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Vehicles are shrouded in smog on a highway in New Delhi on Nov. 18.ANUSHREE FADNAVIS/Reuters

As it happens every year in November, the northern plains of India are shrouded in thick smog under a grey, murky sky. A dangerous spike in pollution levels in Delhi and its neighbouring states has prompted the Supreme Court to intervene, calling this week for emergency measures and criticizing authorities for “bureaucratic inertia” in addressing the recurring public-health crisis.

Delhi and its neighbouring cities quickly shut down schools that had only recently opened after more than 18 months of pandemic lockdowns, ordered work-from-home measures and banned construction work, truck traffic and the burning of crop residue by farmers. Several power plants were ordered to close temporarily.

The air quality index (AQI) of Delhi hovered around the 400 mark this week, soaring above 900 on a few days. An AQI of more than 100 is considered unhealthy.

Multiple factors – vehicular pollution, industrial emissions, smoke from burning agricultural waste, construction dust – combined with the atmospheric doldrums that mark the onset of winter turn New Delhi into one of the world’s most toxic capital cities. The noxious haze settles over the entire region, enveloping neighbouring cities such as Gurugram and Noida. “Sixty-nine per cent of pollution in the city was due to sources in national capital region towns or neighbouring states, while only 30 per cent was generated locally,” said Delhi Environment Minister Gopal Rai.

As states and the city accuse each other of inaction, residents are caught in a quandary that has become an annual crisis. Many families have to make hard decisions, such as leaving the city for good. Others escape to cleaner, smaller towns for a few weeks to avoid the peak pollution season. For those who stay behind, even a short trip outdoors results in stinging eyes, coughs, headaches and other cold-like symptoms, prompting the use of nebulizers and antihistamines. The more vulnerable often land in the hospital with lung and heart conditions.

Citizens have taken to social media and are banding together offline to lobby for cleaner air. Environmental activist Sherebanu Frosh in Gurugram, a member of one such group, Warrior Moms, worries that authorities are not pursuing permanent solutions, but says at least there has been a change in the conversation.

“Now we have courts talking about complete lockdowns when the AQI shoots up, something that would have been unthinkable a few years ago. We need that conversation to penetrate to the masses – and not just in November, all year round,” she said.

Ms. Frosh is one of the millions of parents compelled to keep her children home from school and outdoor sports activities. But she’s also part of the small percentage of the population who can afford air purifying equipment, a rapidly growing industry in India. Six air purifiers stay switched on in her home at all times. But she says this is not a viable solution. “Even if we create a bubble around us, are we okay with other children who can’t afford air purifiers falling sick because of pollution?”

Last year there were some encouraging signs that the government was serious about tackling the problem. It set up a first-of-its-kind commission for air quality management in Delhi and adjoining areas in the states of Haryana, Punjab, Rajasthan and Uttar Pradesh and made it a permanent body this year. But experts say not much has been done on the ground.

“There have been zero changes in the last year,” said Arvind Kumar, the chairman of the Institute of Chest Surgery, Chest Onco Surgery and Lung Transplantation at Gurugram’s Medanta Hospital and the founder and managing trustee of the Lung Care Foundation in New Delhi. “The continuous exposure to air pollution is causing irreparable damage to people’s health. The emergency departments of every hospital are seeing a spike in the number of people admitted because of pneumonia, heart attacks, brain damage. We studied the lung health of 1,200 school-going children in Delhi and compared it with an equal number of children in two cities in the south of India. To our horror we found 50 per cent of the children in Delhi have chest-related health issues and 29 per cent have test-proven asthma. No other country in the world will have as high levels of asthma in children.”

He says the government has repeatedly fallen back on unplanned, knee-jerk measures to deal with a “pure public health emergency.

“Reactionary moves like using anti-smog guns, sprinkling water to curb dust and ordering lockdowns give limited results and are a waste of public money,” he added.

Sunil Dahiya, an analyst at the Centre for Research on Energy and Clean Air, an independent agency, has been studying the impact of power plants on public health and, in a report, “Health and Economic Impacts of Unabated Coal Power Generation in Delhi-NCR,” argues that pollution controls in Delhi and neighbouring areas would have prevented 3,000 deaths, 3.2 million lost workdays, more than 4,700 premature births, some 7,700 ER visits for asthma and 3,000 cases of chronic obstructive pulmonary disease in 2018.

“Few thermal power plants have complied with the emission norms that were put in place by the Ministry of Environment in 2015. With repeated extensions and exemptions given to them by the government, the coal sector has consistently tried to dilute the regulations,” he said.

A lack of political will and an evasive industry lobby continue to be major barriers to clean air. Mr. Dahiya says India needs to use its air pollution forecasting system more effectively and be pro-active rather than resort to last-minute measures. He says it’s also important to engage with farmers to find a solution to the issue of crop burning.

Indeed, even as authorities scramble to remedy the worsening situation, doctors are already sounding the alarm for next year. “We need effective, permanent policies, or we will have a repeat of this health crisis next year too,” warned Prof. Kumar.

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