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Epidemics and their urban context: Covid-19 and lessons from Wuhan

The study has been authored by Madhurima Nundy.
People wearing face masks walk on a street market, following an outbreak of the coronavirus disease in Wuhan, China.(Reuters File Photo)
Published on Jul 31, 2021 02:47 PM IST
ByInstitute of Chinese Studies

Covid-19 emerged in Wuhan, a second-tier city in Hubei province of central China, which went on to become the first epicentre of the epidemic before it moved to other provinces within China and other countries to the West. Wuhan has similar characteristics as any other urban city - an important hub for trade, commerce, political and educational activities, high density of population, high volume of public transportation, governance by local authorities and multiple channels of communication and, heterogeneous subpopulations including a large migrant population.

To top it all the virus affected the city during the period before the spring festival when there was maximum mobility within and across provinces in China. The impact of Covid-19 affected all major cities in the world in full force. Once infections emerge in or reach urban centres, they tend to progress rapidly. Even in normal circumstances urban settings are challenged with huge density of population in housing, workplaces as well as in the use of public transportation and public spaces. All these challenges become pronounced in times of outbreaks.

Maximum economic activities occur in urban centres that comprise of a large working-class population and a globalised heterogeneous middle class. The former is mostly invisible but are the ones who make the city function on a daily basis and drive the economy. They constitute of migrants who come from rural areas to work in various capacities – as workers in manufacturing industries, construction sites, street-vendors, restaurant workers, delivery people, domestic workers and so on. On the other side of the spectrum is the globalised middle class in their own gated residential communities with access to all basic facilities and connected to the larger world. The structural inequalities in cities are apparent in access to housing, clean water, sanitation, food, health care, education and so on. Most of the working-class population has limited access to resources and struggle to survive on an everyday basis. Civic authorities are also harsher towards them and so is the middle and upper-middle classes who need them as labour but are constantly ‘othering’, marginalising and excluding them. They are viewed as carriers and vectors of germs and infections. Ironically, although the infection spread through the world due to global mobility of the well-off, the working class population have faced the maximum hardships in terms of the outcomes of the pandemic. The inequality that already existed has exacerbated.


Health services response: The SARS epidemic of 2003 was a wakeup call for China’s dismal health services. What followed was almost two decades of health sector reforms and rectifications to strengthen many systems, build capacities that brought in new challenges. Greater investments were made to increase access to public health service systems and to strengthen surveillance systems, to avert, recognise and manage epidemics in the future. The government enhanced capacities of infectious disease surveillance and built the web-based Notifiable Infectious Diseases Reporting Information System in 2004. Health care institutes were enabled to notify infectious diseases in real time. China’s health care investments have increased multiple-fold since SARS. While there have been tremendous improvements in the health services, over the years China’s health care system has become hospital-based with a weak primary level of care and a fragmented system, especially in the urban context.

Impact on migrants and unorganised workers: We assume that epidemics and pandemics are equalisers, that anyone could get infected, but most of the times the poor are the most vulnerable. With limited resources, congested living arrangements and low immunity, they are susceptible to get affected disproportionately. In the Covid-19 case, the elderly have also been severely affected. 60 million people were locked down in Hubei province among which many were migrant workers who had returned to Hubei for the spring festival and were unable to return to work thereafter due to the lockdown.

Food Security: Access to food during the lockdown was one of the greatest concerns in China. How does one access food while restraining mobility? Despite these concerns food prices remained stable in China. The local governments gave a boost to online food stores and markets. People were able to access produce through online retail stores. The urban food security programme in China also has what is called ‘the vegetable basket’. The programme that was initiated in 1988, mandates local governments to provide affordable non-grain food. Wuhan is one of the major cities part of this programme that was able to adapt the programme during Covid-19.

Exiting the lockdown: This has been and will be the greatest challenge for cities across the world. How should one exit the lockdown, revive the economy while ensuring the well-being of all people? Wuhan showed the world how it eased the lockdown. Although the city opened its public transport system, air travel and railways, only those whose travel was imperative were allowed. Social distancing and use of masks continued. Offices partially opened, those essential to trade were allowed, the rest were told to work from home as much as they can. But despite all the learnings, Covid-19 has shown a disproportionate impact on the working classes in all affected cities.

The study can be accessed by clicking here

(The study has been authored by Madhurima Nundy)

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