[Managing future pandemics in an urban context: a challenge for public health]

The COVID-19 pandemic posed a challenge for which many countries and cities were unprepared. Cities, due to their physical and social environments, are particularly vulnerable to the effects of health crises. However, there are no specific preparedness and response plans for health crises in cities. Four years after the onset of the pandemic, it is crucial to identify the achievements and areas for improvement in Barcelona. For this, we used four elements: 1) crisis recognition, 2) crisis management, 3) communication and policy, and 4) prevention of future crises. Although the crisis was acknowledged, there was also a lack of preparedness to effectively address and respond to it, primarily due to the historical underfunding of public health resources. However, throughout the three years of the pandemic, notable efforts have been made in key aspects of management: the development of new technological platforms for information systems and the improvement of intersectoral coordination. New communication formats have also been developed for both internal and external channels. These elements are essential tools that require improvement to face future pandemics. The focus now shifts to integrating the lessons learned into preparedness and response plans to address future public health emergencies with a comprehensive and equitable approach in an urban setting, marking an evolution in public health response strategies.