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The Geography of COVID-19

· 11 min read
The Geography of COVID-19
Steam surrounds people and traffic around Times Square intersection in the snow night at Midtown Manhattan New York City NY USA on Jan. 18 2020. Toshi Sasaki / Alamy Stock Photo

The ongoing pandemic is reshaping the geography of our planet, helping some areas and hurting others. In the West, the clear winners have been the sprawling suburbs and exurbs, while dense cores have been dealt a powerful blow. The pandemic also has accelerated class differences and inequality, with poor and working class people around the world paying the dearest price. These conclusions are based on data we have repeatedly updated. Despite some variations, our earlier conclusions hold up: the virus wreaked the most havoc in areas of high urban density. This first became evident in the alarming pre-lockdown fatalities that occurred in New York City and the suburban commuting shed from which many of the employees in the huge Manhattan business district are drawn. Similar patterns have been seen in Europe and Asia as well.

The problem is not density per se but rather the severe overcrowding associated with poverty in high density areas. Overcrowded physical proximity often includes insufficiently ventilated spaces such as crowded public transit, elevators, and employment locations, especially high-rise buildings, which often have windows that cannot be opened. Overcrowded bars, restaurants, and other retail establishments are also a part of the problem. Professor Shlomo Angel head of the New York University Urban Expansion Project at the Marron Institute and the NYU Stern Urbanization Project and principal author of A Planet of Cities and the Atlas of Urban Expansion explains:

It is important to increase density literacy among politicians, professionals, and activists to make it clear that the density that contributed to the pandemic, overcrowded multigenerational housing, mass events, crowded transit cars, or crowded bars and restaurants, is not the kind of density we need to increase to make cities more affordable and to combat climate change. The densification we need involves making room in cities, adding floor space so that more people can occupy the same area without overcrowding.1

Mixed evidence on lockdowns

Overcrowding intensifies exposure density. Recognizing this, governments imposed lockdowns and social distancing measures intended to reduce crowding and viral transmission. But lockdowns can be effective in some situations and not in others. Social distancing and remote work can readily reduce the exposure density of overcrowded trains, workplaces, elevators, and retail establishments, especially in the densest urban cores. Restaurants and bars were forced to close, and as many employers switched to remote working, fatality rates dropped substantially.

But this approach has exacted a steep cost. In New York, San Francisco, Chicago, and Toronto, suburban rail ridership declined by between 75 and 90 percent compared to the previous year. There has been a precipitous decline in the economies of the central business districts (CBDs) of these metropolitan areas, which have suffered economically more than most of their smaller counterparts. City Journal has reported that, in 2020, “New York City lost 500,000 private-sector jobs. Its office buildings are only 15 percent occupied. Ninety percent of the city’s restaurants failed to pay their December 2020 rent, and 5,000 have shut down altogether. Employment in the city’s arts and entertainment sector has plummeted 66 percent. And, perhaps most alarming: 300,000 New Yorkers from high-income neighborhoods have filed change-of-address forms with the Postal Service.” Rents are now the lowest in a decade.

Much of the employment activity central to modern cities—finance, marketing, technology, media, consulting—has been transferred to the “cloud model” of employment. Even in places like Hong Kong and Tokyo that have avoided the worst of the pandemic, there has been a significant reduction in CBD on-site work as remote work has increased. An ominous sign for the future: considerable evidence that productivity has improved or at least remained the same.

Nevertheless, social distancing and dispersion have proven successful in containing the spread of the virus. Our analysis of county fatality rate data shows that, in April 2020, the fatality rate in the New York combined statistical area (31 economically connected counties) was seven times the national rate. By July 2020, the CSA rate had fallen below the national rate. But the price was empty streets, sidewalks, office buildings, as well as bars and restaurants all essential to maintaining a dynamic city.

The future of cities

How many workers will return to the CBDs remains an open question, but it seems likely to be many fewer than before the pandemic. Even as we write, new lockdown measures are being implemented in Ontario, and it seems fair to ask when lockdowns will be sufficiently relaxed for urban cores to begin operating at their new normal. Downtowns have recovered far less quickly than suburban, exurban, and small towns. City centers in London, Paris, Berlin, Melbourne, Sydney, Milan, and elsewhere have suffered huge physical employment losses and increases in remote work.

Between September 2019 and September 2020, nearly 10 percent of jobs were lost in big cities, according to federal data analyzed by the American Communities firm, while rural areas suffered losses of six percent and exurbs of less than five percent. The largest increase in net migration of tech workers last year, according to a study by Big Technology, went to Madison, Wisconsin. At the same time, Seattle and Austin added tech workers at faster rates while cities like San Francisco Bay Area, New York, and Boston saw a net fall in migration.

