“Sara Jensen Carr: On Epidemics” – Open House New York

G = Greg Wessner; S = Sara Jensen Carr; Q = listener question

 

  • Gregory Wessner, the executive director of Open House New York, introduced the launch of the Conversations on the City series. This is their first ever webinar and though he can’t see us he’s going to pretend that he’s talking to all of us at West 26th street.
  • Regarding articles bemoaning whether New York will persist after COVID-19: “ I have no patience for these articles. Certainly cities will continue. Certainly New York City will continue. Literally, for millennia, cities have had to contend with public health threats…. There is no doubt in my mind that we will get through this current situation.”
  • Greg calls out and thanks staff members by name.
  • “I can’t hear the speaker,” someone says through the comment function.
  • Sara has been working on this book for many years. The origins of the book were actually in another disaster. She lived in New Orleans for nine years, working at an architecture firm, doing projects in the health care sector in evidence-based design. Questioning: how can the design of these health care spaces help healing for different ailments? She lived there during Hurricane Katrina, and came back six weeks after the hurricane. The city was “mostly hollowed out.” She took a lot of time to just walk around the city. Thinking: “How could [her work in the health sector] be applied to the public realm?” “What elements of the public realm and the landscape could help healing in the wake of a disaster?”
  • Her dissertation was about walkability, looking at the history of health in the built environment, folding walkability back into urban development, in relationship to public health issues such as obesity and climate change. “The book is a chronicle of that starting with the industrial revolution: the relation of cholera, yellow fever and street design.” Urban nature; Germ theory; relationship of tuberculosis and modernism. Adoption of Modernist prototypes into public housing. Urban crisis in the 60s and 70s, urban blight, which is not a disease per se but is conceptualized as such. Car-centric development and relationship to obesity epidemic and climate change. After this pandemic, that will be one of the main threats to human kind (climate change).
  • “Infectious diseases, like COVID-19, travel in vectors: the triangle of agent, host, environment.” “Etiology is quite linear.”
  • Infectious diseases tend to root in our minds much more easily” [than something like climate change] (I think is what she means). Quotes epidemiologist Nancy Krieger: “spiderless web of causation.”
  • Social determinants of health: race, economy.
  • “It took me by surprise, but there are many recurring patterns, as the ones in my book.”
  • G: What are some examples in the book of particular cities that went through public health crises? How did urban designers/ architects respond?
  • S: Influx of people coming from rural areas and overseas in cities, seeking housing, led to dangerous settlements. “Without a coordinated municipal and waste-management response” rose what were called “filth diseases”: cholera and yellow fever.
    • Detailed reports of NYC streets: account of bones of dead rats, plates, mixed in with brick and mortar (this was a fun one to read she said).
  • George E. Waring, Jr., NYC’s first sanitation commissioner, took a lot of cues from London: the famous cholera water map. (Later in the lecture — seems like we’ve still got cues to take from London re: contactless subway swiping.)
  • Lots of academic people knew how “filth diseases” really originated, but general people were still worried about miasma.
  • Waring moved to move waste and waste water underground so “bad airs” would not come up from stagnant water. That was a major infrastructural movement across multiple cities. A lot of cities still have that original infrastructure today.
  • Also looked at Hausmann’s grand boulevards. Not only helped with conveyance of waste water but, historian William Bennet (?) alleges, streets worked as ways to circulate fresh air within city as well.
  • “Our street design is a confluence of many schools of thought from urban design to medicine to engineering”
  • G: OHNY did a yearlong program a couple years ago on NYC’s sanitation. 0 by 30 waste initiative. Robin Nagle: Picking up. The NY we have today would not and could not exist if those things didn’t happen in the nineteenth century.
  • Blind spots: solutions end up contributing to other problems.
  • S: “Any kind of large urban initiative is going to include a degree of displacement. Most of the time, it’s going to displace the poor and vulnerable, which is ironic, because those are the people that are most vulnerable in the first place.”
  • S: “If you think about the suburb as a response to fears of the city… and the [influenced by the idea of the] moral influence of rural life… [then] the suburbs are the template for… a major health crisis. People wanting their own patch of fresh air and light and green space.” [Comparing the flight to suburbs — environmentally damaging — to those fleeing urban areas now, which is terrible for the pandemic].
