HOK’s Mara Baum, firm-wide sustainable design leader of health + wellness, and Komal Kotwal, sustainable design leader in Texas, describe design strategies for infection prevention, health and wellness. They also explore the increased relevance of the WELL Building Institute’s evidence-based solutions.
COVID-19 has connected many dots linking conditions in buildings to human health. Though we’ve long understood this connection, the pandemic has accelerated action. Designing the built environment for health and well-being has never been more important than it is today.
As we work with clients to address their coronavirus concerns, we have opportunities to design healthier buildings for the long term. It’s relatively easy to make design changes to projects that were just starting when the pandemic struck. But there are also projects that were substantially designed or already under construction. Then there are clients looking for infection prevention strategies in already-occupied spaces. The design interventions we can suggest depend where on the spectrum each project falls.
Strategies for Infection Prevention
As architects and designers, we can’t guarantee risk-free or completely safe interior environments. What we can do is bring external, peer-reviewed best practices from credible sources and help implement them in buildings to mitigate risks.
Specific design strategies for infection prevention in this new coronavirus-era world include:
- Focus on ventilation. As we’ve learned about the significant role that both aerosols and droplets play in transmitting COVID-19, we have paid more attention to ventilation strategies. It’s important for organizations to work with a qualified HVAC engineering firm to investigate ventilation and filtration systems and determine what works best for their conditions. Potential upgrades include things like advanced building automation for real-time HVAC performance evaluation and correction, higher-rated air filters like MERV-13 and MERV-14, operable windows and technologies like ultraviolet germicidal irradiation (UVGI) in return air ducts. Spaces intended for groups can include carbon dioxide sensors so that ventilation increases along with occupancy and carbon dioxide levels. Read more about HVAC strategies here.
- Design spaces that give people plenty of options in how and where they work. The pandemic has underscored how important it is for organizations to have flexible workplace environments, including productive outdoor workspaces. The spaces that are the easiest to change are large and open with flexible furniture. They can accommodate quick reconfigurations to support new needs for physical distancing without requiring major renovations. Read more about workplace distancing strategies here.
- Select materials and finishes durable enough to withstand intense cleaning regimens. Frequently touched surfaces should be able to withstand bleach or alcohol cleaning and disinfecting agents. Take into account differences in the virus half-life—the time it takes for an initial amount of virus to no longer be detectable—on different finish types, e.g., porous vs. non-porous surfaces.
- Don’t specify antimicrobial surfaces. Most antimicrobials have chemical additives and cause more harm than good. Many healthcare systems, including Kaiser Permanente, have banned these added chemical antimicrobials due to human and environmental health impacts. Copper and silver ions can disarm viruses without added chemicals but come with their own challenges.
- Avoid designing surfaces that can’t be cleaned, like inside corners or hard-to-reach spots.
- Consider increasing the size or quantity of janitor closets. Though they may be the least glamorous spaces in any building, janitor closets are more important than ever.
- Consider hygiene by including touchless features, strategically positioning sanitizer stations and sinks, and using paper towels instead of air dryers. Integrating new Internet of Everything (IoE) technologies will enable more hands-free, voice-activated systems.
The Perception vs. Reality of Safety
A recent story in The Atlantic pointed out that making bottomless dispensers of hand sanitizer available and meticulously scrubbing all pathogens from every surface of a building won’t stop the spread of COVID-19—especially with recent scientific evidence showing the prevalence of airborne, person-to-person transmission. The author labeled these strategies as “hygiene theater.”
In some cases, things that building occupants can’t see—like a new MERV-14 filter—might make a bigger impact in creating a healthier environment than a building’s new deep cleaning policies. That said, there may still be considerable value in using a limited form of hygiene theater to help people feel safe. In our new world of heightened sensitivities, organizations must rebuild the trust of their building occupants. Yet we shouldn’t let this get in the way of also focusing on other infection prevention strategies, including use of PPE, physical distancing and moving activities outdoors when possible.
As companies bring their employees back to the workplace, designers can help to rebuild staff trust and feelings of safety by providing an abundance of options for how people work. We want them to be able to take more control over their experiences. The pandemic has shifted these choices from a “nice to have” to a “need to have” for many office occupants. This approach aligns with HOK’s recent research on designing for neurodiversity in the workplace. Read more about enabling choices for all employees in more inclusive COVID-19-era workplace ecosystems here.
WELL’s Evidence-Based Solutions
The COVID-19 pandemic has created opportunities for designers to implement both infection prevention measures and strategies that organizations can use to improve the overall health of their people.
The International WELL Building Institute (IWBI)’s WELL Building Standard contains evidence-based solutions supporting occupant health and well-being. WELL directly addresses strategies for active design, biophilia and access to nature, and use of low-emitting materials. It outlines requirements related to air quality monitoring and awareness, ventilation, handwashing, microbe and mold control, and cleaning procedures. IWBI is updating WELL v2 to incorporate strategies related to the COVID-19 pandemic and recommend additional actionable measures for creating healthier buildings.
IWBI also has released the WELL Health-Safety Rating, which helps address operations and maintenance practices in existing buildings. This is particularly attractive to organizations that need to draw customers into their spaces, i.e., restaurants, retail stores or hotels.
In the past, corporate clients have largely been most interested in WELL for interior office projects. But the WELL rating system that most people are familiar with is applicable to any kind of building: from renovation to ground-up new construction to existing buildings with little or no renovation planned. We have recently had airport and justice clients commit to pursuing WELL certification. WELL’s benefits for COVID-19 are twofold. First, WELL strategies can help reduce the risk of infection. Just as importantly, they address chronic health conditions like diabetes and asthma that lead to worse health outcomes for people who do contract COVID-19.
There is also a pilot for a separate WELL Community Standard for protecting health and well-being in public spaces. HOK’s teams are already looking at that for several large-scale planning projects.
Our design teams can apply WELL-inspired design solutions to every building project—regardless of whether it is seeking certification. When designing for health and wellness, we consider:
- Biophilia: Connections and access to nature
- Restorative spaces: Indoors and outdoors
- Activity-based light levels with good color rendering
- Circadian lighting design (read more here)
- Enhanced daylight access with optimum glare control
- Thermal comfort and thermal controls
- Good acoustics
- Improved air filtration and ventilation rates
- Healthy materials that don’t emit high levels of harmful chemicals
- Easy access to drinking fountains and sinks with filtered water
- Active design strategies to get people moving throughout the day, like indoor stairways, treadmill desks and roof running tracks
- Plans for safety, security and emergency preparedness
People living in our most vulnerable communities were more likely to face chronic health challenges like diabetes, heart disease and obesity before this public health crisis began. Now they are being disproportionately affected by COVID-19 and experiencing a much higher death rate. If we can incorporate more WELL principles into the environments we design, we can help all people live healthier lifestyles and be better prepared for future pandemics and major climate events. Read more about the link between COVID-19, climate change and environmental racism here.