CoVID has brought the age-old problem of containing infectious diseases back into the limelight. To date, clinicians and patients have focussed on the individual and human aspects of infectious containment, but the spread of infections in our built environment must become a priority.
Take hospital architecture. Like most buildings straining for optimal use of space in our overcrowded cities, hospitals have maximized on expensive, and scarce, real estate by building up.
That has meant reliance on elevators and staircases to transport staff, patients and visitors. Not a problem – until you mix airborne pathogens with poor elevator ventilation systems and unventilated stairwells that are ready-made to spread instead of contain the virus.
The Centers for Disease Control and Prevention’s National Healthcare Surveillance Network (CDC-NHSN), estimates that about one in 31 hospitalized patients suffers from a hospital-acquired infection.
In the UK, recognizing that clinicians are a major source of transmitting infectious agents among patients has led to major changes in the way clinicians dress. More than half the personal stethoscopes, neckties and rings worn by clinicians carry pathogens.
Not all that has happened in the modern hospital is infection-generating. The move to private rooms has resulted in a decrease in transmission of infectious diseases. A 10% increase in private rooms was associated with an 8.6% overall decrease in hospital-associated infections.
We could go a lot further to improve existing structures. Strategies to increase natural light (known to decrease pathogens), improved ventilation and fewer toxic substances can help. If we have to build up, then it is critical to incorporate more skylights, large windows (that can be opened), rooftop terraces, balconies, and courtyards to avoid sick-buildings rather than sick people.
In general, the life of a virus is significantly reduced when exposed to direct sunlight – not filtered through glass. Water also can help. Moderating humidity in our ventilation systems is just as important as filters. Water weighs down microorganisms. More humid environments mean less viral spread in the air, for example, when someone creates a microcurrent passing by you. However, the picture is not that simple. High relative humidity helps the microbes transfer to surfaces and therefore requires more surface cleaning.
Touchless technology, which we all now can use in our everyday lives, should become the new hospital interface and remove the requirement for physically pushing or touching a surface. Contactless pathways, such as elevators, could be summoned from a smart phone, as menus are now accessed in some restaurants.
The innovation in healthcare architecture inspired by CoVID is an evolving tableau. CoVID also has spawned new concepts for rapid horizontal facilities. Modular construction in open spaces such as sports fields and carparks, has proved effective to face pandemics or natural disasters and to create less expensive and more quickly constructed buildings.
Great developments to build on for the future.