How COVID-19 Will Change Health, Hospitality and Senior Facility Design
TL;DR: In this paper, a literature review was conducted, the results of which were distributed to a group of experts specializing in health, hospitality and design, and expert focus groups were conducted to further explore the proposed concepts.
Abstract: Background: Based on recent experiences with the COVID-19 pandemic, designers and design researchers are crafting guidelines for the development of future environments. In this context, this paper focuses on future best practices regarding environments for health, hospitality and senior care. Methods: An extensive literature review was conducted, the results of which were distributed to a group of experts (N=12) specializing in health, hospitality and design. After receiving their input, expert focus groups were conducted to further explore the proposed concepts. The document was revised based on the contributions of these field experts, resubmitted for additional input, and ultimately summarized in this paper. Results: Based on the literature review and expert input, dozens of recommendations were made regarding post-COVID health, hospitality and seniors environments. Healthcare facilities will require additional space, access to the outdoors, service hubs, and additional infrastructure to all conversion of garages for emergency use. Hospitality settings will employ new cleaning methods, use of robotics, improved HVAC, Wellness programming, workspace options, and flexible food service operations. Senior facilities will engage more technology, socially distance visiting facilities, increase access to nature, and smaller scale residential clusters. Discussion: By considering health and hospitality simultaneously, we come to understand the symbiotic benefits of applying goals from one sector to the other. Senior living environments are an excellent example of this approach in action. By implementing some of the proposed design recommendations generated by this research, we will be better prepared to face future challenges.
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TL;DR: In this article, a new Monte Carlo simulation method enhanced by a convolutional neural network is presented, which is used to generate site-dependent ground motion time histories using a nonlinear Kanai-Tajimi filter.
Abstract: The evaluation of the structural response statistics constitutes one of the principal tasks in engineering. However, in the tail region near structural failure, engineering structures behave highly nonlinear, making an analytic or closed form of the response statistics difficult or even impossible. Evaluating a series of computer experiments, the Monte Carlo method has been proven a useful tool to provide an unbiased estimate of the response statistics. Naturally, we want structural failure to happen very rarely. Unfortunately, this leads to a disproportionately high number of Monte Carlo samples to be evaluated to ensure an estimation with high confidence for small probabilities. Thus, in this paper, we present a new Monte Carlo simulation method enhanced by a convolutional neural network. The sample-set used for this Monte Carlo approach is provided by artificially generating site-dependent ground motion time histories using a nonlinear Kanai-Tajimi filter. Compared to several state-of-the-art studies, the convolutional neural network learns to extract the relevant input features and the structural response behavior autonomously from the entire time histories instead of learning from a set of hand-chosen intensity inputs. Training the neural network based on a chosen input sample set develops a meta-model that is then used as a meta-model to predict the response of the total Monte Carlo sample set. This paper presents two convolutional neural network-enhanced strategies that allow for a practical design approach of ground motion excited structures. The first strategy enables for an accurate response prediction around the mean of the distribution. It is, therefore, useful regarding structural serviceability. The second strategy enables for an accurate prediction around the tail end of the distribution. It is, therefore, beneficial for the prediction of the probability of failure.
6 citations
TL;DR: The COVID 19 outbreak dramatically highlighted the inadequacy of the Emergency Department (ED) settings in dealing with events that can acutely affect a wide range of population and the immediate urgency to create strictly distinct pathways became also a strategic aspect for reducing possible sources of contagion inside the hospital as discussed by the authors .
Abstract: The COVID 19 outbreak dramatically highlighted the inadequacy of the Emergency Department (ED) settings in dealing with events that can acutely affect a wide range of population. The immediate urgency to create strictly distinct pathways became also a strategic aspect for reducing possible sources of contagion inside the hospital.1 This need has often clashed with inadequate structural conditions of the hospital: in fact, the rigidity of many EDs is due to the hospital typology and its localization (affected by functional program);2,3 and it prevents them from being quickly adapted to new needs in the case of maxi-emergencies.4 In several recent international projects, the presence of a multifunctional space and/or a buffer area guarantees different scenarios in relation to the healthcare/emergency needs.5 [...]
2 citations
TL;DR: The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19 and the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions is considered.
Abstract: Objective: The COVID-19 pandemic has impacted healthcare systems worldwide. Although this disease has primarily impacted general medicine intensive care units, other areas of healthcare including psychiatry were modified in response to corona measures to decrease the transmission of the disease. Reflecting on the modifications to the environment provides an opportunity to design psychiatric environments for future pandemics or other demands for healthcare. Background: The therapeutic environment of psychiatric wards was modified in Friesland, the Netherlands, in response to COVID-19. During this time, an interdisciplinary team met consistently to contribute to the preliminary design of a new psychiatric hospital. Methods: During the first 18 months of the pandemic, clinical reflections were made to describe the impact of COVID-19 on the psychiatric care environment. Architects have created a preliminary design of a new psychiatric hospital based on these reflections, monthly collaborative design discussions based on virtual mock-ups and evidence-based design based on theoretical concepts and research. Results and conclusions: This theoretical and reflective study describes how an inpatient psychiatric environment was restructured to manage infection during COVID-19. The therapeutic environment of the psychiatric ward and patient care changed drastically during COVID-19. The number of patients accessing care decreased, patient autonomy was restricted, and the function of designated behavioral support spaces changed to manage the risk of infection. However, these challenging times have provided an opportunity to reflect on theories and consider the design of new hospital environments that can be adapted in response to future pandemics or be restructured for different care functions.
