Pareesa Afreen 

Who is Accountable for the Air Pakistan’s Children Breathe?

KARACHI: As winter approaches, cities across Pakistan are already covered in a haze, making it hard to tell the difference between fog, smog or dirty air. However, it’s not only the weather that’s changing, people are falling sick even before the temperature drops.

Doctors and climate experts are worried that unusual cold snaps, spurts of air pollution, and shifts in moisture are pushing up cases of respiratory illnesses into the danger zone and indicating a link between climate change and health.

While winter has shortened in recent years, it has grown more bizarre. For example, Temperature swings have become more common, with 30°C one week and single digits the next. Experts say that the volatility of winter is stressing both the climate and our bodies.

Dr. Muhammad Arsalan, a medical officer working in the Sindh Employees Social Security Institution, says he sees a steady increase in cases of respiratory illnesses every year.

“There is an increase in cases of common colds or respiratory infections every year. Major causes are air pollution, dust particles, and carbon emissions from vehicles,” he says. “Sudden decreases in temperature change humidity levels, affecting patients with chronic conditions of asthma and COPD the most.”

These unpredictable changes, he adds, make it more difficult for people — especially people with weak immune responses — to accumulate healthy exposures.

“Cold affects people at both ends of the age spectrum. Toddlers and the elderly have weaker immune systems. A mild infection for a younger person can turn severe in an elderly person or toddler.”

Climate change is rewriting health patterns

According to a 2024 report by The Guardian, Pakistan has been experiencing “off-seasons” illnesses, such as viral infections and allergies, with irregular weather patterns. The article specifically addressed how cities like Lahore and Islamabad have been facing harsher pollution risks due to premature temperature drops before winter formally arrives.

A 2023 research article published in the Pakistan Journal of Meteorology also shares evidence of declining average winter temperatures in Punjab with rising PM2.5 concentrations. This climate discrepancy, cold nights and heavier pollution – means a higher risk for respiratory complications.

In addition to this the World Bank’s Climate Risk Profile for Pakistan (2023) focuses on “shifts in temperature and humidity are elongating pollution duration” and increased incidence of chronic obstructive pulmonary disease (COPD), bronchitis, and cardiovascular complications.

Smog: The silent killer of the season

For environmental researcher Yasir Husain, Director of Climate Action Centre (CAC), smog is not just an urban inconvenience but a symptom of a larger crisis.

“We often consider smog a seasonal issue; however, it is actually a health crisis. When climate change disrupts normal precipitation patterns, pollutants will remain trapped for longer periods of time in our atmosphere and can deteriorate air quality even before winter occurs.”

This correlates with a report from Dawn (December 2024), which indicated a 30% increase in hospital visits for respiratory issues in Punjab and Sindh at the beginning of winter – before the peak cold of December. The report tied the concern directly to stagnant air mixed with vehicle emissions.

Smog’s effects can extend beyond coughing or watery eyes. Dr Arsalan indicates that the toxins in the air “can impact body physiology in many forms,” to the detriment of health.

“Smog has toxins that have mixed with the water; the toxins are inhaled into our lungs. This is going to worsen asthma, impact cancerous changes, or damage the body’s immune system over time,” he states.

Human vulnerability and adaptation

Experts agree that Pakistan’s climate crisis is altering the human body’s response to weather. The 2023 Lancet Countdown on climate and health reports that residents of South Asia are increasingly exposed to “compound climate risks,” where heat, humidity, and pollution interact to disrupt the body’s response to adapting to cold and infection.

Dr. Arsalan adds that our own behaviors have made this vulnerability worse.

“Extra antibiotic abuse has created resistance,” he notes. “Even a simple cold can turn into a strong infection now.”

Hussain emphasizes the need for community awareness.

“Communities need to build resilience — that means wearing masks on smoggy days, planting more trees, and holding local governments accountable for emissions,” he explains.

Protecting health in unpredictable winter

Doctors emphasize prevention as the first line of defense. Dr. Arsalan recommends:

“Wear a mask whenever you go outside, especially in smog. Stay hydrated, wear warm clothes, and close windows during dusty hours.”

Public health experts are calling for the government to promote climate adaptation in healthcare planning. This integrates real-time air quality alerts, preparedness plans for smog warnings, and an increase in access to respiratory care in low-income neighborhoods.

As noted in the UNDP Pakistan brief (2024): “health resilience needs to be part of climate resilience,” which requires clean urban planning, enhanced regulation of industrial emissions, and increased access to information that empowers citizens to protect themselves.

A winter like no other

Pakistan’s winter is no longer a season of calm; it’s a test of adaptation. The cold now comes with a warning, not just of lower temperatures, but of the invisible threats in the air.

“Climate change is real,” Dr. Arsalan reminds. “Rain, drought, cold, and heat — they all contribute to health one way or another. The sudden changes are now showing their impact on all of us.”

As smog thickens and infections rise, experts say the real challenge is learning to live in a climate that no longer behaves as expected.