Cities after Covid: Back to life

George Everly has spent his life responding to the psychological fallout of disasters, from the Oklahoma City bombing to Hurricane Katrina. Nothing had prepared him for Covid. “I’ve been to 39 countries on six continents following disasters and this is the worst thing I’ve ever seen,” says the psychologist at Johns Hopkins University in Maryland. “It’s very toxic.”

Everly’s response is one indication of the profound emotional toll wrought on society by this bleakest of years, with its widespread grief and loss, social isolation, fear of disease and grinding uncertainty. Another is found in a plethora of grim statistics that shine a light on the pandemic’s societal fallout, covering everything from a surge in depression and teenage self-harm to a rise in reports of domestic violence. And as the vaccine rollout continues — and some light is finally discernible at the end of the tunnel — these offer a salutary reminder that Covid’s scars will likely be with us for a long time to come.

For designers and decision-makers involved in shaping the places in which we live and work, this raises a host of questions, both practical and profound. What can be done in buildings, public transport and other shared spaces, to help people not just to be safe, but to feel safe again? Will our relationship with the built environment permanently shift? And as and when we emerge from the pandemic, how can communities be helped to thrive once more?

Follow the neuroscience

Figuring out the answers to such questions won’t be easy, not least because of ongoing uncertainty about the immediate future. We still don’t know how or when the pandemic will end, what our work or social lives will look like six months, a year, or five from now or how long restrictions, such as social distancing or travel bans, might last. All of which makes planning for “normal” something of a challenge.

Huge regional variations complicate the picture — compare New Zealand’s 26 deaths to Brazil’s 496,000; or Japan’s light-touch restrictions to Europe’s deep and rolling lockdowns. And even within countries, cities and neighbourhoods, people’s risk profiles — and risk perception — vary widely.

This ambiguity and fragmentation is not lost on Kay Sargent, Washington DC-based director of workplace practice at architect HOK. “Preparing the space for the people is going to be easier than preparing the people for the space,” she says. “We’re going to have some people who think they’re immune and invincible and then we’re going to have people who are going to be absolutely terrified. And when you put them all together it’s going to be explosive.”

How then can workplaces best prepare? Although some people may continue working from home well into the future, and certain companies will shift to virtual or hybrid models, many employees plan to return to the office as soon as they can — a global survey carried out by real estate company JLL last December suggested as many as three in four want to go back full time.

Sargent believes there are answers to be found in an emerging body of research integrating insights from neuroscience into design. In 2019, ahead of the pandemic, HOK released the report Designing a Neurodiverse Workplace, an investigation into how employers can best support the 15-20% of us with conditions like autism spectrum disorder and attention deficit hyperactivity. People who are neurodivergent, explains Sargent, are often more sensitive than others to aspects of their surroundings — things like touch, smell and proximity to others. “Well, quite frankly, the entire world now has a heightened sensitivity to their surroundings,” she says.

Sargent points to the concept of prospect and refuge as an example — the idea that, just like animals on the Serengeti, we are most at ease when we can see what’s coming and where we could retreat to in case of danger. It’s an instinct that affects all of us to some degree (people tend to prefer to sit with their backs to the wall rather than the door in a restaurant, for example) but in the context of Covid it is significantly strengthened, says Sargent.

“If you think about it, every time you go to a grocery store, you’re prospecting,” she says. “You’re looking down the aisle to see, are there people there? Is it overcrowded or can I easily manoeuvre? And when you’re coming towards somebody who may or may not be wearing a mask, your instinct is, can I retreat? Can I get off this path?”

Recognizing this dynamic not only sheds light on how people are feeling and behaving but can directly inform design decisions, she says. Providing clear lines of sight becomes more important, for instance, as well as wider or one-way circulation paths, easy exit routes and places to retreat into and seek refuge.

It might prompt a total rethink of certain spaces. The office foyer, for example, could be reworked to better reflect its role as a transition zone for people arriving at work from a mentally draining commute. A journey many would have previously done on autopilot now requires them to use mental capacity avoiding risky encounters, Sargent says. “When we get to the office, there’s a whole lot of people who are going to need a moment.”

Underlying much of this is the idea that people are most comfortable when they have options and control over their surroundings and experience — a sentiment echoed by environmental psychologist Sally Augustin, principal at consultancy Design with Science. “Control is going to seem very important to people on return to the workplace because there are going to be so many aspects of their life over which they no longer have it,” she says.

Augustin highlights a range of other easy, practical things that neuroscience shows can help to put people at ease. Humans link the colour blue to trustworthiness and dependability, for example, making it a good colour for signage. Similarly, research shows we are more relaxed when faced with relatively curvy, rather than rectilinear lines, and when we smell lavender — subtly scented hand soap then, could be “a good way to introduce a calming element into the workplace”.

