For design professionals, supporting the ongoing COVID-19 surge in the number of hospital beds needed is a matter of urgency. They are taking steps to educate practitioners about best practices in pop-up hospital design. They also are advising governments about the safe design and construction of temporary facilities. And they are pushing the fledgling Hotel2Hospital movement, with prototype designs and teams ready to act as soon as deals are inked between private hotel owners and the government.

With an eye on mitigating the toll of future epidemics, groups such as the American Institute of Architects (AIA), ASHRAE—which primarily represents heating, ventilating and air-conditioning engineers—and the American Society of Health Care Engineering (ASHE) also are studying ways that codes and standards can be shaped to prevent disease transmission in all buildings.

 Practitioners also are warning officials that haste in providing temporary facilities can create unintended negative consequences. Traci A. Hanegan, chair of ASHRAE’s health care facilities technical committee (TC 9.6) and a principal mechanical engineer with Coffman Engineers Inc., cautions that some methods to segregate COVID-19 patients may be beneficial to the patients, but not to health care providers.

“We have been able to provide input on how to create space for patients while keeping the safety of our health care providers in mind and still preserving life-safety provisions,” says Hanegan.

ASHRAE has formed an epidemic task force. Its first meeting was March 29. “Our immediate focus will be on supporting health care facility capacity needs in the face of the current surge in admissions, but we will also be providing guidance on short-term measures applicable to other types of buildings,” says William P. Bahnfleth, professor of architectural engineering at Pennsylvania State University and the group’s chair.

The multidisciplinary group’s nine voting members have backgrounds in health care facility design, commercial building design, occupational health, medicine, aerosol science, air and surface disinfection and other relevant areas. The group’s nonvoting members are liaisons to key ASHRAE committees—standards, technical activities, government activities—and ASHRAE staff.

Bahnfleth, ASHRAE’s 2013-14 president, expects the task force to be in operation into mid-2021, with the goal of improving preparedness for future epidemics. “I am envisioning production of concise guidance documents targeting different occupancy types produced by experts from our technical and standards committees and coordinated by the task force,” he says. One task force member has already been in touch with the residential buildings committee.

Architects are not sitting still, either. On March 26, AIA launched a national task force to help inform public officials, health care facility owners and architects about the safe adaptation of buildings into temporary health care facilities.

The task force expects to release its report in early April and is developing a COVID-19 rapid-response safety space-assessment document for AIA members. It will include considerations for the suitability of buildings, spaces and other sites for patient care. Architects with expertise in health care facility design, urban design, public health and disaster assistance are developing the document.

The task force is chaired by Molly Scanlon, an environmental scientist who is the director of standards, compliance and research at Phigenics. The group is a direct result of a March 23 virtual meeting convened by Rachel Minnery, AIA’s senior director for resilience, adaptation and disaster assistance.

“Most state health departments are not providing policy on preparing alternative provisions, so there’s tremendous value in sharing what we are learning about policies and practices from the virus hot zones,” says Minnery.

Bahnfleth says the ASHRAE task force’s top priority is mobilizing. Once that is done, he expects to reach out to AIA and other groups to cross-pollinate ideas and activities. “Networking with other organizations is something we view as essential,” he says.

Members of ASHRAE’s TC 9.6 and its Standard 170 committee for ventilation of health care facilities already have disseminated guidance to help hospitals and clinics cope. The committees also developed a 51-page document, with ASHE input. It is downloadable free of charge.

Public convention centers and sports facilities are the low-hanging fruit for surge beds. For the new private Hotel2Hospital (H2H) movement, the biggest stumbling block is insurance, says Mark Pratt, global hospitality practice leader for architect-engineer Leo A Daly. 

“Ninety per cent of hoteliers are looking to do good and also generate income during the pandemic, but they need insurance to protect them,” he says, having  had meetings with 10 large hotel owners. Pratt says the H2H insurance logjam could break, at least in New York City, soon. At ENR press time, a hotelier, an insurer and state officials were close to a resolution, he says, declining to be more specific except to say the hotelier owns a dozen buildings in the city.

At the ready, Daly created H2H prototypes—from simple first responder rooms to COVID-19 patient rooms.

Rooms for first responders to rest away from their families cost little to retrofit, says Joshua Theodore, Daly’s global health practice leader. For non-COVID-19 patients, the cost would be about $125,000 to $150,000 per bed and take about one to two weeks to retrofit. For COVID-19 patients, the cost would be above $150,000 per bed, depending on the facility and the needs, and take two to three weeks, says Theodore. That compares with a cost of about $2 million per bed in a new 100-bed hospital, depending on the region, he says.