Post-Pandemic Architecture Needs to Be Healthier

As an architecture student, I’d normally be building a model in my studio on campus right now. Instead, six months into quarantine, I’m still sitting in my makeshift home office worrying about my friends and family. The death toll climbs every day and my mom, who has an autoimmune disorder, is in the high-risk population. I wish that places like my local grocery store were safer for her. I wonder, how will future building designs combat airborne pathogens?

The COVID-19 outbreak is both a tragedy and a catalyst for change. My architecture professors at the University of Oregon recognize this and are researching how the virus spreads indoors, specifically in hospitals. They realize that the inside world isn’t safe and it’s up to architects to make buildings safer. If their research were used for mass renovations, people with compromised immune systems would be safer, fewer people would get sick, and we’d be better prepared for future pandemics.

Because the average person spends 90% of their life indoors, buildings shape our lives and health. And now, our homes impact us more than any other place. Crowded conditions, narrow hallways, and small apartment units become much bigger problems when people have to stay inside. We need more space, flexibility, and fresh air because it’s hard to maintain social distancing in a cramped lobby or live and work in a studio apartment. But improvements must not be limited to people who can afford expensive real estate. We must also consider the needs of people living in poverty and those with disabilities. We need everything from better affordable housing to wider aisles at the grocery store. COVID-19 is an opportunity for architects to see how buildings need to improve. The coronavirus pandemic may be temporary, but we need to make permanent changes.

Design interventions that mitigate the spread of COVID-19 will be helpful all the time, not just during pandemics. There are more people “at risk” during the annual flu season than you might think. Pregnant people risk complications if they get a cold or flu. And infants under six months old are more likely than the general population to be hospitalized, stay in the ICU, or die from an influenza infection. The flu is especially dangerous for people over 65, who account for 70 to 85% of influenza-related deaths each year. And, no matter their age, people who have disabilities are more likely to suffer complications from common viruses. People on chemotherapy and those with HIV/AIDs are also at greater risk for any infection. Reducing the spread of airborne pathogens would help everyone, but it’s particularly important for the more vulnerable populations.

Unfortunately, it would cost a lot to renovate buildings to mitigate the spread of airborne pathogens. Widening hallways, improving ventilation, and changing surface finishes can drastically increase the total cost of a building. Even though improving public health saves money, it most likely doesn’t balance out the cost of renovation for building owners. Commercial buildings cost $168.53 to $261.24 per square foot to construct and $50 to $150 per square foot to renovate. Accessibility is already about 20% of that budget. If you multiply the cost per square foot by 10,000 or more, it’s clear why people might resist modifications. That’s why it took decades of protests to pass laws, including the Americans with Disabilities Act, requiring basic building accessibility like ramps and elevators.

Most buildings were not designed with extra safety measures for the annual flu season because people are unlikely to pay for changes they don’t need themselves. For able-bodied people, it doesn’t make much of a difference to have a ramp outside the door. Similarly, for people with typical immune systems, flu season is no big deal and they don’t have to worry if their friend has a cold. But to protect the people with compromised immune systems, and the general public during pandemics, architects need to consider healthy building design more carefully.

Renovating buildings after COVID-19 may sound like a radical idea, but architecture has always taken cues from widespread illness. Diseases have been impacting architectural design for centuries. For example, in the late 1700s, King Louis XV of France commissioned alterations in hospital guidelines in response to doctors’ realization that hygiene and clean air promote healing. Louis XV believed in curative environments, which reformers argued could treat illness just as well as medical intervention. In the 1850s, Florence Nightingale, a nurse in the Crimean war, made new discoveries that still inspire hospital design today. She saved thousands of lives by spreading patients out, opening windows, and keeping treatment rooms cleaner. Hospitals continue to uphold these standards and build on them with new interventions like HEPA filters and single patient rooms.

Hospitals aren’t the only buildings to change when pandemics hit. The persistent tuberculosis pandemic, which killed millions in the 18th and 19th centuries, is one factor that sparked the modernist architecture movement. Early 20th-century architects worked against the tuberculosis pandemic to promote public welfare and reduce socioeconomic inequality. Like COVID-19, tuberculosis was more dangerous for the lower class. Besides lacking access to medical care, people living in poverty are more likely to have poorly built, small dwellings and close neighbors. Poor ventilation and close proximity is a recipe for widespread infection. In the 18th and 19th centuries, tuberculosis infected the working class so heavily it became a major economic concern. The measurable health hazard of poor dwellings resulted in laws like New York’s 1901 Tenement House Reform, which banned subpar apartment construction.

An example of streamline, ocean-liner architecture, from Edmonds, WA. (Courtesy Wikimedia)

Architects recognized their role in mitigating the effects of tuberculosis and designed against airborne pathogens. Modern buildings like 1930s ocean-liner style homes are more than structures with smooth, flowing lines and sunbathing space. They’re architectural designs that respond to tuberculosis. Because doctors thought fresh air and sunlight treated tuberculosis, architects incorporated these elements into their designs. Some changes were radical, like open-air schools, which effectively kept students outside so they could continue their education despite the widespread respiratory infections. Changes to residential design were more subtle but had lasting effects. International-style architects popularized balconies, terraces, and flat roofs to allow more access to fresh air and sunlight in apartments. What will be the modern equivalent following the COVID-19 pandemic of 2020? Maybe it’s ventilation systems that don’t pass air between rooms, hallways that allow people to stay six feet apart, and more antiviral surfaces like copper.

The COVID-19 pandemic will pass. But things shouldn’t go back to normal after this, because normal isn’t equitable. While many of us look forward to eating at a restaurant again, annual flu seasons make our current restaurants too dangerous for many people. As a future architect, I want to help make the world safer for those people. Architects have a public responsibility to all users, not just the able-bodied and healthy. Changing buildings to reduce viral infections is crucial for immunocompromised people, but it helps everyone. We can’t predict who is susceptible to the novel coronavirus. We’ve also had pandemics before and we will again. If we make major changes now, we’ll thank ourselves later when our pandemic-friendly buildings save lives.

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