Long Term Effects of COVID-19 on Healthcare Design

Daily news alerts are overtaking my phone notifications and filled to the brim with COVID-19 (coronavirus) details. It’s overwhelming to think that only a few weeks ago life was relatively uneventful. With the nationwide restrictions, school closures, and limited social interactions we enter an unknown era. We hope the temporary measures help flatten the curve, but with the growing influx of COVID-19 patients on top of the standard patient volumes, we are seeing many hospitals stretched beyond capacity.  They are fighting to avoid a state of internal chaos and we in the healthcare design industry should take note.

Medical workers take to the front lines. When patients present with coronavirus type symptoms, isolation is a top priority. An infection of this type sometimes requires the use of an airborne infection isolation room. The outside air pushes into the room and prevents contaminants leaving the space hence protecting nursing staff, family members, fellow patients, etc. The physical construction of a hospital is built per local codes pertaining to the quantity and ratio of isolation rooms available. We typically see 1 isolation room for every 8-10 standard rooms, but in the current situation we will likely see all rooms occupied with infectious patients, putting caregivers at an even greater risk of acquiring an infection.  Depending on the ultimate severity of this outbreak and the success of our collective curve-flattening efforts, we expect to see a change in guidelines and codes regarding isolation rooms.

The demand also prompts many hospitals to redistribute their patient population allowing more space for intensive care and isolation. Conversion of lower-acuity spaces (emergency department, recovery rooms, med/surg patient floors) into ICUs can be troublesome. These rooms typically have fewer electrical, oxygen, and medical vacuum outlets than ICU rooms, requiring staff to use splitters or power strips to accommodate the necessary equipment. Many newer hospitals have patient floors designed with an “acuity-adaptable” design, making the rooms more versatile to accommodate the higher-acuity patients that we are seeing with COVID-19.  For lower-acuity and non-infectious patients, stressed hospitals are considering utilizing nearby hotels as overflow.

In addition to the physical space constraints facing hospitals, we are starting to see increased demand for certain medical equipment.  Many COVID-19 patients are developing pneumonia and other complications requiring additional and more advanced respiratory modalities (ex. ventilators). Equipment suppliers, specifically those manufacturing ventilators, are increasing production to meet the need. The typical lead time is six to eight weeks; however, the need is immediate. Several companies have increased staffing and alternate production methods to meet demand.

All eyes are focused on minimizing infections and the spread of disease, protecting healthcare workers and the system at large. Only time will tell if social distancing and self-imposed quarantines will slow the spread. One thing is definite: the role of infection control and prevention in healthcare design will be forever changed. Once the current chaos ends, how do you think hospital design should change going forward?