Imagine it's January 2007, and our fears of a flu pandemic have been realized.
It's a public health emergency. People are staying home to avoid infection, so there are no employees to work and no customers to serve. The city is effectively shut down.
Most people suffer ill effects. Many become severely ill and have to be hospitalized. Some die.
Today, on June 1, 2006, we're in the early stages of another public health emergency somewhat analogous to our hypothetical pandemic. In the real emergency, the disease vector is not influenza but air pollution.
Air pollution is a killer. Every year, it kills 5,000 people prematurely in Canada's eleven largest cities. 1 It kills more people than breast cancer, prostate cancer, or motor vehicle accidents.
According to Ontario's Ministry of the Environment, the air quality index (AQI) in downtown Hamilton was 67 on Wednesday, March 31 at 5:00 PM. 2 An AQI reading of 50 or above is in the "poor" range.
The main culprit was fine particulate matter, more than half of which comes from automobiles. 3
On Monday, May 29, the Hamilton Spectator reported, "Hamilton had the worst air in all of Ontario yesterday, as the province issued its first air quality advisory of the year.
"Early yesterday afternoon, the provincial air quality index hit 64 in downtown Hamilton, well into the poor range. Air quality is expected to remain bad for the next couple of days."4
Like clockwork, on Wednesday, Hamilton's hospitals "reported a rise in patients coming in to its emergency rooms with respiratory ailments." 5
Laurel Broten, Ontario's Environment Minister, said on Tuesday that air pollution "costs our province millions of dollars and it kills Ontarians each and every day." 6
My friend's eleven-year-old daughter was training on Monday for a 1,500 metre run. She is in excellent health with no illness or disease, but on this particular day, she could not even complete one lap around the track.
Air pollution is a public health emergency, but we don't treat it that way, perhaps because the problem has snuck up on us by degrees. According to Hamilton's Social and Health Issues Report 2005, smog and air pollution have been growing steadily worse for a decade. 7
We seem to have normalized it. As "smog days" become more frequent, people stop thinking about them as something special or alarming, and they become part of the general background noise.
It's time for Hamilton to treat air pollution as the public health emergency it is. Just as an influenza outbreak could temporarily shut down the city, we need to take similarly aggressive measures to address smog and fine particulate.
Air pollution is not as "sexy" as avian flu or West Nile disease, for which the Ontario government just gave Hamilton a large grant to spray mosquito larvae. Last year, West Nile disease killed 12 people in Canada. 8 Air pollution killed 5,000.
I propose that on days with severe air pollution - say, an AQI over 50 - Hamilton's Medical Officer of Health, Dr. Elizabeth Richardson, should issue a blanket ban, enforced with penalties, on non-essential driving and motor use, and announce free HSR service for the entire day.
Driving to work: non-essential (unless you work in emergency services). Driving your children to school: non-essential. Cruising the drive-thru for a coffee: definitely non-essential.
Gas lawn mowers and hedge clippers, propane barbecues: non-essential. These machines are serious offenders, because their crude motors do not filter exhaust the way car engines do. Use a push-mower instead.
Outdoor sports events? Cancelled. It's too dangerous for children to be inhaling deeply.
I'm not saying we should force little old ladies on fixed incomes to overheat in apartments with no air conditioning. I'm saying we should take most vehicles off the road until the air quality improves.
Since cars contribute about half the particles that comprise air pollution, taking half the cars off the road would reduce the total air pollution by a quarter. That could, for example, lower the AQI from a poor 60 to a moderate 45.
It would reduce hospital admissions, prevent deaths, and reduce illness among otherwise healthy people. It would also reduce long term damage caused by inhalation of fine particulate.
Some business owners would be outraged (others would be delighted). Apoplectic letter writers would cite every reason imaginable to defend driving in the face of this emergency: public transit is inferior; there's just no other way to get where I need to go; I need my car's air conditioner to stay cool.
Of course, these just confirm how hopelessly addicted we've become to our cars, and the lengths to which we'll go to continue driving, even when it's literally killing us.
On May 12, Spectator editor Robert Howard wrote, "Smog isn't red eyes and a wheeze, but people in poor health choking to death, children with asthma and people's weakened hearts stop altogether. It's not an inconvenience or an irritant, but a killer." 9
Banning driving is an inconvenience and an irritant - a major one, I'd say - but it may just be that nothing less will persuade us to shake off our denial.
(Note: this idea was originally suggested by Beth Grey.)
1. Exhibit 4.1: "Annual Deaths in Canada Related to Air Pollution Exceed Those From Other Causes", Report of the Commisioner of the Environment and Sustainable Development, Office of the Auditor General of Canada
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