After COVID-19: (Re)Building Resilient Cities

By: Carly Berke

On Thursday, April 30th, 2020, the Boston University School of Public Health (SPH) and the Initiative on Cities (IOC) co-hosted After COVID-19: (Re)Building Resilient Cities, a webinar exploring the role cities play in supporting public health during COVID-19 and as we start to emerge from the pandemic. This seminar is one of several from SPH’s ongoing Coronavirus Seminar Series, and Sandro Galea, Dean and Robert A. Knox Professor in the School of Public Health, moderated a panel of speakers who provided context for the pandemic through the lens of contemporary public health issues. Galea was joined by Jennifer Keesmaat, CEO of The Keesmaat Group and former Chief Planner of Toronto, Katie Swenson, Senior Principal at Mass Design Group, Joan Saba, Partner at NBBJ, and the IOC’s own Katharine Lusk, Co-Director of the Initiative on Cities.

The panelists each approached public health in cities from different perspectives, including architecture, city planning, and communication strategies. The common thread that emerged from the discussion is the remarkable human element of this pandemic and the humanity that must be maintained in cities’ responses. They each emphasized the importance of prioritizing people as we move forward to build more resilient cities.

Keesmaat, CEO of The Keesmaat Group, kicked off the panel by providing context for the health implications surrounding three stages of the pandemic: our current stage, in which most urban residents are practicing social distancing, working from home, and in isolation; the “after-now” phase, a transition period from our current state to a new world changed by coronavirus; and the “post-COVID” stage, when we have a vaccine available but our new “normal” does not necessarily resemble what the world looked like prior to the COVID-19 outbreak.

In the current moment, as Keesmaat explained, cities are characterized by social distancing, unemployment, and isolation, meaning public spaces and infrastructure are underutilized. Streets are empty, public transit is under capacity, and commuting has all but disappeared. Cities’ responses in this context will define how we build our cities moving forward and how we prepare as a community to battle public health crises. Good city planning and governance right now requires a keen attention to health, which Keesmaat says should focus on adaptation. Instant infrastructure, like addressing sidewalks at overcapacity and roads under capacity, means adapting and transforming how we use city infrastructure in our neighborhoods and in cities overall. Public health should be put at the forefront of how we use public spaces in cities and how we think about city planning.

She also emphasized the role that trust plays in cultivating healthy city environments, a theme that was later reiterated by other panelists. 

“The ‘Now’ has been characterized very much by fear,” said Keesmaat. “But cities have always been designed based on trust. Democracy is designed based on trust and on an assumption that the majority of actors will act based on the public good. I would argue that in the ‘now’, we need to take trust as a driving approach to improvement of instant infrastructure.”

The second stage, which Keesmaat calls the “after-now”, will be characterized by incremental changes, like a persistent emphasis on physical distancing and the adaptation of our streets and parks. This period is critical for positioning ourselves to succeed in cultivating a positive culture in cities moving forward from COVID-19 and ensuring infrastructure empowers and uplifts our communities. This in-between stage will mean recognizing we can take a more nuanced approach to how we respond to the virus and about developing multiple societal objectives, like ensuring main street retail and restaurants can survive, prioritizing walkable amenities, and reducing lanes of traffic along main streets.

Lastly, in the “post-COVID” era, in which a vaccine exists and we are no longer enforcing strict social distancing measures, we have to think more broadly about healthy city objectives, which we can develop from lessons we learned in quarantine. This means reinforcing the “15 minute neighborhood”, in which everything is accessible by walking or biking, and mitigating risk on public transit and recalibrating how we approach commutes and traveling. Finally, Keesmaat urged city leaders to use this opportunity to embrace decarbonization and fully push cities in a cleaner, healthier direction, now that we have seen what cities can look like and feel like without oppressive air pollution.

Katie Swenson, Senior Principal at MASS Design Group, discussed her work with MASS Design Group and her life’s mission of using design and architecture to advance social equity and support affordable housing and community development. MASS Design Group has worked on projects around the world that focus on using design to promote health, justice, and human dignity, and some of the work they have done includes interpreting design to minimize the risk of transmittance or water contamination in treatment centers for diseases like cholera, ebola, and tuberculosis.

Swensen emphasized that she hopes we emerge from COVID-19 with long-term spatial learning and a more widespread understanding of how the structures around us can empower and support us. Understanding spatial implications and learning how to apply best practices in urgent scenarios are some of the challenges with which Swenson and her team at MASS Design are currently grappling and working hard to solve. Design is fundamental to how we deliver health care; for instance, Swenson pointed out that temporary solutions currently used to treat COVID-19, like the makeshift tents that have emerged around New York City, actually help spread the disease based on their design. It is critically important that we learn from the challenges facing us now and question how our built environment can be designed to serve a greater purpose in protecting our health and wellbeing.

Swenson’s rules of thumb for limiting contagion in makeshift communities include learning from partners, understanding spatial implications, and applying best practices in urgent scenarios. She emphasized the need for spatial literacy, because hospital spaces are quickly and abruptly being evaluated and/or updated to protect healthcare workers as quickly as possible. One medical center that MASS Design has partnered, with whom they asked clinicians to do “heat maps” of each floor to identify hot, warm, and clean zones, brought Swenson and her team to realize that medical professionals have different interpretations of what was safe. She said this reflects a greater need to understand the strategies we can apply within building design to understand and mitigate risk. 

