Assessing City Resilience in Relation to Infectious Disease
COVID-19 will spread similarly in cities across the world; how well cities are prepared to respond will vary greatly - and the difference will be measured by grim statistics and a death toll.
The outbreak of COVID-19 has created an upheaval of daily life, and the best efforts to respond have been no substitute for better planning. Unfortunately, several agencies explicitly established to plan and prepare for a potential outbreak of an infectious disease were dismantled by the Trump administration. In 2018, at a time when experts already warned that the United States was underprepared for an epidemic, the White House shuttered the office focusing on pandemics. This was on top of a failure to fill crucial public health positions across the government. Back in April of 2017, Lena Sun of the Washington Post reported that the Trump administration had not filled critical public health positions, leaving the US ill-prepared to face a deadly outbreak of an infectious disease. This was in the face of reports from the Centers for Disease Control and Prevention of looming threats highlighting more than 300 outbreaks in 160 countries over the previous three years.
The United States is not as prepared as it could have been. What should be done going forward? What can be done now? In addition to reestablishing and empowering essential national agencies, what can be done at the scale of the city – the front lines in the fight against the new coronavirus? The work with city resilience provides a ready-made body of research and tools to address the many challenges. City resilience refers to the ability of urban systems to maintain continuity through shocks and stresses. Though the concept of resilience would include exogenous threats from infectious disease, the academic discussion and tactical application of urban resilience measures has concentrated on threats from natural disasters, climate change, and terrorism.
An innovation district I led in the US was in an area that had experienced firestorms, with clouds of unhealthy smoke lingering over the city, and ice storms, taking out powerlines and shutting down the airport. Because of experiences with these threats, citizens, institutions, and city officials have proved to be well prepared to respond to subsequent incidents.
For decades, the United States has largely been untouched by disease outbreaks, in comparison to many other countries. Vaccines and advances in public health measures have drastically lowered infectious disease risk over the last century, resulting in only a small proportion of overall mortality in the United States stemming from communicable disease. Instead, climate change and specific regional threats such as earthquakes, droughts, fire, and hurricanes have been a primary focus for resilience assessment across the country.
An assessment of urban resilience, focusing on infectious disease, could provide much-needed insights to both our current response and future planning. It is already a framework for disaster planning used by many cities. Importantly, resilience theory conceives of cities as complex systems. COVID-19 is not a single problem; instead, it poses a set of interrelated problems - that are compounding.
Existing tools are already developed to examine and measure multiple factors of urban resilience. An exemplar resource, because of its robust toolkit of resources, is the City Resilience Index (CRI), developed by Arup and the Rockefeller Foundation. Based on years of research, the project was developed in collaboration with local governments and stakeholders from a hundred cites - home to nearly 500 million people. The index is based on research identifying specific qualities of resilient cities; it details 12 drivers of resilience in the dimensions of health and wellbeing; economy and society; infrastructure & environment; and leadership and strategy.
There is currently a pressing need for past work with city resilience (focused on environmental stresses) to refocus on urban pandemic preparedness and a city’s ability to fulfill and sustain core functions (including emergency and health services, as well as essential resources and basic daily needs).
The literature defines resilience both as the capacity of a system to function or recover in the event of disruption, as well as the quality of adaptation to shocks. Relative to the outbreak of COVID-19, resilience is both a measure of how well cities are prepared for the crisis and how well they are at adapting to the crisis. At the moment, the latter is of the greatest importance.
Sources:
Uni Friedman, “Why America Is Uniquely Unsuited to Dealing With the Coronavirus,” The Atlantic, March 25, 2020.
Lena H. Sun, “Top White House official in charge of pandemic response exits abruptly,” The Washington Post. May 10, 2018.
Lena H. Sun, “The Trump administration is ill-prepared for a global pandemic,” The Washington Post. April, 8, 2017.
Steward T.A. Pickett,. Mary L. Cadenasso, and J Morgan Grove, "Resilient cities: meaning, models, and metaphor for integrating the ecological, socio-economic, and planning realms," Landscape and Urban Planning (2004), 69 (4): 373.
