The role of the built environment in updating design requirements in the post-pandemic scenario: a case study of selected diagnostic facilities in Brazil

This paper aims to discuss the relations between the built environment and the patient’s health, considering the context of the pandemic experienced since 2020. We assessed the results of a systematic literature review to create a theoretical framework. Based on that, we evaluated the performance of five diagnostic facilities sited in Sao Paulo, Brazil, during the occupation phase. These buildings share a similar design programme in a way that enables a systematic qualitative assessment. We organised the design requisites in a Table of Diagnostics and Recommendations. Based on the gathered evidence, we proposed reviewing the existing guidelines to promote healthier indoor environments. Among the leading design guidelines updates are issues regarding the management of contamination risk, such as the strategic planning of circulation routes, increasing outdoor air rates, and the specification of disinfection systems. We also present measures to promote healthiness and well-being for both patients and the medical team, including improving solar access to indoor environments and physical and visual access to the outdoors. © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

[1]  Yu Zhou,et al.  Experimental and numerical study on the transport of droplet aerosols generated by occupants in a fever clinic , 2020, Building and Environment.

[2]  C. Donskey,et al.  Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid contamination of surfaces on a coronavirus disease 2019 (COVID-19) ward and intensive care unit , 2020, Infection Control & Hospital Epidemiology.

[3]  A. Dargahi,et al.  Investigation of SARS CoV-2 virus in environmental surface , 2021, Environmental Research.

[4]  Kiran Shekar,et al.  Planning and provision of ECMO services for severe ARDS during the COVID-19 pandemic and other outbreaks of emerging infectious diseases , 2020, The Lancet Respiratory Medicine.

[5]  Lorissa MacAllister,et al.  Exploring the Concept of Healing Spaces , 2018, HERD.

[6]  Debajyoti Pati,et al.  How to Write a Systematic Review of the Literature , 2018, HERD.

[7]  G. Grasselli,et al.  Preparation of a radiology department in an Italian hospital dedicated to COVID-19 patients , 2020, La radiologia medica.

[8]  R. G. Passos,et al.  Exploratory assessment of the occurrence of SARS-CoV-2 in aerosols in hospital facilities and public spaces of a metropolitan center in Brazil , 2021, Environmental Research.

[9]  J. Sagripanti,et al.  Estimated Inactivation of Coronaviruses by Solar Radiation With Special Reference to COVID‐19 , 2020, Photochemistry and photobiology.

[10]  Joyce S. Lee,et al.  Built Environment Airborne Infection Control Strategies in Pandemic Alternative Care Sites , 2020, HERD.

[11]  Igor Shuryak,et al.  Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses , 2020, Scientific Reports.

[12]  W. Zingg,et al.  Ultraviolet disinfection robots to improve hospital cleaning: Real promise or just a gimmick? , 2021, Antimicrobial resistance and infection control.

[13]  Mike Kagioglou,et al.  Healing built-environment effects on health outcomes: environment–occupant–health framework , 2019 .

[14]  Contradictions in the promotion of publishing academic and scientific journal articles, and the inability to cope with the new coronavirus (COVID-19) , 2021, Antimicrobial resistance and infection control.

[15]  A. R. Escombe,et al.  Improving natural ventilation in hospital waiting and consulting rooms to reduce nosocomial tuberculosis transmission risk in a low resource setting , 2019, BMC Infectious Diseases.

[16]  Xiaosheng Wang,et al.  Comparative Review of SARS-CoV-2, SARS-CoV, MERS-CoV, and Influenza A Respiratory Viruses , 2020, Frontiers in Immunology.

[17]  Lih-Jen Kau,et al.  Planning and Design of a Full-Outer-Air-Intake Natural Air-Conditioning System for Medical Negative Pressure Isolation Wards , 2021, Journal of healthcare engineering.

[18]  M. Pagano,et al.  Institutional Tuberculosis Transmission. Controlled Trial of Upper Room Ultraviolet Air Disinfection: A Basis for New Dosing Guidelines. , 2015, American journal of respiratory and critical care medicine.

[19]  Helianthe S.M. Kort,et al.  The integrated and evidence-based design of healthcare environments , 2015 .

[20]  Eric Bardenhagen,et al.  The Seniors' Outdoor Survey (SOS Tool): A Proposed Weighting and Scoring Framework to Assess Outdoor Environments in Residential Care Settings , 2018 .

[21]  H. Solo-Gabriele,et al.  Estimating Health Risks to Children Associated with Recreational Play on Oil Spill-Contaminated Beaches , 2020, International journal of environmental research and public health.

[22]  É. Oksenhendler,et al.  Surfaces and equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the emergency department at a university hospital , 2020, International Journal of Hygiene and Environmental Health.

[23]  Jianzhong Liu,et al.  Environmental contamination by SARS-CoV-2 in a designated hospital for coronavirus disease 2019 , 2020, American Journal of Infection Control.

[24]  M. Mildner,et al.  Re-epithelialization and immune cell behaviour in an ex vivo human skin model , 2020, Scientific Reports.

