Population density and the transmission of COVID-19 and other respiratory viruses (search done in October 2020)
Citation: Zhang X, Sun Z, Ashcroft T, et al. Compact cities and the Covid-19 pandemic: systematic review of the associations between transmission of Covid-19 or other respiratory viruses and population density or other features of neighbourhood design. Health & Place. 2022;76:102827.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: The authors of the review reported that they had no external funding for this review.
What is this? In this systematic review, the authors searched for quantitative studies that assessed the association between neighbourhood population density and respiratory virus transmission (including COVID-19) in middle- and high-income countries. They did not restrict their searches by date or language of publication did the search in October 2020. They included 21 studies, which were from China (6 studies), Israel (1), UK (1), and USA (13) and covered COVID-19 (15), influenza (1), SARS (1), lower respiratory infections in children (1), and Haemophilus influenzae in children (1).
What was found: At the time of this review, no consistent evidence was found for a positive or negative association between population or housing density and the transmission of COVID-19 and other respiratory infections.
At the time of this review, a clear connection could not be drawn between other components of a compact city neighbourhood design and the transmission of respiratory infections.
Implications: The authors of the review stated that globally, further research is needed to design policies related to the design of compact neighbourhoods, considering the transmission of respiratory infections. They also stated that further research should assess neighbourhood design and infection transmission in different contexts and phases of a pandemic.
Other considerations: The authors of the review discussed their findings in the context of place of residence, race, and socioeconomic status.
This summary was prepared by Yasmeen Saeed, checked by Cristián Mansilla and Jawaria Karim, and finalized by Mike Clarke.
Evidence Gaps: This review identified one main gap:
| Evidence gap | Classification | Population/ setting identified | Study type |
| ‘’ There is a need to consider the relevance of the compact city, and to research similar associations with respiratory infections and other health outcomes, in low-income setting’’ | More research is needed | Compact cities | N/A |
These gaps were identified up to October 2020 with no geographical restrictions and included only articles written in English and Chinese. An updated search was conducted on 27 November 2023 to check if new studies have filled this gap, finding:
- No more recent systematic review addressing the same or a broader question.
- Two primary studies, one testing the relationship between COVID-19 infection rates and population density and socio-economic measures, and another one revealing the joint and interactive associations between urban socioeconomic, density, connectivity, and functionality characteristics and the COVID-19 spread within a high-density city could contribute to fill the gap.
This evidence gap was identified, extracted, and classified by Ana Beatriz Pizarro and Jawaria Karim. Updated searches were carried out by Jane McHugh. Ana Beatriz Pizarro assessed the search results to address the gaps, and the findings were checked and finalized by Cristián Mansilla. The methodology we used to assess each gap can be found here.