Health Care Infrastructure is all around us (If we know where to look)

How to alleviate the strain on health care using architectural innovation

There are endless architectural structures that make up a city, and in times of crisis, the focus lasers in on a single one: Hospitals.

Hospitals are specifically designed for a non-pandemic world, where there is more than enough space for citizens to get the care they need. But when confronted with a worldwide and unexpected crisis, how can these incredibly large structures be expected to expand and modify? They shouldn´t. Hospitals and their staff have enough to deal with without the added burden of thinking of how to expand their existing structure.

This is where we (designers) come in.

This hyper focus on existing health care structures can create a tunnel vision where we forget that most of the architecture that surrounds us (whether by design or not) can be adapted. We have seen examples of this pop-up all over the world, with the Javits Center in New York turning into a space for critical patients and Cental Park functioning as a tent hospital, large buildings and public spaces have been successfully repurposed for a critical need.

Javits Center in New York City, completely repurposed for emergency hospital units

Now is the time when Architects and Designers all over the world should put on their thinking caps in order to be able to tackle this complex problem and expand the availability of health care units as quickly and sustainably as possible.

One great example of innovation in emergency architecture is 57uno´s proposal for Colombia´s TransMilenio buses. Utilizing the existing public transportation infrastructure, they propose repurposing the interior to create emergency COVID response units. This could rapidly increase existing health care structures while maintaining a certain flexibility needed in the process. This solution creates modular treatment centers that can be transported to where they are needed most, all while taking advantage of existent infrastructures that are currently not being used to their fullest potential. The modifications needed for the buses can be easily installed with prefabricated materials, which means lower cost and quicker production times for each unit.

57uno´s proposal for Arquitectura en Tránsito
57uno´s proposal for Arquitectura en Tránsito.

Public Transportation is something that every big city has always taken for granted, and loved to complain about. While I am fully aware of the need for improvements in the current transportation system, in times like these, we are so used to seeing the faults in the system that we fail to see the opportunity of using them as a jumping off point where innovation could happen.

This worldwide pandemic has forced everyone to stay home, meaning that the regularly packed public transportation systems all over the world are now in disuse and eerily empty. Why not use this time to repurpose them for something everyone needs? The wide spread implementation of emergency architecture through the use of existing public infrastructure such as this is not only doable, but an extremely sustainable and resilient way of approaching this complex problem.

MTA buses looking completely empty amid the COVID19 pandemic.

Buses that have little to no use all over the country could become emergency COVID19 centers. Creating a fleet of mobile hospital units that can safely travel from city to city, providing extra beds and care where they are most needed. Keeping in mind that resources are limited (and even more so in a pandemic) we also need to use proposals like Governor Cuomo´s, where all emergency equipment will be shared and shipped to the places that need it the most. If the plan is to do this with the ventilators that will hopefully arrive in NYC, that same sharing spirit can easily be translated to mobile hospital units.

If we expand on this proposal from the public sector to the private sector, we could design and repurpose all the trucks used by moving companies to create more mobile hospitals. The moving industry already has empty shells on wheels that can be quickly modified for our emergent needs. This could not only be an innovative pivot for companies like U-Haul, but it could provide much needed emergency health care space wherever it is most needed.

These are a few examples of how emergency architecture can repurpose existing structures for this and any future pandemic. There are undoubtedly more, we just need to find them together.
Here are some guidelines to rank the potential structures/spaces for intervention:

1. Ease of transformation
· What was this space originally designed for? Would you need to change it significantly for it to work?

2. Cost of refurbishment
· How costly would it be to change the existing space?

3. Mass availability
· Is this space similarly available in multiple places?

4. Flexibility
· How easily can it be adapted and expanded?

5. Re-location capability*
· Can it be transported?
*Not everything needs to be mobile, but it can help!

By taking these guidelines into consideration, we can more quickly identify the possible intervention points within a city´s infrastructure that could create the biggest impact on the creation of emergency health care units.

In every problem lies an opportunity to innovate, and with the world in a state of crisis, there is no time like today to think up new solutions.

Architect and Strategic Designer

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