What determines city's resilience against epidemic outbreak: evidence from China's COVID-19 experience

By employing the city-level data from China during the spring of 2020, this study investigates the relationship between city-level resilience against the outbreak of COVID-19 pandemics and its affecting factors, including the inflow risk pressure of COVID-19 virus (population inflow from the epicenter), city agglomeration characteristics (urban population density and city size), healthcare resource adequacy, among others. The results reveal that, while managing COVID-19 inflow risk pressure plays a critical role in the city's pandemic disaster resilience, city agglomeration characteristics also matters. To be exact, we find that large and high-density cities with high inter and intra-city mobility flows have more difficulties in containing the epidemic spread, but improving healthcare infrastructure adequacy and urban governance capacity can increase time efficacy of pandemic control and then improve the city's resilience against pandemic. Although our analysis is based on the performance of Chinese cities in the case of COVID-19, the research framework can be applied in understanding COVID-19 control performance of cities in other countries and the findings can be useful for improving health-related urban resilience and sustainability.

Automated summary

This study explores the relationship between city-level resilience against COVID-19 and factors such as inflow risk pressure, city agglomeration characteristics, and healthcare resource adequacy. The findings suggest that managing inflow risk pressure and city agglomeration characteristics are crucial for pandemic disaster resilience. Improving healthcare infrastructure and urban governance capacity can enhance pandemic control efficacy and increase city resilience.