  • G: Late nineteenth century: poor and immigrant communities served inadequately as well by urban architecture
  • S: While we talk about the positives of density in cites, it’s actually inaccessible to a great deal of people because though it is walkable, it is not affordable.
  • S: We have to confront a more nuanced conversation about density. People right now are leaving the city to go to vacation homes; we saw the same thing at the end of the nineteenth century with the onset of respiratory diseases.
  • Walking around in green spaces is one of the only forms of safe participatory activity right now. So we need to not only build more of these green spaces but also distribute them equitably. This is the discussion now and what I hope stays in the back of our minds because what’s happened before is clearing out neighborhoods that are seen as disease clusters and conflating disease-ridden areas with bad personal habits.
  • G: We celebrate density because it’s density that makes cities great and lively and great places to live. But it also makes them susceptible to infectious disease. I was wondering, what’s your thought about the question of density and how do you manage density in ways that are safe for the public?
  • “First off, I’m not an epidemiologist, I’m an architect.” [everyone laughs.]
  • S: But also thinking about all the things that have changed since the industrial revolution. There will be a vaccine at some point. Some of the most pressing health issues have been surmounted by technology in some ways, e.g. waste management. The vectors of infectious disease will be overcome at some point. It’s also in some ways where the best health care is. That said, we’re already seeing, in the media, the demonization of density.
  • “I mean, density can mean anything — there’s FAR, there’s housing units, and there’s actual crowding.”
  • “What we have to be aware of, as urbanists, is after a decade of valorizing density for its health benefits, we should be thinking about [the way that actually plays out:] it can be impossible to quarantine from family, especially workers who have to be on the front line now: health care workers, grocery workers… many of whom were already living in extremely susceptible conditions.”
  • S: “Let me put this bluntly: the built environment is not going to fix any failures in our healthcare system.” The most problematic developments have been where they are not working with public health officials. Hopefully the thinking returns to deciding appropriately where urbanists and architects are experts, and when they should work with public health experts.
  • Q: Public transit and epidemics and public transit
  • S: The development of streetcars. Olmsted’s design of Riverside, Illinois: you would see the sequence of leaving the city and moving into the healthy suburbs. It’ll be interesting to see what people work on when this is over. I hope this will spark some overhaul of our mass transit system.
  • S: In London, you don’t have to touch anything, whereas in New York you have to touch five different surfaces to get on the subway.
  • G: From a design standpoint: what are you touching? How to minimize the number of surfaces you’re touching. That’s an instance of how design can thoughtfully respond to something like this.
  • Q: Did you come across other cities or models that are exemplary to look toward for lessons?
  • S: Portland, Oregon has done a really good job of integrating urban nature and instituting growth limits. The downside of that is Oregon is increasingly unaffordable for many people.
  • Q: School design. Did you look at how this plays across multiple types of building typologies?
  • S: I had worked in school design and hospital design. She used to teach a class of half public health students and half architecture students. I don’t know how this will transform infrastructure post pandemic. Pre pandemic there was a move to outfit students with, for instance, chairs where they could rock back and forth, integrating gardens, bars in the hallways that kids could swing from. On a less positive note, designing around safety in the case of school shootings.
  • G: When you work on projects like this, even with everything you’re reading, there are moments when you discover something you’ve never thought about. What were some of those?
  • S: Olmsted’s projects were problematic in how they displaced lower-income people. But when you read his writings it’s amazing how much of its has been proven by scientific screening today. The promise of foliage in cleaning the air. The importance of getting away from the city to soothe anxiety (?) and etc. How much that was intuitive became proven scientifically. What we’re seeing now will become very important in the wake of a pandemic.
  • Book is coming out in Spring of 2021. “Time to significantly revise the conclusion!”