In 2006, in Tugela Ferry, South Africa, an extremely virulent, drug-resistant strain of tuberculosis raged through a hospital—and the building was partially to blame. The hospital was not designed for infection control. The transmission of the disease was through particles suspended in the air, inhaled by patients in a poorly ventilated building with overcrowded waiting areas.
Since then, architects, epidemiologists and builders have been working together to find better ways to construct hospitals, in ways that allow for the prevention, containment, and treatment of infectious disease.
Three recent epidemics around the globe have taught important lessons that designers are taking to heart. Particularly, they are looking at methods of transmission: air, surfaces, and water.
With aerosolized viruses, like the coronavirus as well as the bacteria that causes tuberculosis, the particles remain in the air, so airflow is an problem and a solution: opening windows, increasing air movement, using filters, and turning on fans could slow the spread; on the other hand, closed-off hallways, waiting areas, and other spaces with little airflow become petri dishes.
Regarding water, while COVID-19 isn’t known to be transmitted by water, other epidemics, such as the cholera outbreak in Haiti in 2010, was traced to poor water hygiene. Contaminated water was found in water used for drinking, washing, and cleaning. Even when emergency tents were put up, the used water allowed to flow into the ground, contaminating wells. Doctors and architects worked together to build a new hospital that safely treated wastewater and provided clean water for the facility.
The 2014 Ebola outbreak displayed the danger of germs lasting on surfaces, as the virus could live on surfaces for more than two weeks. Though cleaning was a major component of dealing with it, the design of the buildings to use different antimicrobial materials was also important. Studies are showing that the coronavirus can last on plastic and steel much longer than porous material like cotton, leather and cardboard. Designers are now trying to incorporate these materials into their buildings.
And we’ve now seen that builders and architects stand at the ready to build virus-resistant pop-up facilities, as illustrated by the Southampton Street Shelter in the South End of Boston, which was designed and constructed in less than a week and met all of the needs of virus protection. It’s a good pathway forward, and a pattern that we will need to see used in the post-corona world.