COVID-19: never again as before.
Five recommendations on urban health.
Virologists had predicted it all. Bill Gates, as one of the brightest and most influential philanthropists, had warned about it five years ago: The next outbreak is coming, and we’re not done. “And now we are all watching a movie, the scenes of which unfold one by one in front of us. We are at the tip of our seat for what will follow, and as we get to see more, you begin to understand the story. ” These are just the words of Andrew Cuomo, the Governor of New York State, at his daily press conference last Sunday, April 5. A total of 4,758 deaths, 122,000 people infected in the world’s epicentre of the COVID-19 pandemic, as we speak. The sustained curve of corona cases in New York is now towering above that of Wuhan, China and Italy. However, the peak is yet to come in the next two weeks.
The combination of a very weak, almost completely privatized U.S. health system, a presidency that contempts public and a hyper-connected metropolis have been shaken in turbo- mode as a deadly cocktail. Everything is chaos here now: a shortage of tests, health personnel, beds, fans. The governor convinces as a crisis manager, flanked by virologists and experts who, just like in Belgium, rightly receive all credit. The dialogues with the press, supported with figures and slide presentations, are a relief, because at federal level, every ounce of credibility or any allusion to facts has long evaporated. Despite the late instructions to residents to stay at home, the city has frozen in slow motion at the end, featuring as the surrealistic background for haunting scenes: the hospital ship USNS Comfort with 1000 beds and the red cross on the white hull that slowly enters the port, the temporary hospital tents that got set up hastily this weekend in a Central Park full of spring blossoms, as well as the saddening image of travellers crammed in the metro. Travelers who provide many essential services in the city but are fully exposed to the virus. The so-called underclass that underpins the informal and formal economy as it turns out, providing services that we all depend on, but without a social safety net, without much choice.
In the eye of the storm, I enter quarantine day 21 with my family. Both school and work activities have shifted as good as possible completely online. I devour professional media, analyse the impressive COVID-19 data dashboards developed by John Hopkins University and try to understand what we should think of this crisis as city planners.
Within ISOCARP I coincidently took the initiative last month to establish a Community of Practice on Urban Health. Because it is high tide to walk back on an important historical line of urban planning and seek more connection with the social, health and welfare sector. City planners also potentially have the necessary insights and tools to assist local governments and the private sector in the design of healthy cities, in the short and long term. and ensure communities lead the process and take . We want to examine the arsenal of current urban planning processes, plans, research processes and legislation with other professionals, to ensure people-centred and community-led change. Should we do things drastically differently? Sometimes yes, but it is equally right to say that in the current practice of sustainable urban planning, a lot of common sense prevails, albeit too implicitly.
Five considerations, as a shot ahead.
1. Physical distancing reveals the human right of space
It has taken a long time, but the World Health Organization is finally starting to use a term that better describes the intended measure: physical distancing instead of social distancing. Social distancing rightly alludes to the need to adapt social habits, which made eradicating recent epidemics in low-tech environments difficult, remembering past Ebola outbreaks. But in most urban contexts, the Internet of Things has provided many alternative ways to stay socially connected to your community, moving to online work and education. Physical distancing clarifies better the harrowing powerlessness to tackle COVID-19 in deprived neighborhoods and slums, where there is structurally lack of space to organize in all areas. Even if there was an extreme amount of test capacity, how can you impose insulation and ensure services and income? Physical distancing reminds us about the importance of norms and standards that determine minimum amounts and quality of space to provide healthy habitats for people, where services can be delivered through collective infrastructure and open space networks.
2. Public space as the communal health resort
Physical distancing is not only literally what is needed, but also highlights the importance of taking additional measures that provide space for physical activity and infrastructure for safe mobility. In dense districts in particular, it is now a matter of re-designing and re-organising public space tailored to people, temporarily or permanently. As playgrounds and youth centers close, children need to get alternative options, to cope with the particular stress of lockdowns, increased screen time and sadly also violence.
Since public transport cannot be geared enough to the necessary physical distancing rules, the maps to increase cycling and walking in cities must be drawn in full. Cities such as Bogota, Berlin and Brussels are shifting up a gear in previously deployed sustainable urban traffic policy, unfortunately other dense cities like New York stand on the brakes. Air quality is finally acceptable through COVID-19 measures: can sustainable energy and transport be introduced more quickly, in analogy with the digital revolution that is now taking place in everyday life?
3. Monitoring density and compactness: for a healthy planet, life and economy.
The COVID-19 crisis also brings up the discussion about the dense city, a discussion that is usually useless if it is not framed within a broader picture. After all, there is little choice whether or not to live in cities in a more compact way, bearing in mind the other crises, the climate crises. Although New York is now severely affected by the current crisis, other similar dense cities and countries in Asia show that they can control the spread of the virus, by testing a lot, by strict isolation, by modernized government services that can adapt and respond quickly, and thanks to civic responsibility.
The pandemic also highlights how important transit infrastructure is to ensure metropolitan supply chains can be kept operational. Transit infrastructure is key and not just a favour for lower income riders. We depend on them: workers in hospitals, logistics and manufacturing that are creating, shipping and selling urgently needed supplies. But road, transit and other infrastructure comes with investment and maintenance cost, that can reduce significantly by planning compact growth. After all, how can we argue after this crisis, which will burden all governments with an unprecedented debt, about investing in suburbanization and urban sprawl, the social costs of which have recently been calculated in detail?
There are a lot of urban planning instruments that could be imposed to ensure more qualitative residential environments as well. Could the COVID-19 crisis be the necessary pressure to invest in people-centred urban planning, for example to impose more and larger balconies, more collective spaces, more gradients, bearing in mind the origins of contemporary urban design?
4. The neighbourhood as delivery platform for urban health
With the closure of schools in New York, support for the weakest families collapses. Families rely on the school, not only for education, but also for free lunch. An alternative supply system must now be sought, keeping schools open as infrastructure in the neighbourhood, which prooves that schools have become part of a broader health and recovery network. Poor neighborhoods in the periphery of the city in particular lack basic social services that could form this platform for urban health. A call for the 15-minute compact city suddenly no longer sounds like a manifesto, but a logic itself to plan for in any neighbourhood.
5. The unhealthy living environment: the silent virus
In the health sector, there has been a growing awareness for some time that a person’s health and quality of life is strongly related to environmental factors, which cannot be cured, but must above all be tackled in a preventive and multidisciplinary manner. The hive major non-communicable diseases (cardiovascular disease, diabetes, cancer, lung, and mental illness) are associated with five major risk factors (smoking, unhealthy diet, lack of physical activity, alcohol, and environmental pollution). Planning a healthy, safe living environment is therefore an essential part of a 21st century health policy, with access to health services, but also to balanced nutrition, play, exercise and fresh air. Patients with chronic non-communicable diseases now appear to be extra vulnerable to the COVID-19 virus. Cities and local authorities are therefore central to providing that healthy environment that tackles non-communicable diseases — and road traffic injuries as well — in order to make local communities resilient, both physically and digitally, during this crisis and afterwards.
The crucial questions that planners in practice and policy must now ask themselves: are we sufficiently involved in defining crisis measures that are carefully weighed between health specialists and supralocal authorities? Is the translation done sufficiently, clearly and with relevant complementary measures at local level? And above all, how do we rebuild the solid bridge between spatial planning and health? Because we cannot return to the former normal.
Let us further discuss as a discipline, study case studies and outline research pathways, especially in collaboration with epidemiologists and other health experts!
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