Apocalypse master plan: what cities need to consider to combat the epidemic

What are the differences between the strategies of different cities and what changes await us in the future?

The coronavirus epidemic, which continues to gain momentum around the world, will have a huge impact on many aspects of everyday life. The main tool in the fight against the spread of the virus is a sharp decrease in the density of spontaneous contacts, the main feature of urban life. How will everything that happens affect the management of cities?

The city as a phenomenon has existed for more than 6 thousand years. Its main properties are: the simultaneous presence of many very different people in the same territory, the availability of infrastructure for their life and movement, the exchange of goods, services, knowledge and skills. The same number of years and epidemics, rapidly spreading among people nearby. Epidemics have brought dramatic changes to the urban environment, but they have also given the world recreational space, spacious streets, and running water.

At the beginning of the XNUMXth century, the restructuring of Paris began, the results of which we can admire today. Napoleon Bonaparte took the first steps to modernize the sprawling medieval city, but the changes were slow – only a few streets in the very center were expanded and the construction of a canal began to bring fresh water into the city. A real leap occurred when, on behalf of Napoleon III, the city began to be rebuilt according to the plan of the Prefect of the Department of Seine, Georges Eugene Haussmann.

In addition to long overdue reasons – the concentration of slums in the center of the medieval city, which is impressive even for today’s cities with a population density of 5,5 thousand people per square kilometer (for comparison, this is the density of present-day Minsk or Moscow, and the density of Manhattan is 25 thousand people per square kilometer). kilometer) and erratic movement, cholera outbreaks in 1832 and 1848 played a significant role – then up to 5% of the inhabitants died in some areas.

Almost at the same time as Paris, the current center of London was also changing – the outbreak of cholera also contributed to this. The impetus for the reconstruction was the successful investigation of Dr. John Snow, who defused a deadly pump in Soho – by marking all cases of infection and death on a map, he found out the exact location and cause of the disease. To modernize the sewage system and prevent sewage from entering the city’s water supply, the banks of the Thames were redeveloped, in particular, the Victoria Embankment running from Westminster to the City of London. Before the reconstruction, private houses stood on the bank close to the river, and now there are gardens, front state buildings, and the embankment itself has become the most important transport artery of the city.

The Spanish flu at the beginning of the 20th century became a powerful impetus for the development of housing construction – new standards were developed and implemented, they provided for sunlight, space and air in every apartment. Architects and planners responded by working out natural ventilation and lighting schemes for districts and courtyards, widening streets and creating squares and parks within walking distance. Huge public funds were invested in support of new construction – this is how mass rental housing appeared, which could not be bought, but rented from the owners.

At the beginning of the 21st century, health issues and health problems caused by low mobility, unbalanced nutrition and environmental conditions appeared on the agenda of modern megacities. The problem of mental health was also actively catching up with them. The WHO estimates that depressive and anxiety disorders account for 14% of the global burden of disease, affect people’s performance just as much as physical illnesses, and cost the global economy $1 trillion annually. To solve this problem, architects and designers primarily worked with the external appearance of buildings and the urban environment.

Each city was faced with the challenge of deploying new systems to ensure the improvement of citizens in the short term, demonstrating whether they can rethink existing approaches.

Over the past few years, Moscow has been supplementing the ideology of urban development by switching from a “comfortable city” to a “healthy city”. The authors of the report presented at the Moscow Urban Forum in July 2019 note the high potential of Moscow for such a transition.

But it turned out to be difficult for Moscow, like other megacities, to quickly adapt to the conditions of the pandemic. This situation revealed important systemic problems – the lack of regulations for actions in such situations, as well as the low level of trust between people and government, including health workers as its representatives. According to a 2019 FOM survey, only 57% of our countries trust doctors in hospitals and clinics.

Less than a year ago, within the framework of the Moscow Urban Forum, an expert discussion “Are epidemics still on the agenda of cities?” took place. and foreign experts answered the question in the affirmative, agreeing with each other. Moreover, it became clear that the cities are not very ready for them. Deputy Head of Rospotrebnadzor Vyacheslav Smolensky explicitly stated that in conditions of intensive passenger traffic of modern cities, infections and viruses can spread at lightning speed, and a basic urban need in case of epidemics is a coherent system for detecting and responding to threats.

In turn, the president of Doctors Without Borders. Netherlands” Marit van Lente stressed the importance of pre-development of scenarios in case of an epidemic and informing citizens. In her opinion, the main thing in a critical situation in the city is to maintain trust between the fighters against the epidemic and possible victims. Hundreds of profile officials were present on the stages and in the halls of the forum, the statements of the speakers were widely broadcast. Six months later, the pandemic covered both Moscow and the whole world, and the absence of the mentioned scenarios and the lack of trust became the main reasons for the unpreparedness for it.

