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Social Distance, Sustainable Cities and Building Public Health Capacity

by |April 20, 2020

The spread of the coronavirus and the need for social distance is seen by some as a fundamental challenge to globalism, population density, and urban life. The virus is both a challenge and a catastrophe, but it does not change the basic appeal and benefit of our way of life. While wealthy people in this era of extreme income inequality seek to find a safe haven from contamination, as the virus spreads into rural America, it becomes clear that you can run from the modern world, but you can’t hide from it. Cities, suburbs, the countryside: Everyone is in the pathway of exposure.

My view of environmental sustainability centers on the goal of developing sustainable cities that provide energy, transport, entertainment, education, social engagement, food, clothing and shelter with the least possible impact on the planet’s ecosystems. We concentrate people in beautiful and exciting cities and leave as much of nature alone as we can. This requires population density to support economies of scale coupled with decentralized, energy, food, transport, water and waste systems that permit resiliency and safety. In the first edition of my book, The Sustainable City, I discussed the infrastructure needed to support a sustainable city: sustainable energy, water, food, transport, waste management and open space. In the second edition, co-authored with my colleague Dong Guo, we’ve added another piece of essential infrastructure: A competent and well-resourced system of public health. In order to facilitate the density needed for dynamic cities built with renewable, circular economies, people must feel free from the threat of pandemics.

One of the great benefits of the sustainable lifestyle is its emphasis on social engagement and interaction. Cities enable enjoyment of public spaces, the arts, and the diversity of a city’s neighborhoods. The goal is to engage in experiences rather than ownership and consumption. This enables economic activity with relatively low levels of environmental impact. People enjoy parks instead of private gardens, theaters instead of private screening rooms, mass transit, walking or biking instead of personal transport. They view rather than own art and live in smaller private spaces due to their easy access to diverse public spaces. Social distancing makes it impossible to share resources and experiences (so much for the sharing economy…).

In the last month of living away from people, some city dwellers are wondering if they’d have been better off in the suburbs, and some have moved to their country homes or parents’ homes in the suburbs. Is this a permanent change, and what impact will this have on cities? Similar questions are being asked about the global travel industry, about convention and event businesses and even about professional sports. My view of this is that cities, travel, and the global economy developed because of the benefits they provide, and this pandemic has not ended those benefits but made us painfully aware of how much we miss them when they are gone. As Prince might have said, “we want to party like it’s 1999” or at least 2019. We want our normal life back and so the changes brought on by this pandemic are temporary as long as the technology of virus prevention and treatment quickly advances and brings an end to the pandemic. Many of us realize how much we took for granted. We long to sit at an outdoor café and people-watch over an espresso. We miss planning travel and thinking about a spectacular view that can’t be captured fully unless it follows a hike to the summit. Of course, the high housing cost of cities like New York and San Francisco has been driving some people from large cities to smaller ones, but even small cities can generate the density needed for sustainable infrastructure.

There are many factors that lead me to believe this disaster will not continue endlessly. With trillions of dollars in play, there is simply too much at stake, and the resources needed to discover treatment and prevention technologies are already being invested. This should result in a fix hopefully sooner rather than later. But what about the next pandemic and the one after that? Should we learn how to live away from people? It’s true that on a more populated planet in a global economy, COVID-19 will not be the last pandemic we will see. There will be more. But just as global terrorism led to airport searches, video surveillance, and massive institutional capacity to track and prevent terror, this pandemic will lead to increased capacity to track, prevent and treat disease.

This will happen because we do not want to live lifestyles defined by social distance. We want social engagement and social interaction. We want to hear people laughing and crying at the theatre, we want to see children playing in the playground in public parks. Zoom is a great tool, but it is not a replacement for the real world.

The capacity we need is a vastly enhanced system of public health. Laboratories, researchers, clinics, isolation wards, equipment stockpiles, global transparency and communication and everything we need to make sure this never happens again. We also need to build greater understanding of science and expertise by policymakers and the public. When a new virus is discovered and is spreading, we need to deploy a global disease SWAT team to contain it and we need a global team of scientists to study and learn how to stop it.  We need a system with national-level research and testing expertise and local level public health monitors and implementors.

An unfortunate part of the current story is the search for a scapegoat and the politicization of the pandemic and government’s response. The president is blamed for his early dismissal of the threat and now he and his political crew are trying to blame COVID-19 on someone else: China, WHO, the media, democratic governors, anyone but him. But blame is really beside the point. Today, the job is to build the capacity to enable us to return to the lives we were leading before the lockdown. Another difficulty in the White House response is the constant push-back on science and the president’s wish to present the current crisis as a success and that he has somehow defeated the threat from the virus. As Donald G. McNeil Jr. reported in the New York Times this past weekend:

The coronavirus is spreading from America’s biggest cities to its suburbs and has begun encroaching on the nation’s rural regions. The virus is believed to have infected millions of citizens and has killed more than 34,000. Yet President Trump this week proposed guidelines for reopening the economy and suggested that a swath of the United States would soon resume something resembling normalcy. For weeks now, the administration’s view of the crisis and our future has been rosier than that of its own medical advisers, and of scientists generally. In truth, it is not clear to anyone where this crisis is leading us. More than 20 experts in public health, medicine, epidemiology and history shared their thoughts on the future during in-depth interviews…Some felt that American ingenuity, once fully engaged, might well produce advances to ease the burdens. The path forward depends on factors that are certainly difficult but doable, they said: a carefully staggered approach to reopening, widespread testing and surveillance, a treatment that works, adequate resources for health care providers — and eventually an effective vaccine. Still, it was impossible to avoid gloomy forecasts for the next year. The scenario that Mr. Trump has been unrolling at his daily press briefings — that the lockdowns will end soon, that a protective pill is almost at hand, that football stadiums and restaurants will soon be full — is a fantasy, most experts said.

The return to a normal way of life and to renewing our push toward sustainable cities requires that we develop an apolitical, science-driven public health capacity. There are some difficult, short-term decisions ahead where governments and individuals will need to balance economic survival against health risk. We need a mature, spin-free discussion of the costs and benefits of each stage of reopening the economy. While I have no confidence that the president is capable of such a dialogue, I am optimistic that nearly all of our governors will be able to do so. It will help that the results of their actions will be easily seen in hospitals and funeral homes throughout their state. You cannot spin hospital admissions and death. Facts are facts.  No news will indeed be good news.

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