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The social structure of India is rapidly evolving, towards modernization. The urban population of India is projected to approach 60 crores by 2036. Urban health resilience stands for building the capacity of urban systems to withstand and adapt to health-related stresses like natural disasters, man-made disasters, and pandemics like COVID-19 and the capability to recover from them by well-equipped hospitals, efficient emergency response mechanisms, and a network of well-trained and motivated healthcare professionals. Also, the involvement of communities is central to building urban health resilience. Strong policy frameworks are required for establishing a resilient urban health ecosystem. Addressing social determinants, such as income inequality, education, and housing, is also a basis of building urban health resilience. Some examples have been instrumental in designing a resilient urban health system like Singapore’s Smart Nation Initiative, Copenhagen, Denmark’s Model for Sustainable Urban Living internationally, Ahmedabad’s Heat Action Plan and Kochi’s Waterfront Development for Climate Resilience are excellent examples from our country. The suggested strategy for an urban resilient system is a Rapid, Extensive, Sturdy, Ingenious, Lucid approach with an International collaboration for an Enthusiastic, Non-latent, Continuous Early warning system (RESILIENCE).

BackgroundCOVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them.MethodologyA nested case–control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021.ResultsA total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53–1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019–1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148–3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006–1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079–7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201–2.901]; p = 0.006).ConclusionThe study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.