“We need to cultivate a closer connection to the spaces, places, and infrastructure around us. We have come to understand, without a shadow of a doubt, that our places and spaces affect our choices and behavior, and our health,” said Swenson. “Public spaces like buildings and transportation systems are not abstract concepts that need to be left to design professionals. We all need to demand more of our built environment. How are we going to design all buildings to make us healthier?”

Swenson touched on the importance of rethinking the concept of home and committing in urban planning to ensuring home is available to energy. Housing is imperative not only because it is a fundamental human right, but also because it is a public health necessity to ensure everyone has a safe and healthy place to live and return to, as quarantine has demonstrated. Swenson also reiterated Keesmaat’s point about encouraging trust in our people and in the built environment around us—and integrating the idea that what affects one of us affects all of us.

“I hope we won’t look at our cities with fear, but with a commonality of understanding,” said Swenson. “I hope we emerge from this pandemic stronger and that we seize this opportunity to solve seemingly unsolvable epidemics of the past—homelessness, environment, gun violence—we can do it if we set our mind to it.”

Joan Saba is a partner at NBBJ, a global architecture, planning, and design firm. She offered several takeaways from the COVID-19 pandemic and its effect on public health and public spaces, and she provided her perspective through the lens of a healthcare architect. Using design now, in a time when there is so much that cannot be controlled, means thinking about things like outdoor spaces and courtyards in hospitals, which can help visitors and patients feel more safe in an urban environment.

Saba argued that how we interpret and think about this experience will shape our design choices moving forward; when disaster strikes in cities, we have rebounded by learning how to build stronger hospitals and infrastructure. In this sense, design and public health have never been more important. 

Saba also emphasized the importance of prioritizing humanity in our approaches to public health, urban design, and cities. She explained that there is an opportunity in designing hospitals to recognize the basic need for human support. As a designer, she is thinking about the need to strengthen human connection in a tough environment like a hospital. “How can we think about spaces and design in a way that allows us to be human?” said Saba. “How can we enable a place where we feel we can have mutual resiliency and we can act on it?”

She closed with several different definitions of resiliency, all of which should be integral to city and hospital design moving forward. Human resilience means focusing on designs for frontline workers and for people and families fighting for their lives and empowering them through emotional support and safety. Material resilience means strategies to minimize waste in emergency medical clinics and facilities and using innovation in hospital design. Lastly, mutual resiliency is a sense of trust, in which we are relying on each other to be resilient, and how we act within our urban environments is our opportunity to support each other.

Katharine Lusk, Co-Director of the IOC, closed the panel by asking what we need now from cities and city leaders.

“The ‘Post-COVID City’ is a city in worse fiscal health than it was going into this crisis,” said Lusk. “Layoffs, furloughs, and service cuts are coming, and anything that cities do in the next five years or so will be with that financial restraint in mind.”

Lusk explored an area not often discussed in this context: confronting grief as a community. While the death numbers continue to climb, isolation and social distancing has kept us from grieving together as a community. Cities and city leaders must find ways to help their communities enter and persevere through a grieving phase. Lusk reflected on her own experience in Mayor Thomas Menino’s office in 2013, when the Boston Marathon bombing killed three and left hundreds injured. Lusk helped manage the public memorial that emerged in response to the event, where people left commemorative items to honor the victims.

“What I learned along the way is that public mourning, tribute-paying, and tokens of remembrances are all instinctive,” said Lusk. “They are things we do in the face of mass tragedy, and we have been deprived of the opportunity to do that while we’re all sheltered at home.” Lusk wants city leaders to use COVID-19 as an opportunity to help their cities become more compassionate and confront grief in every capacity beyond COVID-19, including gun violence. 

Aside from tackling grief and emotional resilience, Lusk also highlighted several other changes she hopes to see city leaders prioritize as we emerge from COVID-19. She reiterated the points made by Keesmaat about making space for people and challenging the status quo in urban planning, which includes widening sidewalks, adding bike and bus lanes, increasing transit frequency to reduce overcrowding, devoting more space to open air markets, and continuing select street closures, especially in neighborhoods at greater risk. She also urged city leaders to build resilience by investing in green infrastructure, investing in energy assistance and home energy audits to anticipate summer heat waves and cold snaps, and doubling down on decarbonization in buildings, transit, and municipal fleets. She picked up on previous points in the panel about living local and sustaining 15 minute neighborhoods, and she hopes employers will be recognized for formalizing work from home policies, staggering work hours, and investing in bike parking and EV charging, all of which are changes that City Hall can use to lead by example. Lusk made particular mention of the impact that COVID-19 and environmental factors like air pollution have on communities of color, who have always suffered disproportionately from poor air quality, and she expressed her hope that this crisis has generated a newfound political will to invest in clean air. 

Finally, Lusk encouraged city officials to continue working toward a healthy and open dialogue, which means surveying residents and health officials to understand both risk and anxiety and how we can redesign our streets and spaces to make them feel welcoming for all. Moreover, she emphasized that city officials can work hard to utilize strong communication strategies to inspire confidence in their city, particularly in communities that might not trust the government as much, don’t use social media frequently, or don’t speak English as their primary language.

“I hope that resilient cities of the future are where elected officials are focused, as they are today, on communicating frequently, regularly, with integrity, to all residents, meeting them where they are, and inspiring confidence that government is actually doing the right thing and working on their behalf and working to promote health and well-being of all residents.”

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