Wuhan 2020 and Surat 1994 - “déjà vu all over again”

During an exceptionally rainy August in 1994, pneumonic plague broke out in the city of Surat, in western India. A quarter of that city’s then population of a little over a million people, mostly poor migrant workers from other parts of the country, panicked and dispersed across four different states. The crisis took four months to bring under control. It severely disrupted the local as well as the national economy, which itself was going through a painful fiscal recalibration during that period. The government reported around 1,200 people infected and 63 deaths to the WHO^[1].

At that time, long before I joined the World Bank, I was teaching urban planning at CEPT University in Ahmedabad 260 kilometers north from Surat. Our daughter was only four years old. Everyone in my city of four plus million went about scared with handkerchiefs tied to our faces – no one except doctors had access to or stocked surgical masks at that time. We stayed indoors, tried to remain calm, avoided human contact and wished things would get better, which they did – three to four months later.

Twenty-six years later, in January 2020, my wife and I are based in Beijing, China and it’s “déjà vu all over again”. As we looked forward to spending a quiet Chinese Lunar New Year week at home, there came the terrible news that the city of Wuhan, a thousand kilometers to the south, had experienced an outbreak of a novel (new) coronavirus (a.k.a. 2019-nCoV). The world’s news media is full of all the trouble and pain this outbreak is causing the residents of Wuhan, the surrounding areas, and to the gigantic country of China, just as people were about to celebrate their New Year. We have been advised to take precautions, stay at and work from home.

I am not a public health specialist; our daughter is. However, as an urban sector specialist, I have been painfully reminded about the critical intersection of public health, urban planning and city management. After all, modern urban planning traces some of its roots and methods to the London Broad Street cholera outbreak in 1854 when the “focus of infection” – one water stand pump - was identified thru meticulous field-work and mapping^[2].

In Surat, the “focus of infection” had been overflowing cross-connected rainwater and city sewers which had pushed rats that tend to inhabit such lines out on to the city’s streets and remain outside while solid waste collection by the city had been suspended. In Wuhan, yet to be confirmed early reports speculate that a lightly regulated municipal wet market where the virus could have jumped from animals to humans may have been the focus - though it is too early to be certain at this point. There could be other, yet to be identified, reasons.

I leave the health aspects - which are of primary concern - of such outbreaks to those who know better. To me, both these instances are reminders why it is critically important for city authorities to be mindful of how urban infrastructure – including underground sewer and rainwater networks and solid waste systems -- is planned and maintained.  Sound land use planning is also important to ensure safe siting of urban wet markets, waste collection points and dumps. Effective city management systems are also required to identify, regulate and monitor likely “foci of infection”. And above all -- constantly updated and transparent municipal information systems must be openly available to city officials across all departments as well as to the general population.

The World Bank’s urban investment projects have done a lot to strengthen urban planning and management systems, but episodes like these that shut down dynamic cities, impact national economies and lead people to hunker down at home, sometimes for weeks or months on end, remind us that we need to do much more.

I hope I never have to say this again, but I’ve seen this before.