The current crisis is an opportunity to understand that the well-functioning of the health care system in a daily format does not at all guarantee its effectiveness in case of an emergency. The rapidly growing volume of calls, the lack of protective equipment and inaccurate compliance with instructions break any processes built for ordinary life in a few weeks.

In times of peace, hospitals are designed to provide the best possible patient experience while maintaining sound budget and management. Any hospital under construction should ideally provide self-sufficiency and, in the long run, a return on investment. However, making the medical complex ready for a pandemic already at the start with the same project budget means lowering the quality of the everyday experience of patients and doctors, which can hardly be called a popular solution in the absence of a clear threat. It is much more appropriate to talk about ready-made scenarios for refurbishing spaces.

At the same time, in Moscow, it was as if they had not heard about this practice – during these difficult weeks, the cycling track in Krylatskoye, the Tekstilshchiki racing arena, indoor tennis courts in Luzhniki are empty. Moreover, even the infectious diseases hospital in Pechatniki, converted in 2015 into a warehouse, could receive patients in case of emergency, but does not. While the choice is not obvious, the decision to build an infectious disease hospital in New Moscow looks like a spontaneous one, based on the Chinese project in Wuhan, and working only with a specific management model and budget.

Such a decision not only creates a real infrastructure for responding to the epidemic, but also spins the informational narrative of the fight against the virus. Replicating this experience looks difficult, but by the beginning of April, 16 regions had already announced the construction of such centers. Due to a shortage of equipment or people, the Ministry of Defense is engaged in construction, all work is tentatively estimated at 88 billion rubles. We are not talking about “architectural excesses”, and in urban planning everything is limited to compliance with sanitary standards – hospital projects are modular, typical, their service life is estimated at 20 years. How they will fit into the city or regional health care system is not clear, apparently, to anyone yet. While hospitals are being built, thousands of patients with suspected coronavirus infection are turning to doctors, hundreds of them have the diagnosis confirmed. There is no talk yet about the intentions to convert any of the stadiums or concert halls into a temporary hospital.

At the same time, urban planning decisions are not required when there is a previously worked out plan of action, effective management and the possibility of strict control by the state. South Korea showed an example of a quick and effective response. After the discovery of the first case in the country in January, a pre-developed system of rapid and mass testing was launched. To avoid new infections, the test could be taken free of charge, without leaving the car, in the open air. Thus, even in queues, the risk of infection transmission was completely eliminated.

In South Korea, protective masks have always been a popular preventive measure and have not disappeared from sale – but after the outbreak of the epidemic, they began to be sold two pieces a week to one person, under a strict accounting system. The video surveillance system also became an important tool – information about the movements of potentially infected citizens and their contacts was collected in a single center, then forced isolation took place.

But in the United States, the scale of measures in the field of urban infrastructure turned out to be enormous: this includes the construction of medical centers for testing and treatment, and the acquisition by the state of hotels and inns to expand medical facilities and accommodate convalescent patients, the replacement of air conditioning, ventilation and heating systems in temporarily empty commercial buildings and schools to convert them into treatment centers. This also includes the construction of hostels for patients undergoing treatment, the creation of emergency shelters with everything necessary for life. In parallel, each city received the right to promptly allocate funds to help pay rent and pay utility bills, as well as to provide temporary housing for all categories of citizens. They are trying to make up for lost time with huge injections into the tools to support life in isolation and a stopped economy.

As in Athens before the beginning of our era, so now, all over the world, the epidemic is transforming the familiar, erasing the boundaries of what is permissible, while simultaneously launching large-scale construction projects and adjusting urban infrastructure. In the current situation, when all measures are aimed at reducing the number of human contacts, the idea of ​​​​a sharp decrease in density, the relocation of residents of megacities to individual houses outside the city, has become popular again. However, as noted by the famous sociologist, professor emeritus of several universities, Richard Sennett, this situation creates a paradox:

It can be argued with a high degree of confidence that the course towards reducing the occurrence of non-communicable and mental diseases in cities will continue, while the attitude towards the risk of another pandemic will definitely become more serious. How will this affect urban development and governance policies?

There are three main vectors:

The social environment will also change. In the system of values ​​of urban life, the opportunity not to expose health to destructive stresses in the form of air pollution, noise and social inequality will come to the fore.

The city authorities will start developing rapid response scenarios and transforming infrastructure to meet situational needs. Global cities of the post-pandemic era will compete for people, presenting their plans and strategies for situations of future cataclysms that will inevitably await us.

At the same time, at any time, the most important element of the systemic fight against the pandemic will still be people’s trust in the government, which, unlike the hospital’s infectious diseases building, takes much more than a month to build.

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