Managing public health clutter, like signage and gates, will be important, says Augustin, since “nothing makes us tenser than being in a space that’s just too complex visually”. But blank spaces also stress us out, so stripping everything back isn’t an answer either. “You’re looking for a happy medium,” she says, adding that Frank Lloyd Wright’s residential interiors have been shown to be the ideal in moderate visual complexity.

While such science-informed interventions may help boost comfort, Augustin stresses that responding to people’s expectations and subjective experience will be just as important. We will all be looking for non-verbal signals that our environment is safe, she says — handwashing stations, for example, will need to be really prominent, as much for the fact that they show that hygiene is being taken seriously as their impact on controlling germs.

Perception is paramount, agrees Sargent, pointing to the enduring emphasis on deep cleaning and surface disinfection, despite the clear evidence that Covid is rarely transmitted via surfaces. It is clear from history too — during the early days of the AIDS epidemic, when people thought HIV was passed on in bathrooms, automatic faucets and hand dryers were suddenly very popular, says Jo Hays, professor emeritus at Loyola University Chicago and expert in the social history of disease. They remained a feature of public bathrooms long after it became clear there was no epidemiological link. Today many consider them a hygiene basic.

Markers of security

That reassurance can be provided by signals in our environment is borne out by data from Wuhan, ground zero of the Covid crisis, which came out of an intense, ten-week lockdown in April 2020. In July of that year, Tong Zhou, a psychology PhD candidate at East China Normal University, started interviewing a collection of 300 people she had recruited on messaging app WeChat about their experiences during and after lockdown for a study later published by Royal Society Open Science. This may have been the high-water mark of caution: Zhou points out that the interviews were conducted before the development of any vaccine, when Wuhan’s citizens were the first people anywhere to have to learn for themselves how to live with the virus.

Even though participants estimated that 75% of pre-pandemic life had returned two months after lockdown lifted, in certain respects life was different — they reported being more cautious about interactions with strangers, meeting acquaintances less than before and almost never inviting anyone into their homes, as well as being less tolerant of crowded or poorly ventilated places, says Zhou.

In the workplace, they derived comfort from the infrastructure put in place to ensure others in the space were not infectious and were taking care of their own, and by extension other people’s, health, she adds — this included body temperature checks, masks and use of green, or “healthy”, QR codes, proving that those accessing the building have not been anywhere risky for 14 days.

Even simple interventions, like markings on the floor of transit platforms to show where people should stand, can go a long way to reducing anxiety, suggests Jared Thomas, New Zealand-based technical principal in behavioural sciences at WSP.

Part of the trick is shifting good behaviour from an individual burden to a shared obligation, he suggests. On public transport, for example, where people tend to retreat into their own shell and avoid conversation with others, it can be awkward to ask someone to move back if you think they are standing too close. If there are visible indicators, however, it becomes “more of a shared social role”.

Thomas believes there is an opportunity here — not just to ease Covid-specific anxiety, but to find ways of doing things better than before and optimizing how we move around cities. He points to a study of 6,000 people across 40 countries, which looked at the distance from another person at which people feel comfortable. The mean distance for strangers was 1.35m, compared to 0.3m for family. “If you think about it, public transport forces people into intimate proximity with complete strangers. So they’re already motivated to reduce that interpersonal discomfort if we can provide the opportunity,” says Thomas. Part of the answer, he says, is “smarter alignment between design and user needs”.

His team are also looking at how to design trains, buses and transit hubs to encourage one-way circulation — already the norm for air travel, but not for intra-city transport. Passenger apps and displays indicating not only the time of the next service but how full it is allow those with the time and inclination to wait for a seat (something that is already being tried in Auckland), while in-built features such as spaced leaning bars at bus stops fulfil a function at the same time as encouraging people to keep a safe distance.

“Everyone is saying this isn’t going to be our last pandemic,” says Louise Malcolm, a senior behavioural science researcher who works with Thomas. “Rather than temporary markers that go up and down, designers should be considering ways of building these things in.”

Beware best intentions

But how easy is it to design for a better world, when the current one is on shifting sands? Could carefully laid plans for high-functioning workspace or transport systems, say, be rendered irrelevant by unforeseen shifts in our habits?

Kathy Wilson-Ellis, a UK-based human factors associate at WSP, whose previous jobs have included developing strategies to reduce fatal collisions on UK highways, says we need to tread carefully. “I think at the moment we’re in danger of doing one of my pet hates which is designing and planning things based on assumptions,” she says.

“Take me, for instance. If someone said to me now, ‘Are you going to go back to the office after all this is over?’, I’d say, ‘Absolutely not, what’s the point?’ But another day I might say, ‘Actually I’m craving to put some lipstick on and get out of the house’. Until we actually get to that point, I don’t think people really know.”

