It would not be wrong to say that the manifestation of COVID-19 in India has an urban bias. As of 4 May, of the 42,533 people who had tested positive for COVID-19, a disproportionately large number were in large cities. Mumbai alone had 8,800 cases, while the National Capital Territory of Delhi had 4,549. In most states, major cities were the epicentres of the pandemic, with 472 of the 1,082 cases in Telangana being from Hyderabad alone and 1,458 of the 3,023 cases in Tamil Nadu being from Chennai. Since the lockdown measures were enacted, it has been easy to slip into catastrophic thinking about cities. The economies of cities have ground to a halt. It seems natural to ask: will Indian cities survive this onslaught?
Health and the spread of disease are very closely linked to how we live and how our cities operate. The good news is that cities are incredibly resilient. Many cities have experienced epidemics in the past and have not only survived, but prospered. Before the rise of modern medicine, disease spread was often addressed by changes to the urban environment through infrastructure, better designed buildings, sanitation and decongestion.
During the lockdown, government efforts are rightly placing emphasis on vaccines, physical separation and emergency healthcare. When the lockdown ends, however, not everything will go back to the way things were—the fabric and infrastructure of our cities will have to adapt to a new normal. What lessons can we learn from the past about how cities have adapted their architecture and infrastructure after epidemics? What can we apply to make cities even more healthy and liveable?
The nineteenth and early-twentieth centuries saw devastating outbreaks of cholera, typhoid, typhus and influenza in European cities. Physicians such as Jon Snow, from England, and Rudolf Virchow, of Germany, saw the connection between poor living conditions, overcrowding, sanitation and disease. A recognition of this connection led to the replanning and rebuilding of cities to stem the spread and severity of epidemics. In the mid-nineteenth century, London made major infrastructural changes to combat the spread of cholera, a disease that constantly harrowed the city. London’s pioneering sewer system, which still serves it today, was built as a result of the understanding that clean water and better sanitation can stop the spread of cholera.
Alongside an efficient sewerage system, cities also recognised the importance of decongesting residential areas and creating green spaces. Parks became a mainstay of urban design. New York’s famous Central Park is an example of this. Built in 1857 to function as the “lungs of the city,” it created green open spaces where city dwellers could breathe clean air. Before antibiotics appeared, the only recommended treatment for tuberculosis, a disease common in cities, was being outdoors. There was a mass exit of people from cities to sanatoria—places where there was fresh air and green space available. Sanatorium design reflected this with balconies, roof terraces, patios and covered outdoor-seating areas. The physician Esther M Sternberg echoes this in her book Healing Spaces. “Just as the sanitation movement of Victorian times stopped epidemics of infectious disease, so should urban design incorporate features that encourage exercise and healthy living and control the modern epidemic of obesity,” she writes. “The new movement of sustainability, green architecture and urban planning is helping to do just that.”