The myth of the urban plague

A costly error

On April 24, 2020, New York Times columnist Bret Stephens wrote a piece titled “America Shouldn’t Have to Play by New York Rules.”

You could imagine a good column with that headline since New York’s rules, at the time, were in fact too strict — playgrounds were closed for example — and America should not have played by those rules. But Stephens’ actual thesis was that New York City was at unique risk from Covid-19 due to its high population density, and less urbanized parts of the country (which is to say, all other parts of the country) needn’t feel so vulnerable.

If this was just a bad Bret Stephens take, then who cares? But the perception that the pandemic was a specifically urban problem was everywhere in the spring and summer of 2020. I remember this acutely because at the time I was wrapping up “One Billion Americans,” which was conceived and mostly written pre-pandemic, and a major source of editorial comments about my draft focused on the interplay between density and the pandemic. So while the city-Covid linkage was in part grounded in anti-urban bias and right-wing politics, it was also on the minds of liberal New Yorkers working in book publishing.

Looking back, I think we can now say pretty definitively that this was totally wrong. But it’s worth revisiting, not to dunk on Stephens, but because understanding the relationship between urbanization and pandemic can help make us more resilient in the future.

Low density didn’t save anyone

If you look at per-capita deaths in the United States, you still see New Jersey (the densest state) up there at number two and New York at number five. And it’s no big mystery why: the initial Covid outbreak hit New York City first, and the one thing that’s totally clear from global statistics is that you really, really did not want to be at one of the early epicenters of the outbreak.

The early outbreak cities like New York and Milan suffered from several problems.

Critically, best practices for Covid treatment were at that point unknown. And the disease spread widely with absolutely no mitigation measures in place, not just on a policy level but on an individual level. When I was in Kerrville, Texas this summer, masks weren’t mandatory anywhere, but I saw some people wearing them at HEB anyway — especially as news stories about Delta heated up.

The other high-ranking states are Mississippi (number one), Louisiana (three), and Alabama (four). These are basically just states with very low levels of vaccination. And if you look at a map of deaths per capita since June 2020, you see that it’s basically just conservative states, including incredibly rural ones like Arkansas and South Dakota.

Now maybe the residents of those states stand by their leaders’ policy choices, and maybe they don’t. But my suspicion is that some of the initial polarization of the Covid issue was driven by the assumption that people living in low-density areas had nothing to fear from the virus. And that was just wrong — these days, more people are dying in rural areas.

Sparse places have dense spaces

I think the basic fallacy at work here is that even in regions of the country that aren’t densely populated, people still spend their time mostly indoors. And the level of crowding in indoor spaces has basically nothing to do with population density.

A Starbucks in Kerrville is just the same as a Starbucks in suburban New Jersey and not particularly different from an urban Starbucks in New York or D.C. If a lot of people are in there drinking and eating and talking, then you have a lot of virus in the air. Low-density parts of the country have bars, restaurants, gyms, churches, and all kinds of other places where people gather and spread respiratory viruses.

Here is a map of the age-adjusted death rate for flu in 2019. I have no idea what, if anything, this correlates with, but it’s certainly not population density.

It’s also interestingly different from the Covid map, with Florida and Arizona having gotten off easy with the flu while they’ve been devastated by Covid. There’s no big politics to the flu, and it’s not totally clear what drives disparities in flu deaths (possibly dumb luck).

Three urban pandemic vulnerabilities

All that said, there really are three respects in which pandemics are an unusually tough problem for big cities.

One is that as we saw very clearly with Covid, getting hit early is really bad. And while being a big city doesn’t guarantee you’ll be hit early (Milan was, but Rome wasn’t; New York was, but Chicago wasn’t), it clearly elevates your risk. The problem isn’t the population density; it’s that tons of people from all around the world are flying into New York on any given day. In the modern world, when initial attempts to contain a new virus fail, it’s going to spread along major air routes, which means big cities rather than rural areas are at the highest risk of getting hit first.

Another is that contrary to the partisan politics of Covid, shutting down restaurants and entertainment venues — which are one of the raisons d’être of a modern city — is much more costly to cities. It puts tremendous pressure on the tax and employment base.

The third point is the inverse of the second. My family was lucky to be able to relocate from D.C. to coastal Maine for several months during the summer of 2020. It was nice not because Maine is inherently safer during a pandemic, but because the things that are nice about Maine are pretty pandemic safe. There’s not much of a point to living in a city if the offices are going to be closed and the restaurants and the museums are also going to be closed. But you can take a hike or nature walk, go out on a boat, or enjoy a scenic view in the countryside just fine.

So this is an issue going forward. If there are more pandemics, they will tend to hit big cities first. And non-pharmaceutical interventions will tend to disproportionately harm urban economies and disproportionately disrupt the urban quality of life.

At the same time, what we’ve seen during Covid is that it is incredibly dangerous — tons of people have died! — for people in rural and exurban areas to talk themselves into the idea that infectious diseases are a peculiarly urban malady rather than one that simply tends to hit cities first.

Density vs. crowding

Last but not least, because everything needs a zoning angle, it’s worth discussing the distinction between population density (a lot of people per square mile) and housing crowding (a lot of people per square foot).

I don’t think this has been a primary driver of Covid’s spread, but clearly, you are more likely to see intra-household spread of the virus when families are living in crowded conditions with less ability to isolate from one another. And it is certainly true that one way to generate high population density is with high levels of crowded housing. That’s something you often see in poor countries.

But the United States is not poor. In terms of pure hard construction costs, Americans can afford a lot of square feet. Crowding tends to happen in places where land is expensive and development is overregulated such that the actual price of housing soars far above what hard construction costs warrant. If you went berserk and upzoned the hell out of D.C., quadrupling the city’s built floor area ratio, the population almost certainly wouldn’t quadruple. It would go up. But people would also have bigger houses.

The Covid angle is far from the only reason for this, but I think urbanists and even some YIMBYs sometimes underrate the value of letting people have bigger houses. Bigger houses make it easier for people to start families. People also just like them, and they would make cities more attractive to live in. A lot of progress has been made recently in some jurisdictions on bills that legalize duplexes (or sometimes even higher-order plexes) without necessarily authorizing larger structures. I support those reforms; there’s no reason you shouldn’t be able to build two small units on a lot rather than one big one. But ultimately you should also be allowed to build two big units — or five — if you want to tackle the problem of overcrowded housing.