COVID-19 is an urban disease

A great deal has ben said about the biology of COVID-19 but I think it is significant that we note, if we're thinking about future plans for these sorts of diseases, that deaths from the disease are very considerably greater in big cities and dense urban areas. In the UK, mortality is twice as high or more in large conurbations:

It's also worth noting another geographical feature - urban density isn't a simple measure, what matters is the density of close interactions with other people especially involuntary interactions.

As of April 24, Los Angeles County, with nearly 2 million more residents than the five boroughs, had 850 coronavirus-related deaths compared with 16,646 in New York City.

Now while there are other factors at play here and we can't put it all down to the nature of these places, geography matters. As Joel Kotkin points out, Los Angeles was purposefully designed as a sprawling city:

Los Angeles’ urban form emerged early in the last century as civic leaders such as Dana Bartlett, a Protestant minister, envisioned Los Angeles as “a better city,” an alternative to the congestion and squalor so common in the big cities of the time. Developers and the public embraced this vision of single-family homes, as Los Angeles became among the fastest-growing big cities in the country.

Looking at New York, demographer Wendell Cox makes the observation that reported density figures for large cities don't reflect the density at which most people actually live because, in most cases, large areas of urban fringe (often protected from development) is included:

The vast majority of New Yorkers in live at population densities far higher than the New York City average. The population density of the four boroughs served by the New York City Subway (Manhattan, Brooklyn, Queens, and the Bronx) is about 31,600 per square mile (12,200 per square kilometer), yet 78% of the population lives at much higher densities than these averages. The median resident --- half live at higher densities and half live at lower --- lives at a density of 56,600 per square mile

The same applies when we look at London where densities in Tower Hamlets run to over 16,000 per square kilometre compared to just over 2,000 in Bromley. And, when we look at the ONS data on COVID-19 deaths, the relationship with density does seem stark (the map is from the ONS and maps deaths per 100,000):

Taking a wider view of England and Wales, the link between incidence and population density is still more evident

There will be confounding factors, the seemingly greater mortality rate among non-white populations, for example, but the relationship between density and incidence does seem to be considerable. Even acknowledging a degree of lag with England's regons being behind London in the spread of the disease, we should be asking questions about how we might be better prepared to act in the future. If, as Wendell Cox argues, mass transit systems and especially subway systems are critical to rapid spread, then we should consider whether less economic harm would be caused by closing these systems early in the onset of a virus epidemic than has been caused by keeping them open and locking down right across the country.

We clearly can't do anything to change the reality of places like London being reliant on mass transit but we should perhaps be asking whether, with remote working options, electric and autonomous vehicles, and the deregulation of taxi systems, we might need to reconsider the current anti-car, pro-transit orthodoxy. In already dense places like London, we will see more people opting for personal transport in the form of cycling, e-bikes and mini-scooters. A forward-looking transport leadership would be looking to create a safer environment for these vehicles, probably by further restricting access by cars. But if this is done without options for multi-model travel (car+bike, car+walk) or trialing of 3D options like drones and air taxis then opportunities for a very different future might be missed.

Another important consideration is that we are approaching the problem wrongly by seeing it as a single national response - what we do in rural Suffolk or the Welsh mountains needs to be very different to how we respond in big city environments. There is also a strong case for using travel restrictions between places (an approach New Zealand used with seeming success) and for longer-term investment in reducing the need to make these journeys. How many of the people on the daily 7am Leeds-London train are making a journey that could be replaced relatively easily with a remote option?

I hope, however, that these figures make us pause when thinking about future urban design and how we meet our population's housing needs. Densification is driven by two things - a positive one where urban agglomeration creates innovation and growth, and a negative one where density is seen as an excuse for not building on some of Surrey's golf courses or putting houses on the dozens of essentially redundant airports in the South East. And, given the desire (and policy - whaever we think of the climate change argument)to shift into electric vehicles, the air pollution argument reduces and we can consider how we return to building suburbs with the sort of space - for renters and owners - that people enjoyed in the places bullt during the 1930s housing boom.

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