1 citations
TL;DR: This study provided originality for the implementation and future development of hospital layout designs that can prevent the spread of COVID-19 throughout Thai community hospitals.
Abstract: The unprecedented outbreak of COVID-19 has had a tremendous negative impact on healthcare facilities, especially public hospitals. Thai community hospitals serve as primary care for COVID-19 patients. However, many hospital buildings were constructed in the 1990s and are now becoming outdated. Community hospitals faced many difficulties during the Thailand COVID-19 outbreak. To identify these difficulties this study focused on the physical settings of the community hospital’s outpatient departments (OPD) between 2020 and 2021. Furthermore, the study provided design suggestions for preventing the spread of respiratory infectious diseases. The study used a three-step process of data collection. The first was to observe the physical settings of the OPD buildings of the three hospitals. Secondly, interviews were conducted with thirty healthcare employees: 11 from the first hospital, 11 from the second hospital and 8 from the third hospital. Interviews were transcribed and analyzed using content analysis. Subsequently, the architectural design was produced based on observation and interview analysis. In the third step, the same thirty participants evaluated the architectural design through a focus group. Findings from the interviews led to four themes: 1) factors leading to the accumulation of pathogens, 2) measures for preventing the spread of respiratory diseases, 3) the effect of patient numbers on virus transmission, and 4) suggestions for improving the physical setting of OPDs. The analysis of the four themes led to the preliminary design recommendation, which was evaluated through a focus group, leading to suggestions for the improvement of thirteen areas. The analysis results showed that the participants were satisfied with the architectural design with additional minor recommendations. This study provided originality for the implementation and future development of hospital layout designs that can prevent the spread of COVID-19 throughout Thai community hospitals.
References
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TL;DR: Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends, and this may increase as enforced isolation continues.
Abstract: Objective Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method For this rapid review, we searched MEDLINE, PsycInfo, and Web of Science for articles published between January 1, 1946, and March 29, 2020. Of the articles, 20% were double screened using predefined criteria, and 20% of data was double extracted for quality assurance. Results A total of 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n = 51,576; mean age 15.3 years). In all, 61 studies were observational, 18 were longitudinal, and 43 were cross-sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias, although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time at which loneliness was measured and between 0.25 and 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion Children and adolescents are probably more likely to experience high rates of depression and most likely anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventive support and early intervention where possible and be prepared for an increase in mental health problems.
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1,356 citations
TL;DR: In this article, the authors conducted a systematic review of the evidence base for effectiveness of multiple mitigation measures: isolating ill persons, contact tracing, quarantining exposed persons, school closures, workplace measures/closures, and avoiding crowding.
Abstract: Influenza virus infections are believed to spread mostly by close contact in the community. Social distancing measures are essential components of the public health response to influenza pandemics. The objective of these mitigation measures is to reduce transmission, thereby delaying the epidemic peak, reducing the size of the epidemic peak, and spreading cases over a longer time to relieve pressure on the healthcare system. We conducted systematic reviews of the evidence base for effectiveness of multiple mitigation measures: isolating ill persons, contact tracing, quarantining exposed persons, school closures, workplace measures/closures, and avoiding crowding. Evidence supporting the effectiveness of these measures was obtained largely from observational studies and simulation studies. Voluntary isolation at home might be a more feasible social distancing measure, and pandemic plans should consider how to facilitate this measure. More drastic social distancing measures might be reserved for severe pandemics.
485 citations
TL;DR: A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China and a risk of fatality among hospitalised cases is estimated at 14% (95% confidence interval: 3.9–32%).
Abstract: A novel coronavirus (2019-nCoV) causing severe acute respiratory disease emerged recently in Wuhan, China. Information on reported cases strongly indicates human-to-human spread, and the most recent information is increasingly indicative of sustained human-to-human transmission. While the overall severity profile among cases may change as more mild cases are identified, we estimate a risk of fatality among hospitalised cases at 14% (95% confidence interval: 3.9–32%).
391 citations
31 Jul 2020
TL;DR: Restrictions on the use of public space and physical distancing have been key policy measures to reduce the transmission of COVID-19 and protect public health.
Abstract: Restrictions on the use of public space and physical distancing have been key policy measures to reduce the transmission of COVID-19 and protect public health. At the time of writing, one half of t...
333 citations