Cities are the epicenter of the pandemic. From Wuhan to Madrid to So Paulo, the scenes have been grim – wards full of patients, queues of refrigerated lorries serving as makeshift morgues, food-bank lines around empty streets. At the same time, people and animals have flocked to streets and parks, while carbon emissions and smog levels have dropped from New Mexico to Delhi.
Still running its course. The immediate shocks – job losses, poverty, food shortages – need to be addressed urgently. But a lot has been learned. Experience is already driving change.
In May, the mayors of the world’s 38 largest cities – including Hong Kong, Los Angeles in California and Durban in South Africa – announced a set of principles to make their metros more sustainable and equitable. Combatting climate change is a priority of the Global Mayors Recovery Task Force. Milan, Paris, Bogotá and Barcelona, for example, will close off areas to motorized traffic, expand sidewalks and increase cycling.
Such initiatives are welcome. But cities need a massive rethink on how they are governed and operated. They need to strengthen leadership and health care systems, improve the way they communicate, source more food, goods and services locally, prioritize nature, and tackle inequalities.
One action, above all – strengthening and expanding networks within cities and between cities – would make urban areas more resilient to future pandemics and other crises such as climate change. By building the link now, cities will be placed in a better position to act quickly and will be able to give or receive help from others when another disaster strikes.
learn a lesson
The scorecards of the cities are mixed. While the picture is evolving, they are already telling us a lot about what works and what doesn’t.
First, strong leadership and governance at all levels are critical to ensuring a rapid response3,4. Well-run cities such as Hanoi in Vietnam were able to avoid major outbreaks by rapidly restricting travel and increasing testing, tracing and quarantining.
Similarly, Thiruvananthapuram (Trivandrum), the capital of the Indian state of Kerala, which has an estimated population of over 2.5 million, has one of the lowest infection and death rates in the country – with more than 4,000 confirmed cases and 12 deaths as of August 1 – with thousands of returning international students.
And in spite of having workers. In contrast, places such as Sao Paulo in Brazil, Delhi and New York City responded slowly or ineffectively, ending up with overcrowded hospitalizations and hundreds of times more deaths.
Timely, reliable, accurate and science-based information is important. Individuals need to know why and how they should maintain social distancing, wear masks and quarantine. For example, Bangalore in India publishes a daily dashboard and maps of newly diagnosed infections used for local tracing.
Yet confusion, contradiction and underestimation are often the norm. The Chinese city of Wuhan has been criticized for its slow response to the emergence of the virus. Lack of information about the lockdown in India left lakhs of migrant workers scrambling to arrange for home transport in March and May.
Some cities have manipulated information for political gains or to avoid social instability. For example, in New York City, St Petersburg, Milan and Lahore mortality rates were initially under-reported or delayed. Misinformation can lead to unrest. For example, in March, rumors of infectious people returning from China sparked a riot in the Ukrainian city of Novi Sanzhar.
Misinformation is also rife about well-established issues such as wearing face masks to prevent the airborne spread of the disease. Asian cities, including Hong Kong, Tokyo, Beijing and Ho Chi Minh City, some of which experienced or prepared an epidemic of severe acute respiratory syndrome (SARS) in 2003, soon mandated masks.
Western cities such as Milan, New York City and Barcelona took the lead; Many still do not enforce the use of face masks. Multiple languages can be a barrier to communication. In Lusaka, Zambia, a nun and social activist named Sister Astridah Banda organizes a live radio show in seven local languages to answer people’s questions.
Even the richest cities lack medical facilities that are well equipped to deal with the pandemic. Some large hospitals are designed to isolate hundreds of people with infectious diseases. For example, out of 90 hospitals in Wuhan, only 3 were initially designated as fit for such people; By April there were 65. Mobile and large temporary wards were quickly set up to treat thousands more.