A similar pattern can be observed in Australia as the economy, and particularly the suburban property market, soars and employment recovers. Consumer confidence, job growth, and production are returning, even though the central cores of its largest cities remain largely abandoned, and certainly down-sized. So, a reduction in urban density combined with the shift to remote working seems likely to permit fairly normal operation of the economy.

Predictably, there’s already a cottage industry that denies any connection between density, overcrowding, and rates of infections and fatalities. Some organizations, like the Chicago Council of Global Trade, still insist that whenever the pandemic ends, the luxury city will rebound in all its glory. But this seems unlikely and possibly even delusional.

A growing class divide

Yet, some of the densest neighborhoods in Manhattan, San Francisco, and Los Angeles have suffered markedly lower rates of infections and fatalities than the surrounding, equally dense neighborhoods populated by poorer families, who often live in crowded housing and rely more on transit for their mobility. In Manhattan, where households are wealthier and smaller, upper earners were far more likely to stay at home and access online services than workers in poorer boroughs. Many residents simply moved away which resulted in the partial evacuation of the city’s elite neighborhoods. For example, the four southernmost postal codes of New York’s affluent Upper West Side lost between just under four percent and just under five percent of their population to the 2020 COVID exodus.

In contrast, fatality and hospitalization rates were higher in places like East New York, Brownsville, Flushing, and the Bronx. These residents suffered the greatest exposure density—the greatest transit crowding, the longest rides, and the most crowded homes and streets. As of April 27th, 2021, the death rate in poor and overwhelmingly minority Brownsville was two-and-a-half times that of Yorkville on the affluent Upper East Side, New York City’s highest density postal code (10028).

In America’s second largest metropolitan area, Los Angeles, the geographic differences are, if anything, starker. Our analysis through April 30th shows that although Los Angeles had a fatality rate one-third lower than that of the New York metropolitan area, the region’s poorer communities suffered a dreadful death toll in part due to some of the nation’s most crowded housing. Los Angeles has an overcrowding rate of 10.7 percent, according to the American Community Survey (US Census Bureau) data, the highest in the nation.

COVID has been far less prevalent in the more affluent areas populated by non-Hispanic whites and in the more professionally based west side. In the areas that cling to the coast or the Santa Monica mountains, housing overcrowding and fatality rates are a fraction of those in the poorer neighborhoods. According to Los Angeles County Department of Public Health data, the fatality rates in south central Los Angeles (such as the Florence-Firestone unincorporated area) are 10 times or more those in the most affluent Westside neighborhoods (Mandeville Canyon and Bel Air).

Poverty and inequality

By exposing the fragility of high urban density and its related overcrowding factors, the pandemic has burst the notion that cities are the cure for poverty and inequality. Oxfam has described COVID-19 as “the inequality virus” because the billionaire class has become richer, and inequality has widened in virtually all countries. Most of the economists the charity surveyed in 79 countries expect the situation to get worse. Regrettably, social distancing measures do not address two fundamental problems tied to COVID: overcrowded housing and the inability to work remotely. There is no short-term solution to this problem without reducing or eliminating deprivation, a goal that continues to be elusive in the United States more than a half-century after the “War on Poverty.”

Overcrowded housing is one of the greatest maladies of poverty. Given that in many US core cities, affordable housing programs may not even accept new applications or have years-long waiting lists, there is no reason to believe that this is a problem that can be solved quickly. Moreover, the shortage of affordable housing for low-income families has become worse of late, as land use regulations have become stricter, raising the cost of market-produced housing even further out of reach, increasing the households eligible for government assistance.

So, lockdowns and remote work cannot offer much respite to the poorer precincts of dense urbanization. The lockdowns have pummeled low-income workers over the past year in the US. The top 25 percent of earners suffered negligible job losses while nearly 30 percent of workers in the bottom quartile suffered major losses. Similarly, divergences can be seen in countries like Canada with strong social safety nets. Martin Kulldorff, a professor at Harvard Medical School, summarized the impact: “Lockdowns have protected the laptop class of young low-risk journalists, scientists, teachers, politicians and lawyers, while throwing children, the working class and high-risk older people under the bus.”

A broader health emergency

COVID has also revealed related health crises, even in wealthy countries. Often tied to poverty, maladies like obesity, diabetes, and other ailments have accounted for a large portion of deaths. In the United States, the severely obese are far more likely than average to die from COVID and 33 percent more likely to be hospitalized according to CDC research. One study found that 90 percent of worldwide COVID-19 deaths occurred in countries with high obesity rates. The US ranks No. 12 in obesity worldwide, one of the highest rates among developed countries.

