are an essential tool which the health authorities must use in order to be in a position to arrest the spread of the virus and consequently to save lives as well as to reduce the suffering of all, but primarily of those most vulnerable amongst us.

The elderly and the sick, in particular those subject to a chronic asthma condition – approximately numbering 30,000 in Malta – need effective solidarity which can only be put into effect through the responsible behaviour of all of us. Acting responsibly by following the instructions issued by the health authorities will save lives. Each case of avoidance of quarantine, whenever this is required, will encourage the spread of the virus and consequently may lead to the death of some of the most vulnerable amongst us.

If we follow to the letter the instructions issued, we may avoid more restrictive actions in the coming days.

published in The Malta Independent on Sunday : 15 March 2020

The Quality of Life Account

Considering the Delimara power station extension in terms of the integrated pollution prevention and control application, the Malta Environment and Planning Authority asked Enemalta to submit an economic study on the different fuels that could be used. With a working language in euros, the study inevitably ends up considering whether preventing or reversing air quality degradation is, in fact, feasible due to the costs involved. I am being crude but that is basically what it entails.

It has been explained elsewhere that opting for gas oil instead of heavy fuel oil (HFO) will result in 37.75 per cent lower emissions of PM2.5 (particulate matter having up to 2.5 microns diameter).

Cubed Consultants Limited, author of the Delimara cost benefit analysis, recognises that gas oil has a better emissions performance than HFO. It arrives at this conclusion notwithstanding the incomplete information at its disposal, which information ignores a number of significant HFO emissions.

Cubed Consultants Limited concludes that there is an immediately apparent trade-off between low financial costs and high emission costs: they balance each other out! This may be so in the context of the economic philosophy adopted by Enemalta’s consultants but in the real world things work out differently.

The high emission costs are billed elsewhere. The health account foots part of the bill shouldering higher expenses for health care in general and respiratory ailments in particular. The quality of life account foots the rest of the bill. As a result of opting for lower fuel expenses the higher emissions produced will affect residents in the areas impacted. The varying impacts on their health will reduce their quality of life. Residents in neighbouring areas will also share the effects of the lower air quality.

One of the documents submitted to Mepa by the Marsaxlokk, Birżebbuġa and Żejtun local councils in reply to Enemalta’s IPPC submissions is authored by medical doctor Jason Bonnici and deals with the health effects of air pollution.

Dr Bonnici refers to studies carried out in Atlanta, US in 1996 both before and after the Olympic Games. As a result of measures taken to reduce air pollution during the three weeks of the Games, various indicators (ozone, NO2, carbon monoxide, PM10…) registered a substantial decrease. PM10 (particulate matter up to 10 microns diameter) for example, registered a 16 per cent decrease over the pre-Games levels.

As a result, Atlanta achieved a 40 per cent reduction of consultations in medical practices for asthma in children and a decline of between 11 and 19 per cent of asthma-related visits to emergency departments.

In Beijing, during the 2008 Olympic Games, similar efforts to reduce pollution resulted in a reduction of 31 per cent in PM2.5 and 35 per cent in PM10 concentrations. Results on the impacts of this achievement on health are not yet available.

Faced with this information, it is clear that the generation of air pollution through the use of HFO comes at a heavy health and environmental cost. No amount of economic benefit may balance out the reduction in the quality of life of those whose health is impaired. That is if they live on, as studies quoted by Dr Bonnici indicate an increased death rate in areas that experience the impact of high level PM2.5 and PM10 emissions.

Now, the PM2.5 and PM10 emissions measured by Mepa at Birżebbuġa and Marsaxlokk in April and May 2011 are already very high. Average PM2.5 daily readings measured 52.50μg/m3 at Marsaxlokk and 34.70μg/m3 at Birżebbuġa in contrast with the EU mandatory target value of 25μg/m3. On the other hand, average PM10 daily readings measured 54.10μg/m3 at Marsa­xlokk and 70μg/m3 at Birżebbuġa. The EU mandatory daily average is of 50μg/m3.

Faced with this reality, Mepa should feel in duty bound to ensure that the fuel option with the least impacts is selected. It is gas oil that pollutes the least and, hence, it presents the minimum of environmental and health impacts.

