Rachel Kapisak Jones

In the midst of the COVID-19 pandemic, American architects are putting their ingenuity to work by helping to quickly identify and adapt buildings and spaces into temporary health care facilities for an influx of patients.

Convention centers like Manhattan’s Javits Center have been converted into makeshift hospitals while parking garages have been turned into critical care units or emergency triage stations. Design professionals have helped erect an emergency field hospital made up of tents in New York City’s Central Park. And still other buildings—previously used for a variety of purposes—are now serving as quarantine locations for people exposed to the novel coronavirus.

“This is not just about designing a converted space,” says Molly Scanlon, FAIA. “This is about leveraging our advanced problem-solving abilities and technical skills to rapidly convert a non-health-care setting for change of occupancy during a pandemic.”

Scanlon is an environmental health scientist with more than 25 years of experience in planning, designing, and constructing health care facilities as a health care architect. She is now director of standards, compliance & research at Phigenics, an independent water management company.

As the appointed member of the Design and Health Leadership Group at The American Institute of Architects’ Academy of Architecture for Health, Scanlon chairs AIA’s COVID-19 response task force. Her team is charged with developing tools to inform public officials, health care facility owners and architects on site adaptation for accommodating patients—both those with COVID-19 and other illnesses—at alternative care sites.

Ahead of the release of the task force’s first briefing, we spoke with Scanlon on what architects can do during this crisis and what skills they may be asked to use in adaptively reusing existing spaces.

What has been asked of architects so far during this crisis and what has the industry’s response been?

Health care architects have been working on this problem since January when health care institutions and other clients called them for help because it was unknown what the government’s response would be.

Health care providers asked health care architects to come up with ways to adapt their hospital systems and to put up temporary structures. They’ve also been determining space allocations for repurposing within alternative care sites and shuttered buildings.

What roles can other architects play in curbing the pandemic?

If a building that you previously worked on is being commandeered and adapted for health care needs, you might want to offer a helping hand by pairing up with a health care architect. We have heard from some facility managers that it’s not helpful to have architects directly calling the facilities themselves to offer services. They’re a little overwhelmed right now. However, architects can contact health care architects, contractors, or state and local authorities.

And if your firm was the architect-of-record for a building under consideration as an alternative care site, you’re probably the best person to assist with site adaptation because you would have important background knowledge about the building.

Each state may differ, but architects ought to know that New York Gov. Andrew Cuomo compiled an inventory of large facilities to be designated for COVID-19 and non-COVID-19 treatment and inquired about local firm knowledge of those facilities.

What are some challenges that architects are facing in this crisis?

In health care design, architects typically respond to building codes. And so, we always come at it from, “This is the minimum standard of care in assessing the quality of the built environment.”

However, what is that minimum response during a pandemic? I’m finding that no one seems to have defined this lower threshold for health care operations in a non-health-care setting. This is a challenge we are working to resolve.

What should architects be doing to prepare for both an expected surge in the number of COVID-19 cases and a prolonged fight amid economic uncertainty?

Call your colleagues and try to logically place your expertise within ongoing efforts. If you don’t have relevant expertise, volunteer in your community and use your problem-solving skills. It’s also important to stay in your swim lane.

Some architects are concerned about liability and stepping in during an emergency. Health care design and construction requirements have to be relaxed state-by-state regarding construction and to avoid increasing your legal liability.

What other precautions should architects be taking during this pandemic?

We need people taking time for self-care. This crisis is emotionally challenging for health care architects who are working near health care workers on the front lines. Other architects need to be sensitive to the emotional impact this is having on their colleagues. They will need emotional support and other architects need to be ready to step up when they are asked.

What has Phigenics’s experience been in this crisis?

As a water management company, we’ve been called in by government and private health care facilities to verify and validate that water systems and water quality are appropriate for patient care settings in repurposed, previously shuttered spaces and alternative care sites. As the surge is increasing, our specialty services are increasing for rapid testing response.

The concern is if you take a COVID-19-infectious person who is already immunocompromised, and you place them in a dormitory that was shuttered for two years and then activate the water system, they might survive COVID-19—only to die of Legionnaires’ disease.

Another problem is that all these hotels and other buildings are now sitting largely empty and their owners have to maintain those buildings until the economy returns.