Are cities a safe place to live during a pandemic?

In the spring, when thousands of people fell ill from the coronavirus, bodies began to pile up in one of the densest urban centers in the country: New York City.

The news headlines rolled like a constant drumming of doom. The region became known as the epicenter of the pandemic. Economists predicted that the city’s recovery would take years. Some New Yorkers began to move, “fleeing” to the suburbs.

Government leaders, including Governor Andrew M. Cuomo, blamed the city’s population density for driving the spread of the virus. And it soon appeared that large cities, especially those that relied heavily on crowded public transportation, were inherently some of the most dangerous places to live during a pandemic.

“Those outbreaks started and spread in those cities because, as major international travel hubs, those were the places where cases came to this country,” said Janet Baseman, an epidemiologist at the University of Washington School of Public Health. in Seattle.

But now, coronavirus cases are on the rise across much of the United States. In recent months, the pandemic has increased in some of the least densely populated states, such as Alaska, the Dakotas, Nebraska, and Wyoming. Suburbs like Westchester County, New York, and small towns like Dewey, South Dakota, now have more cases per capita than New York City.

“During a pandemic, there really are no safe places,” said Kim Weeden, a sociology professor and director of the Cornell University Center for the Study of Inequality in Ithaca, New York.

So is it still correct to assume that living in a city is riskier when faced with a highly contagious respiratory virus? We asked seven public health experts.

More space, but fewer resources.

During a pandemic, regions with fewer people and more space, such as suburbs and rural areas, can offer more space to isolate yourself from others, which can help you avoid getting sick. A more spacious home can also help preserve your mental health during confinement, especially if you are quarantined with the family, said Sandra Albrecht, assistant professor of epidemiology at Columbia University Mailman School of Public Health in New York City. York and the main epidemiologist behind “Dear Pandemic”, a scientific communication initiative on social networks.

But while less populated areas may have more space, they may also lack critical resources.

“It’s not hard to find rural areas where the closest hospital with testing capacity is more than 100 miles away,” said Tracy H. Loh, fellow at the Brookings Institution and an expert on urban and regional planning.

In editorials published in the spring on the Brookings website and in NextCity, a nonprofit news organization, Loh and his co-authors have argued that some of the same traits that can make cities more dangerous during a pandemic, Like population density, they can also make it more advantageous if a pandemic occurs.

Urban areas and populated cities can offer larger safety nets than rural regions, Loh said. New York City, for example, has abundant hospitals, specialists, equipment and resources for coronavirus testing.

Cities also tend to offer a greater variety of social support services, said Jenifer E. Allsworth, an epidemiologist at the University of Missouri-Kansas City, which includes several child care and public transportation options. (So ​​far, public transportation does not appear to contribute significantly to the spread of the coronavirus, as long as there is adequate ventilation and passengers wear masks.) And cities tend to have more delivery options for all kinds of items, including food, medicine and the home. supplies.

It’s also easier for small businesses like restaurants to use delivery services to stay afloat when there are more leads per square mile – a boon to city residents who own or depend on those businesses. And cities tend to have more job opportunities than rural areas, Loh said.

“Urban areas are more resilient because they have more diversified economies,” he added.

How you (and your community) behave is more important than where you live.

In the end, all the experts agreed that when it comes to reducing the risk of getting sick, behavior is more important than location.

“This virus is relentless and will haunt anyone who ignores social distancing practices,” said Dr. Lee W. Riley, professor of infectious diseases at the School of Public Health at the University of California, Berkeley. “So it is not necessarily the type of space where people live, but the type of behavior that people have in their spaces that ultimately determines who gets infected.”

New York City was able to combat the virus in the late spring and summer months by enforcing critical public health measures such as closing non-essential businesses, adopting the use of masks and encouraging social distancing. Other areas that did not take such precautions, such as parts of the South and the upper Midwest, saw large increases.

Generally speaking, people in cities may have more incentive to follow public health guidelines because they are often surrounded by strangers who may or may not take proper precautions, said Dr. Michael Mina, assistant professor of epidemiology at the School. TH Chan from Harvard. of Public Health.

Mina, who lives on a quiet street in Boston, said her city right now “is as safe or safer than anywhere in rural America,” though she added that this has the potential to change if the community doesn’t take measures to suppress the virus.

He is grateful that his house has a small backyard. But, like many of us, he often yearns for even more freedom to move without a mask.

“I think if I had the opportunity, it would be very nice to live in a place where there is a lot more space,” he said.

The best possible environment to cope with a pandemic can vary for each person, experts said. Ideally, it is a place where you can protect yourself and others from the coronavirus while maintaining your income and preserving your mental and emotional health.

However, being able to choose where you live or how you self-quarantine is a huge privilege.

Many residents in parts of Queens, where thousands fell ill earlier this year, held service jobs that did not allow them to work remotely and lived in tight, cramped places with family, friends or roommates.

Those with more money, autonomy and job flexibility can more easily reduce their risk of infection and live more comfortably in isolation, Allsworth said, regardless of whether they are in a rural, suburban or urban setting.

After the long, dark winter is through and cases eventually begin to decline, those who left the cities may find that living in a suburban or rural setting has lost much of its former appeal.

“Many will return to cities or remain in cities once they feel protected by the vaccine, because of all the amenities and social activities that cities have to offer,” Riley said.

As for Albrecht, she stays in New York City.

“While I understand why people left during the confinement, a large part of what keeps me here is the idea that once all of this is over, the city, with all its energy and vitality, is where I would like to be.” , said.

All personal preferences aside, experts said the best course of action right now is to just duck, wherever you are.

“COVID is so widespread across much of the US Now the safest place to be is at home with members of your household,” said Baseman, “whether that home is in the city or in the mountains. “.

© The New York Times Company