There is one further point that Edward Mallia has illustrated time and again. The cost to produce a unit of electricity at the Delimara extension making use of gas oil as a fuel is cheaper than what it presently costs at the Marsa power station using HFO. In the local councils’ documents presented to Mepa, Prof. Mallia and engineer Arthur Ciantar present the workings proving that it is not correct to state that using gas oil instead of HFO would lead to higher electricity bills.

Reducing health and environmental issues to prices and incremental costs or savings tends to lead to a situation of knowing the price of everything but the value of nothing, particularly the value of human life. Euros are not a suitable tool to measure the value of human life, health, the quality of life and the environment.

The ball is now in Mepa’s court. In the next few weeks, we will be able to comprehend the extent to which human life, health, quality of life and environmental issues are factored in (if at all) when important decisions are taken by Mepa.

Published in The Times, October 29,  2011

Micro-managing environment policy

Issues of environmental nuisance have so far not featured in the debate on the National Environment Policy. Odours would top the list of such nuisances. Consider industrial kitchens. The issue may arise in residential areas that have their ground floor used as a restaurant or a snack bar. This mixed use causes problems as can be attested to by residents in areas such as Buġibba, Qawra, Paceville and Marsascala. Odours are rarely adequately taken care of.

The issue also arises in the case of confectioners when manufacturing is carried out in a residential area. In terms of planning policy, it is possible to site such an activity within a residential area but it must be compatible with its surroundings. When the activity gets too large it is time to move out of the residential area to an alternative site where it belongs: an industrial estate.

A considerable amount of environmental nuisance is caused by noise.

Placing air-conditioning units in common shafts or backyards in residential properties close to someone’s bedroom is, without doubt, the cause of an environmental nuisance. This can cause problems, particularly in the case of maisonettes or flats if proper care is not exercised in identifying the right place for fixing the unit.

Retail outlets in residential areas, in particular those selling frozen foodstuffs and making use of industrial freezers, can also be the cause of nuisance if the noise-generating unit is not properly installed relative to overlying and/or adjacent residential units.

Chimneys in residential areas can cause environmental nuisance. Current policy establishes that the flue must be at least three metres higher than adjacent buildings. For normal domestic use this is generally sufficient to ensure dispersal of smoke emitted. Notwithstanding, problems sometimes occur due to changes in the height of buildings in the vicinity of existing flues, which, all of a sudden, render problematic a flue that has functioned without causing nuisance for ages!

Complaints are also encountered relative to the emissions of bakeries in residential areas. In most cases this state of affairs crops up due to the fact that some of these bakeries are housed in old structures in residential areas that have developed. The building height of part of the residential areas would be such that a number of residential units are normally situated at a height above the flue level.

This means that emissions go straight through the windows of residences. This is certainly not a pleasant experience.

Dust resulting from construction activity is another cause of environmental nuisance. This is an issue which the Construction Management Regulations of 2007 attempted to regulate but, so far, have failed to tackle adequately. The solution (reducing substantially construction dust) can only be attained gradually and is primarily dependent on improved work methods on sites of work and more attention to health and safety issues in the construction industry.

The problem also arises because the construction industry is primarily made up of non-unionised labour. A large proportion are small firms spread over a number of sites. Traditionally, these small units within the industry have not given sufficient importance to health and safety issues. On the other hand, most of the large construction firms are equipped to tackle issues of nuisance on site on both the environment front as well as on the health and safety front. Their complaint is that these measures increase their costs while others in the industry ignore their responsibilities.

Factories making/distributing products used in the building industry are also contributing to the dust problem as is evidenced by the Lija saga, which made the national headlines when Mabel Strickland instituted the first legal action on the matter over 40 years ago. The solution is simple yet expensive: Move all activities indoors in a controlled environment. The expense the industry has not incurred to date has been borne by the community through medication for various ailments: asthma and other allergies topping the list.

Some may consider issues of environmental nuisance as being minor in terms of policy. They are, however, what the environment means to the man in the street. At times impacts resulting from environmental nuisance are the only direct knowledge which Joe Bloggs has of environmental impacts. This requires micro-management of environment policy and is no less important than addressing issues of biodiversity, light pollution or corporate social responsibility.

I hasten to add that ensuring an appropriate micro-management of the environment may sensitise the community to move on and be interested in other important environmental impacts.

Think global but act local. Local communities through local councils can play an important role in identifying environmental nuisances and assisting in their solution. This would develop environmental policy at the grassroots and can help gradually in its acceptance on a much wider scale than at present.

published in the Times of Malta, Saturday October 2, 2010