Infrastructure Guidance for COVID-19/Alternate Care Sites/Case Studies

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Alternate Care Sites: Typology dictates & case studies

SARS ACS precedents

Site type: Existing Hospital

Response: Minor Adaptive Reuse

Service Model: Clustered Cohort

Examples:

Sung-Shan Military Hospital Taipei[1]
Conversion of existing non-isolation buildings to isolation wards for the treatment of SARS patients. Steps for conversion and implementation described. Nosocomial infection rate 0.6% ascribed to non-compliance with procedures.

Infrastructure steps were taken:

  1. Clear buildings of people & equipment.
  2. Fans (commercial grade 3 X 1 m blades, 65W, 60Hz) above each window.
  3. Plug doors to create negative pressure relative to the corridor (0.028-0.07 water gauge in rooms to 0.0 in corridors.)
  4. Close stairways between floors.
  5. Creating three zones at the ground floor for entry A: clean zone for changing and administration; B: Intermediate zone for removing the inner layer of PPE, showering; C: contaminated zone for removing the outer layer of PPE;
  6. Cleaning regime described.
  7. Patient transport described;
  8. Treatment of SARS patients and handling of the equipment described: Interesting: Centralize facilities to better manage and train health care workers and control nosocomial infection.


Response: Augmentation

Service Model: Mass ICU

Examples:

Richmond University Medical Center in West Brighton[2]


Site type: Existing Hotel

Response: Minor Adaptive Reuse

Service Model: Obligate - Cellular/ single room

Examples:

Theory Only[3][4]


Site type: Conference Centre

Response: Repurposing

Service Model: Mass ICU

Examples:

NHS Nightingale Hospital, London[5], Javits Center, New York[6], Los Angeles Convention Centre[7]


Site type: Open Field

Response: Modular Construction

Service Model: Cellular / Single Room

Examples:

Volumetric Building Companies (VBC) Philadelphia[9] (Linear format), MAII – USA[10] (Clustered configuration)


Response: Repurposed Shipping Containers

Service Model: Mass ICU

Examples:

CURA, Milan[11]


Response: Tented Construction

Service Model: Mass ICU or Triage

Examples:

Central Park, New York [12] Brescia, Lombardy, Italy [13]

  1. Fung, C., Hsieh, T., Tan, K., Loh, C., Wu, J., Li, C., . . . Lee, C. (2004). Rapid Creation of a Temporary Isolation Ward for Patients With Severe Acute Respiratory Syndrome in Taiwan. Infection Control & Hospital Epidemiology, 25(12), 1026-1032. doi:10.1086/502339 [1]
  2. 2.0 2.1 Joseph Ostapiuk, 2020 https://www.silive.com/coronavirus/2020/03/staten-island-hospitals-boosting-capacity-to-meet-potential-coronavirus-scenarios.html
  3. Salus, 2020, https://www.salus.global/article-show/architecture-a-critical-ingredient-of-pandemic-medicine
  4. 4.0 4.1 4.2 Schroer, 2020 https://www.ashe.org/what-if-we-used-hotel-patients
  5. 5.0 5.1 Coronavirus: Building NHS Nightingale Hospital London, 2020 https://www.bbc.com/news
  6. 6.0 6.1 6.2 KATHARINE KEANE 2020, These Architects Are Addressing COVID-19 Health Care Infrastructure Capacity
  7. Annlee Ellingson 2020, L.A. Convention Center transforming into a field hospital during coronavirus crisis, [2]
  8. Governor Cuomo, 2020 www.flickr.com
  9. 9.0 9.1 Mike Beirne, 2020[https://www.probuilder.com/modular-builders-mobilize-deliver-prefab-modules-coronavirus-care https://www.probuilder.com
  10. 10.0 10.1 Courtesy Philip Patrick Sun
  11. 11.0 11.1 11.2 Matthew Marani, 2020, CURA aims to retrofit shipping containers into COVID-19 treatment centers [3]
  12. 12.0 12.1 Ben Kesslen, 2020, Central Park tent hospital admits first COVID-19 patient https://www.nbcnews.com/health/health-news/live-blog/
  13. 13.0 13.1 Francesca Volpi/Bloomberg, 2020 https://www.bloomberg.com/news/articles/2020-04-02/the-world-just-hit-1-million-coronavirus-infections