Supporting healthcare facilities

COVID-19 Healthcare Series: Part 1

In the face of the COVID-19 global health crisis, engineers and designers like so many others, are being called upon to support the global healthcare response effort.

In early March, Stuart Smith, Beca’s Healthcare Practice leader, was already talking with our healthcare clients who were watching the COVID-19 epidemic unfold globally with increasing concern, and wanted to discuss the potential impacts on their facilities. 

One month later, many countries across Asia Pacific are under varying levels of lockdown and facing increasing demand on their healthcare infrastructure. Healthcare providers and institutions have actively responded to this call to arms - the urgent need to provide adequate infrastructure to support COVID-19 patients - but also to continue to safely care for other patients while keeping front-line healthcare workers safe.

Through our offices across the Asia Pacific region, we have been actively providing support for many healthcare providers. The needs of facilities and institutions vary – and context-specific advice is critical – however we have seen some common challenges, including:

Expansion / conversion of patient care units for COVID-19 patients

• Assessment of room and ward conversion options to provide additional COVID-19 isolation capacity. Protecting healthcare workers is one of the most important challenges facing institutions, so consideration needs to include how to avoid transmission of the virus from COVID-19 patients to other patients and staff.
• Add additional physical separation. Space conversion has included adding new walls, ante-rooms and other features. We have also seen conversion of spaces from one use to another; although - modifications still need to address regulatory requirements despite being temporary in nature. We are seeing heightened communication between councils / regulatory agencies and hospital facilities to ensure emergency modifications are implemented correctly and quickly.
• Some healthcare providers have established temporary facilities to assess and triage patients. These include temporary and modular structures for drive-through testing to minimise potential transmission of the virus and protect healthcare workers and other patients.
• With conversions/ expansions, it’s important to watch for fire safety issues such as egress paths, emergency lighting, sprinkler systems, fire alarm systems, and flammability of temporary or new building elements.

Modification of HVAC (Heating Ventilation and Air Conditioning)

• Some interventions have resulted in modifications to existing HVAC systems to enable negatively pressurised, or neutral pressurized systems. Avoiding recirculating air into common areas from spaces that have been modified for COVID-19 isolation use has also been considered. We note that as knowledge about the disease transmission has developed, the emphasis on this approach has softened; this still needs to be assessed on a case by case basis depending on the application.
• Some equipment suppliers and engineers are working on ‘plug and play’ HVAC componentry to enable faster space conversion.

Reinforcement of Medical Gas Systems

• The demand for medical air and oxygen may increase significantly due to an influx of COVID-19 patients in ICU spaces or those spaces being converted for this use. This requires assessment of the existing system’s capacity to support larger demand, e.g. pipeline size effect on pressure, oxygen flow and manifolds, pressure reducing stations and evaporators to prevent systems icing up.
• Work with medical gas suppliers to ensure increased supply and delivery schedules are available.

Review Critical Electrical and ICT Infrastructure

• Emergency power systems and generators need to be fully functional and maintained. Review capacity of systems to support additional medical equipment demand and other emergency building modifications. Check generator fuel supplies and systems are available. Information and Communications Technology (ICT) systems need to be fully operational.

Communication of Best Practice

• Understanding about the disease transmission is increasing very rapidly. All engineers and designers must keep abreast of new guidance and seek appropriate professional support to ensure issues are being addressed and implemented correctly. Our team has a system for sharing updates as they emerge.

We are doing our best to support our health organisations in creating more and better space to enable them to fight the ravages of this pandemic. Ultimately, our thoughts are with all the health workers globally who are battling this disease on the front lines. On behalf of all of us, thank you.

This is part 1 of our COVID-19 healthcare series. Stay tuned for more insights we’ve gained on helping our healthcare clients prepare for one of the biggest challenges they’ve ever faced!

The full series can be viewed here:

• Part 1 - Supporting healthcare facilities
• Part 2 - Helping our healthcare clients prepare for a global pandemic
• Part 3 - Valuable lessons for future hospital design