A large proportion of those hospitalized or killed by COVID-19 have suffered from “co-morbidity factors” such as diabetes, heart conditions, and drug abuse. Not all the victims are adults. Children have been far less vulnerable to the ravages of the disease itself, but their prospects have declined, too. UNICEF predicts that child poverty has grown by 15 percent while hundreds of millions, many of them from illiterate families, have been kept from school. Between six and seven million malnourished children will remain highly vulnerable to disease not only due to a lack of vaccines, but also a dearth of basic sanitation, including hot water for handwashing. UNICEF noted that as many as one-in-seven children forced to stay at home have suffered “feelings of anxiety, depression and isolation.”

A longer-term problem may be a decline in academic achievement, particularly among students attending poor and inner-city schools in the US. Brookings has concluded that schools posed a minimal risk of transmission but that re-openings were delayed for reasons “more linked to politics than public health.” The closures were more prevalent in inner-city districts with powerful teachers’ unions, so while more white kids went back, minority students, who often need the instruction and lack strong home environments, often had no options. Half of non-Hispanic white kids this spring were back in school compared to just 33 percent of Latino children and only 28 percent of blacks. Meanwhile, nearly all private schools remained open and have attracted students from the public system. This is another example, as the authors of an essay at Tablet suggest, of how “elites bought their way out of pandemic restrictions.”

The developing world

This pattern of increased inequality and disproportionate effects will be felt most strongly in the developing world. Overall, notes Pew, COVID has reversed the steady growth of the global middle class, decreasing by 150 million those earning middle-class incomes while increasing the ranks of the poor by roughly the same amount. The pandemic may only now be entering its early stages in developing countries with new infection rates exceeding 300,000 in late April. India is now hardest hit. The crisis is exacerbated by shortages of hospital beds, oxygen, ventilators, and other medical supplies. The scale of the problem may be even greater, as there are estimates that about 80 percent of fatalities are not recorded.

This divergence between rich and poor countries was already troublesome but it appears to be widening as a result of the pandemic. Vaccination rates have remained low across much of the developing world—only 0.2 percent of the 700 million vaccinations to date have been administered in poor countries. Whole parts of the world could suffer further isolation from their prime sources of customers, tourists, and capital. In some countries, vaccinations are only available to a small sub-set of the population. Just one percent of African adults have received their first jab, compared to a global average of 13 percent. Scant supply is the biggest problem, but not the only one.

COVID-19 and the geographic future

COVID will reshape how we live. Some areas of the globe, like south Asia, may remain essentially quarantined from the rest of the world. Even in wealthy countries such as France, vaccine skepticism could leave populations stuck behind the COVID curtain longer than necessary. Seventy percent of Americans, according to Pew, intend to be vaccinated but there may be pockets of refusal, notably in rural and working-class areas.

Perhaps most disturbing of all, these disparate impacts may persist as, historically, pandemics tend to follow one after the other. Urban crowding and pervasive poverty—particularly in the developing world, and the great cities of Asia, Africa, and the Middle East—remain ideal breeding grounds for pestilence, which can then find their way to higher income countries, just as Laurie Garrett predicted over three decades ago.

Plagues won’t kill off cities or end civilizations, but they could change their demographics, and discourage overly dense urbanization. Concerns about sanitation, overcrowding, and developing better healthcare delivery systems need to become priorities in developing and developed countries alike. History shows that pandemics leave lasting imprints that are capable of reversing urban growth for centuries. It took Paris, for example, 200 years to recover the population it lost to the plague years of the 14th century. The health problems associated with extremely high densities in cities like New York, especially the Lower East Side, led to policies and personal behaviors that dispersed the population from the early-to-late 20th century. According to US Census Bureau data, the population of Manhattan dropped from 2.33 million in 1910 to 1.42 million in 1980. By 2019, it had recovered only 200,000 of the more than 900,000 (little more than 20 percent) lost between 1910 and 1980.

This pattern may be repeating itself. The New York Times has reported that New York City lost 420,000 residents during the first two months of the pandemic. The city may have lost as many residents as it gained over the past half-century while London’s population has dropped by a reported 700,000 since 2019. So are dense urban cores doomed? Not at all, but high-density overcrowding will surely become less appealing. Instead, we will need to accept greater dispersion and hopefully greater emphasis on health as we try to address the vast and fundamentally unsustainable class chasm.

The geographies that will emerge from the COVID pandemic must be more capable of maintaining health standards and allowing for more work in remote or simply less crowded settings. Urbanity will survive but the great shift will be to those geographies better suited to meet the health challenges and seize technological opportunities that will define our era.

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