In fact, no correlation exists between population density and rates of COVID-19 infection, according to recent studies examining the disease in China and Chicago. But if state and local governments still conclude that density itself is a problem, they are more likely to promote suburban sprawl as a matter of law—instead of making the accommodations, in their housing stock and their streetscapes, that allow people to live in cities safely and move about them comfortably.
The policies that local governments adopt have profound effects on the health of their residents. While the nation’s densest city, New York, experienced a severe COVID-19 outbreak—more than 195,000 confirmed cases and more than 19,000 deaths to date—one must simply look at our nation’s second-densest city, San Francisco, to see a very different picture. San Francisco has so far experienced far fewer infections, with more than 2,000 confirmed cases and 36 deaths. While comparing confirmed-case rates is somewhat challenging because of disparate testing levels, the comparative death rates are revealing. Though New York City has approximately 10 times as many people as San Francisco, the former has suffered more than 500 times the deaths.
Fred Milgrim: A New York doctor’s warning
One difference between New York City and San Francisco? The Bay Area responded to the pandemic earlier and more decisively than New York did, imposing social-distancing measures before major cities on the East Coast.
San Francisco is not alone. Some of the world’s most densely populated cities—for example, Taipei, Hong Kong, and Seoul—have been much more successful than other less dense, more sprawling cities in containing the virus. To be clear, these cities are still struggling to contain the coronavirus. But they’ve taken firm, science-based steps to stop it from cascading into disaster and have seen positive results.
In California, we’ve also heard significant discussion of the relationship between crowded housing and COVID-19 infections. Crowding within homes is, indeed, bad for public health. Callous social policy and economic inequity—typically along racial lines—have forced many low-income people to live in crowded households. But density and crowding are different things. Crowding is what happens when, because of a lack of sufficient housing, families and roommates are forced into tight quarters designed for a smaller number of inhabitants. That crowding can increase the spread of a contagion. Density in cities—where people can live in uncrowded homes near neighbors, services, and commercial corridors—doesn’t.
To blame density for the devastation caused by the coronavirus is to ignore all the factors that really determine how badly communities suffer in crises such as the present one. Cities large and small that responded in a timely, effective, and firm manner appear to have fared better than those that responded more slowly or without a coordinated effort. A significant determinant of a community’s exposure to COVID-19, regardless of that community’s size and density, is the government’s responsiveness—or lack thereof—to its basic needs. Adding to this disparity is our nation’s pernicious legacy of racism, segregation, and willful neglect of the fundamental health needs of communities of color and low-income communities. We are sadly seeing these same patterns show up in full force during the pandemic.