Does Density Aggravate the COVID-19 Pandemic?

Abstract

Problem, research strategy, and findings: The impact of density on emerging highly contagious infectious diseases has rarely been studied. In theory, dense areas lead to more face-to-face interaction among residents, which makes them potential hotspots for the rapid spread of pandemics. On the other hand, dense areas may have better access to health care facilities and greater implementation of social distancing policies and practices. The current COVID-19 pandemic is a perfect case study to investigate these relationships. Our study uses structural equation modeling to account for both direct and indirect impacts of density on the COVID-19 infection and mortality rates for 913 U.S. metropolitan counties, controlling for key confounding factors. We find metropolitan population to be one of the most significant predictors of infection rates; larger metropolitan areas have higher infection and higher mortality rates. We also find that after controlling for metropolitan population, county density is not significantly related to the infection rate, possibly due to more adherence to social distancing guidelines. However, counties with higher densities have significantly lower virus-related mortality rates than do counties with lower densities, possibly due to superior health care systems. Takeaway for practice: These findings suggest that connectivity matters more than density in the spread of the COVID-19 pandemic. Large metropolitan areas with a higher number of counties tightly linked together through economic, social, and commuting relationships are the most vulnerable to the pandemic outbreaks. They are more likely to exchange tourists and businesspeople within themselves and with other parts, thus increasing the risk of cross-border infections. Our study concludes with a key recommendation that planners continue to advocate dense development for a host of reasons, including lower death rates due to infectious diseases like COVID-19.

COVID-19 pandemic: environmental and social factors influencing the spread of SARS-CoV-2 in São Paulo, Brazil

“…Therefore, using spatial analysis, we have observed that the spread of COVID-19 from the capital city São Paulo-its epicenter in Brazil-is directly associated with the availability of highways within the expanded metropolitan area of São Paulo. Our findings are consistent with recent literature, as Hamidi et al (2020) have reported metropolitan population as one of the most significant predictors of infection rates in the USA, due to shared transportation and interaction of people in metropolitan areas.…”

“…Similarly, Şahin (2020) reported high correlation between population and total cases in Turkey, and Ahmadi et al (2020) found significant correlation between population density and total cases in Iran. Interestingly, Hamidi et al (2020) have reported that at county level in the USA, population density is not significantly related to infection rate possibly because of adherence to social distancing. In low-and middle-income countries though, high population density is commonly associated with informal urban settlements, being social distancing impracticable (Wilkinson 2020).…”

“…A few investigations have also considered social aspects potentially associated with the spread of COVID-19, such as population density, metropolitan population, intra-provincial traffic, and national lockdown, indicating that the social distancing measures have been successful in reducing new cases (Ahmadi et al 2020;Hamidi et al 2020;Tobías 2020).…”

Spatial Distribution and Trend Analysis of Current Status of COVID-19 in Nepal and Global Future Preventive Perspectives

“…6). One of the reasons behind the higher death cases in hilly regions may be due to lack of rapid access to health facilities [35].…”

Causal Analysis of Health Interventions and Environments for Influencing the Spread of COVID-19 in the United States of America

“…As of August 27, 2020, the number of cumulative cases of COVID-19 in the US exceeded 5,863,363 and included 180,595 deaths, thus causing a devastating public health and economic crisis. Since the number of new cases in the US remains high (43,814 reuse, remix, or adapt this material for any purpose without crediting the original authors. this preprint (which was not certified by peer review) in the Public Domain.…”