As compared to other crisis situations; an emergency/mass casualty event, or major storm event; the pandemic has overwhelmed the healthcare system facilities in a manner never experienced before, now being called “the surge”.

 

Immediately, the pandemic demonstrated that not only was the need for space critical, but the need for isolated, protected space was necessary to treat patients and protect the public and healthcare workers. Lining corridors with beds or doubling up of rooms did not help treatment capacity and would have added to the spread of the disease. Additional intensive care beds are not created thru easily convertible space. To the contrary, medical advances have lowered the need for intensive care beds, yet in this crisis, they became the most needed and critical component of the hospital with patients far exceeding capacity.

 

The Coronavirus demonstrated that the word flexibility can be an ambiguous and overused word in the design of medical facilities where specific criteria and critical infectious disease needs change the design paradigm. Therefore, the success of medical space flexibility will include technical, operational and organizational design features. We need to rethink everything from waiting and diagnostic spaces, to the more integrated use of technology and analytics.

 

What has also been identified as a critical shortcoming is the amount of space necessary to protect healthcare providers. No options for social distancing for staff requires the acknowledgement of their space needs in the “pop up” treatment spaces in tents, conference rooms, and convention centers; gowning spaces, cleansing stations and access to equipment in all these locations are critical design functions necessary for staff safety.

 

The ability to control and use alternate spaces is critical in the successful containment of a pandemic. The management of mechanical systems within any space has a reaction to the adjacent spaces if adequate balancing controls are not in place.

 

For the past decade, as great advances were made in moving more and more medical treatment to outpatient facilities, the use of hospitals was being scrutinized with an ultimate goal of decreasing in-hospital bed capacity. Now that capacity needs have become apparent in an emergency, we need to resist the urge to build more as a knee jerk reaction. We need to build smarter, with flexibility defined to include the “plug and play” systems and technology which will allow multiple physical spaces to be converted and used appropriately; situationally.

 

Statistical analysis of this pandemic will demonstrate that age and social economic groups impacted the medical facilities in specific neighborhoods and the surge levels within specific hospitals. As such, a regional response that would ask multiple hospitals to act in tandem as a response to a pandemic should be part of the emergency planning processes.