Throughout modern times, natural and man-made disasters have significantly influenced how we design buildings. The Great Chicago Fire of 1871 resulted in legislative changes and marked the inception of early Fire Prevention Codes. Hurricane Andrew in 1992 inspired Florida State officials to introduce stringent wind resistant code requirements. COVID-19 with its unprecedented impact on the world, will surely be next in line in influencing how buildings are designed.
Considering the close relationship that exists between COVID-19 and the elderly, and the virus’ overwhelming impact on Senior Living Communities, it behooves us as architects and designers, whose primary objective is the safety of building occupants, to start looking for design solutions that can limit the spread of the virus. Although we are yet to gain a true understanding of how the virus transmits from human to human, there are existing design options, materials, and best practices that we can start implementing today in Assisted Living communities to curb the spread of pathogens.
The most straight forward approach to controlling the spread of bacteria and microbes is by actively washing our hands. The cruise industry for long has encouraged its patrons to wash their hands as they make their way into self serving buffets. Introducing attractive/built-in washing stations at building entrances, and providing multiple washing and disinfectant stations throughout the building is a great start. Facilities would need to encourage or even enforce visitors to wash their hands prior to entering the premises.
Viruses like COVID-19 mostly spread through touching everyday surfaces. Reducing the number of instances an infected person touches a surface greatly reduces the chance of contamination. The use of automatic doors whenever feasible, as well as motion sensors on light switches, faucets, soap dispensers and dryers is highly recommended.
When contact with surfaces is unavoidable, specifying copper or copper infused products is a great option. Ions within copper provide a 24/7 fight against viruses and microbes making it a naturally anti-bacterial product. Countertops, grab bars, faucets, soap dispensers, light switches, door handles, and elevator buttons are all available in full copper, copper plated coatings and copper infused finish options that will actively kill germs on contact.
LEVER-LESS DOOR HARDWARE
In addition to using copper door handles, there are other options specific to door hardware that are worth mentioning, considering door levers are a primary host for germs and viruses. A 2012 study conducted in a working hospital environment showed that a door handle is five times more likely to transfer germs than a door with push plates1 . Introducing double acting doors and push plates whenever possible is a great way to reduce the spread of bacteria.
Push button door operators are somewhat similar to push plates, in that they allow a person to open a door with their elbows, hence reducing the need for full hand contact with a door lever.
The jury is still out on how long COVID-19 can live on everyday interior surfaces, however multiple studies show that non-porous surfaces such as porcelain, plastics and glass hold viruses twice as long as porous surfaces, such as wood or carpet. On the flip side, porous surfaces are inherently more difficult to clean than their non-porous counterpart, making the right selection of interior finishes particularly challenging. As designers we need weigh-in a finish product against its potential to transmit viruses based on its proposed location. For instance, porcelain tile on a countertop will host a virus for the same period of time that a porcelain tile floor would, yet the chances of cross contamination from a flooring product is much less likely than a kitchen countertop.
If there’s one thing we’ve learned in recent months following the outbreak, is the need to isolate those who are infected, from those who are not. Current Assisted Living and Memory Care facilities are not designed with this need in mind. We recommend dedicating specific areas within each facility that could be blocked off from the rest of the building during an outbreak, where the sick or those suspected of being sick can be moved to prior to getting transported to a hospital. Ideally this area would have direct access to the outside. Isolated areas will need to have a dedicated HVAC equipment designed as a negative pressure system, that can exhaust independently from the rest of the building. In the State of Florida, the area of refuge currently required for all Nursing Homes and Assisted Living Facilities during a hurricane, can be designed to double up as an isolation area during a pandemic.
HVAC DESIGN AND INDOOR AIR QUALITY
Health experts agree that COVID-19 is an airborne illness, and health officials have recently said that infected droplets can travel across far distances. This makes HVAC systems and indoor air quality important topics to discuss.
In addition to restricting air movement between various building areas and isolated compartments as mentioned above, increased humidity has been shown to reduce the spread of infected droplets and the time the virus lives on surfaces. Specifying VRFs (Variable Refrigerant Flow) units, ductless mini-splits, or PTAC units specified with hot gas reheat, allow users better humidity control than unmodified traditional split systems.
Bi-Polar Ionization units are another option available for consideration. they work by sending out electrically charged ions into occupied spaces which bond with harmful bacteria and as a result become too heavy to stay airborne and drop to the floor. This effectively reduces the spread of odors, contaminants, and viruses.
Owners and operators of Assisted Living Facilities should start thinking about which option(s) or line of defense makes the most sense for them, in their existing facilitates or as they develop news ones. As the dust settles and a clearer understanding of how COVID-19 infects and affects human beings, we anticipate tweaks to this list, as well as additional recommendations that owners and operators of facilities will have at their disposal.
It is important to also note the following link to the CDC’s preparedness checklist for Nursing Homes and other Long-Term Care Settings. Each facility can take steps for self-assessment and to improve their preparedness for this disease: download the checklist here »
Are We Pulling against Closed Doors? By Hedieh Wojgani, Catherine Kehsa, Elaine Cloutman-Green, Colin Gray, Vanya Gant, Nigel Klein. 2012.
Baker Barrios Architects would like to thank the following people for their input in developing this white paper. We will continue to advance this study through our Research and Development Team, and look forward to sharing our findings with you in the near future.
Shelly Esden, Chief Operating Officer, Sonata Senior Living
Charlie Jennings, Chief Development Officer, Harbor Retirement Associates
Brian Hessinger, PE, Chief Operating Officer, Ingenuity Engineers, Inc.
Bill Graney Jr, PE, Senior Mechanical Engineer, Ingenuity Engineers, Inc.
White Paper: COVID-19 Senior Living Best Practices
Johnny Dagher, AIA, NCARB, LEED AP