[25]  A. Nafez,et al.  Environmental disinfection against COVID-19 in different areas of health care facilities: a review , 2020, Reviews on environmental health.

[26]  Sunand Prasad Regenerative Agents: Patient-Focused Architectures , 2017 .

[27]  Göran Lindahl,et al.  Validation of a multiple criteria tool for healthcare facilities quality evaluation , 2020, Facilities.

[28]  Gabrielle M. String,et al.  A Systematic Review of Surface Contamination, Stability, and Disinfection Data on SARS-CoV-2 (Through July 10, 2020). , 2020, Environmental science & technology.

[29]  Bogdan Andrei Fezi HEALTH ENGAGED ARCHITECTURE IN THE CONTEXT OF COVID-19 , 2020 .

[30]  Alan Godfrey,et al.  Evaluation of the Finis Swimsense® and the Garmin Swim™ activity monitors for swimming performance and stroke kinematics analysis , 2017, PloS one.

[31]  C. Napoli,et al.  SARS-CoV-2 indoor contamination: considerations on anti-COVID-19 management of ventilation systems, and finishing materials in healthcare facilities. , 2020, Annali di igiene : medicina preventiva e di comunita.

[32]  Shelly L. Miller,et al.  How can airborne transmission of COVID-19 indoors be minimised? , 2020, Environment International.

[33]  Kai Schuster,et al.  Clinic Design as Placebo—Using Design to Promote Healing and Support Treatments , 2017, Behavioral sciences.

[34]  Marie Elf,et al.  The built environment and its impact on health outcomes and experiences of patients, significant others and staff—A protocol for a systematic review , 2020, Nursing open.

[35]  Wladyslaw Kowalski,et al.  Ultraviolet Germicidal Irradiation Handbook , 2009 .

[36]  A. Devlin,et al.  Do the hospital rooms make a difference for patients’ stress? A multilevel analysis of the role of perceived control, positive distraction, and social support , 2017 .

[37]  M. Lynch,et al.  Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room? , 2020, Journal of Hospital Infection.

[38]  Neemat Jaafarzadeh,et al.  A systematic review of possible airborne transmission of the COVID-19 virus (SARS-CoV-2) in the indoor air environment , 2020, Environmental Research.

[39]  Yusen Duan,et al.  Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals , 2020, Nature.

[40]  S. Boufous,et al.  Helmets for preventing injury in motorcycle riders. , 2008, The Cochrane database of systematic reviews.

[41]  B. McSharry,et al.  Manipulation of the Innate Immune Response by Varicella Zoster Virus , 2020, Frontiers in Immunology.

[42]  Zhe Wang Use the Environment to Prevent and Control COVID-19 in Senior-Living Facilities: An Analysis of the Guidelines Used in China , 2020, HERD.

[43]  Shelly L. Miller Upper Room Germicidal Ultraviolet Systems for Air Disinfection Are Ready for Wide Implementation. , 2015, American journal of respiratory and critical care medicine.

[44]  Gesine Marquardt,et al.  Impact of the Design of the Built Environment on People with Dementia: An Evidence-Based Review , 2014, HERD.

[45]  Stephen Verderber,et al.  On the Planning and Design of Hospital Circulation Zones , 2017, HERD.

[46]  V. Sharma,et al.  Current understanding of the surface contamination and contact transmission of SARS-CoV-2 in healthcare settings , 2021, Environmental Chemistry Letters.

[47]  N. Seixas,et al.  Estimating the burden of United States workers exposed to infection or disease: A key factor in containing risk of COVID-19 infection , 2020, PloS one.

[48]  Richard Mazuch,et al.  Salutogenic and Biophilic Design as Therapeutic Approaches to Sustainable Architecture , 2017 .

[49]  Shanna A. Ratnesar-Shumate,et al.  Simulated Sunlight Rapidly Inactivates SARS-CoV-2 on Surfaces , 2020, The Journal of infectious diseases.

[50]  F. Bull,et al.  The impact of the built environment on health across the life course: design of a cross-sectional data linkage study , 2013, BMJ Open.

[51]  Y. Gerchman,et al.  UV-LED disinfection of Coronavirus: Wavelength effect , 2020, Journal of Photochemistry and Photobiology B: Biology.

[52]  G. Kenttä,et al.  Potentially Prolonged Psychological Distress from Postponed Olympic and Paralympic Games during COVID-19—Career Uncertainty in Elite Athletes , 2020, International journal of environmental research and public health.

[53]  C. Desha,et al.  Healing gardens in children’s hospitals: Reflections on benefits, preferences and design from visitors’ books , 2017 .

[54]  C. Lemorini,et al.  The origin of early Acheulean expansion in Europe 700 ka ago: new findings at Notarchirico (Italy) , 2020, Scientific Reports.

[55]  K. To,et al.  Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19) , 2020, Infection Control & Hospital Epidemiology.

[56]  Shufa Zheng,et al.  Evaluation of disinfection procedures in a designated hospital for COVID-19 , 2020, American Journal of Infection Control.