The only answer, says Wilson-Ellis, is to engage the end user throughout the process, and be prepared to adapt as people’s post-pandemic habits become clear. “One thing to come out of Covid is that the lockdown was done to people and people didn’t like it … so let’s learn from that and whatever it is that we’re trying to do we need to make sure that people have a choice, they feel that they’re being listened to, they feel part of the solution, not just part of the problem.”

It’s a message that chimes with the aftermath of historical disasters, when the desire to improve public health has sometimes fallen out of step with people’s psychological and social needs.

With London housing stock badly damaged after the Second World War, there was a push to clear slum districts and move people to new towns with more open spaces and better welfare services, explains Edgar Jones, professor in the history of medicine and psychiatry at King’s College, London. Despite best intentions, however, it sometimes went wrong. Older people wanted to stay in their familiar neighbourhoods and when younger generations did move out, familial bonds and support networks were broken.

A 1964 study comparing Harlow New Town with Tottenham — the area of London where many Harlow residents had moved from — found around 30% of the population in both places were suffering from low-level psychological problems such as mild depression, anxiety and poor sleep. The new town had not brought the expected health or wellbeing benefits, says Jones, and it had created new pressures too. Women with small children, cut off from grandparental support, were often left isolated as their husbands went to work, now commuting beyond their areas of residence.

When it comes to rebuilding communities after Covid, there is a lesson here, says Jones. Just as in the Blitz, areas of crowded housing and socioeconomic deprivation have suffered worst. Studies in Germany, Italy, the UK and elsewhere show higher levels of mortality and infection in these areas and they are where the greatest mental health impacts are expected too, says Jones. Public health initiatives that improve housing and welfare services would be welcome, he says, but they need to be responsive to observed needs.

Mental health services should also be targeted at those at greatest risk, he adds — the majority of people have found Covid stressful but are likely to find a way through without professional help; others won’t bounce back so easily.

There is a generational divide at play here too, points out George Everly at Johns Hopkins: “If you take a look at Generation Z, people born after 1996, they seem to be the least prepared to deal with this. An American Psychological Association survey found that they are the most depressed and most anxious of any generation: 22% said they had no close friends. That’s worrisome because resilience is predicated on having people in your corner, having connections to others.”

A sense of belonging

That Covid interacts with old lines of inequality is clear from both the Wuhan data and University College London research tracking individual wellbeing over the course of lockdown. Both show clear differences linked to people’s resources, income levels and to some degree gender, says Thuy-vy Nguyen, assistant professor in social quantitative psychology at Durham University, who worked with Tong Zhou on the Wuhan study. 

Unsurprisingly, those with greatest resources, including communal support, tended to weather the storm best. When we talk about the pandemic, says Nguyen, “we tend to talk in general terms — ‘we are all suffering right now’. But from the very beginning of lockdown we can see that people are different.

“At a human level, we have that capability to be resilient,” she adds. “But if the environment, or society, doesn’t provide the resources for people to bounce back, that does create a challenge.”

Moreover, pandemics can worsen inequalities by igniting or reigniting prejudice and stigmatization of groups and classes, suggests Loyola University’s Jo Hays — a warning given grim credence by a reported rise in racist attacks on Asian Americans over the past year.

When syphilis appeared in the late 15th century, it was variously called the French pox, the Italian pox and the German pox, he points out. “Everyone pointed the finger at someone else and that has persisted in many diseases since,” says Hays, adding that hostility and suspicion tend to linger even after the immediate effects of pandemics wane.

Asking designers to rid the world of prejudice may be over-ambitious. But in the aftermath of Covid, many are hoping that new thinking about the structures in which we live and interact could help to create and empower communities to succeed — and survive — together.

Michael Friedman, professor at Columbia School of Social Work and founder of the policy centre at the Mental Health Association of New York City, would like to see investment and energy going into development of new models like age-friendly, or liveable communities, with attention on everything from designing safe spaces for people with dementia to creating community centres that “don’t feel like dumping grounds for poor people”.

“Everyone is talking about the high-tech solutions — things like Zoom. But there needs to be more thought about how to construct communities to support and encourage people to be socially connected, to have a sense of belonging.”

It is a point echoed by George Everly, who as the author of more than 20 books on human resilience perhaps knows as well as anyone how post-pandemic societies might fare: “Every country is different culturally, but what I can say universally is that cohesive communities deal well with adversity. I would say the same thing to the mayor of London or a small town in Scotland: whatever you do, build a sense of community, cohesion, collaboration and support. How you do that may differ, but this is what needs to happen. This is human nature.”