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>> Sreenivasan: AS COVID-19

CASES SURGED IN MARCH AND APRIL,

THERE WAS A SCRAMBLE TO SECURE

PROTECTIVE EQUIPMENT FOR

HEALTHCARE WORKERS ON THE FRONT

LINES.

BUT WHAT ABOUT CHANGES TO THE

MEDICAL SPACES THEMSELVES TO

PROTECT BOTH WORKERS AND

PATIENTS?

NEWSHOUR WEEKEND'S CHRISTOPHER

BOOKER HAS A LOOK AT ONE

HOSPITAL RETROFITTING ITS SPACES

TO FIGHT THE VIRUS.

>> Reporter: ON THE AFTERNOON OF

APRIL 15, 2013, TWO PRESSURE

COOKER BOMBS DETONATED NEAR THE

FINISH LINE OF THE BOSTON

MARATHON, KILLING THREE AND

INJURING HUNDREDS.

WITHIN MINUTES THE HOSPITALS IN

THE AREA WERE FLOODED WITH

PATIENTS AND QUICKLY RESPONDED.

>> THE HYPOTHETICALS WERE THE

9/11 TYPE OF HYPOTHETICAL.

THE BOSTON MARATHON DISASTER,

YOU KNOW, THAT TRAGEDY IN WHICH

THERE WAS A HUGE INFLUX OF

CRITICALLY ILL PEOPLE THAT WERE

GOING TO COME IN.

YOU KNOW, THAT, THAT IS

ABSOLUTELY IN PLACE.

>> Reporter: ACCORDING TO DR.

JOHN BUCUVALAS OF MOUNT SINAI

HOSPITAL, TRAUMA CENTERS PREPARE

FOR THESE MASS CASUALTY EVENTS.

WHAT ISN'T IN PLACE ARE PLANS

FOR HOW HOSPITALS NEED TO

PHYSICALLY CHANGE TO RESPOND TO

WHAT THE GLOBE IS FACING NOW:

THE OUTBREAK OF AN AIRBORNE

PANDEMIC DISEASE.

>> ONE OF THE BIG TAKEAWAYS IS

THAT OUR MEDICAL SYSTEM IS NOT

DESIGNED TO MANAGE A SURGE OF A

PANDEMIC OF THIS NATURE.

AND THAT SHOULD KIND OF AWAKEN

ALL OF US TO THE CHALLENGES WE

HAVE OF OUR HEALTHCARE

INFRASTRUCTURE, FULL STOP.

>> Reporter: MICHAEL MURPHY IS

THE EXECUTIVE DIRECTOR OF THE

SOCIALLY-MINDED ARCHITECTURE AND

DESIGN COLLECTIVE, MASS DESIGN

GROUP.

>> OUR HOSPITALS ARE DESIGNED

WITH VERY TIGHT MARGINS TO FILL

BEDS AND HAVE THEM LARGELY FULL

ALL THE TIME.

THEY'RE NOT DESIGNED TO HAVE

EXCESS OF BEDS.

AND WHAT THAT MEANS DURING THIS

OUTBREAK AND SURGE IS THAT THE

SYSTEM ITSELF HAS BEEN PUSHED TO

ITS LIMITS.

>> Reporter: AT DOCTOR

BUCUVALAS'S HOSPITAL IN NEW

YORK, THE MEDICAL CENTER WAS

FORCED TO RAPIDLY TRANSITION

TRADITIONAL CARE SPACES TO WARDS

EXCLUSIVELY FOR COVID-19

PATIENTS.

>> EVEN AT BASELINE, THE

CLINICAL WORLD HAS NOT THOUGHT

VERY DELIBERATELY ABOUT THE

BUILT ENVIRONMENT.

>> Reporter: AS THE PANDEMIC

GREW, THE HOSPITAL BROUGHT IN

DR. NEEL SHAH OF THE GLOBAL

HEALTH INNOVATION CENTER,

ARIADNE LABS, AS WELL AS

ARCHITECT MICHAEL MURPHY, TO

STUDY HOW A HOSPITAL REDESIGN

COULD KEEP PATIENTS AND HEALTH

WORKERS SAFE.

>> BASICALLY EVERY DELIVERY

SYSTEM IN THE COUNTRY AND IN THE

WORLD HAD TO ADAPT ON THE FLY.

AND NEW YORK CITY AT MOUNT SINAI

HOSPITAL WAS LITERAL GROUND ZERO

FOR THIS GLOBAL PANDEMIC FOR A

COUPLE OF WEEKS.

IT WAS AN EXTRAORDINARY

OPPORTUNITY TO TRY TO FIGURE OUT

HOW WE NOT ONLY LEARN WHAT MOUNT

SINAI IS DOING, BUT CREATE

LESSONS FOR THE REST OF THE

WORLD VERY QUICKLY.

>> Reporter: OVER A THREE WEEK

PERIOD IN EARLY APRIL, MOUNT

SINAI USED REMOTE OBSERVERS TO

EXAMINE THE VARIOUS SPATIAL

CHANGES THE HOSPITAL

IMPLEMENTED.

USING GOPRO CAMERAS, DOCTORS

WALKED THROUGH THE MEDICAL UNITS

TO GIVE THE OUTSIDE CLINICIANS

AND DESIGNERS A SENSE OF THE

INFECTION CONTROL DESIGNS.

>> WE TOOK VIDEO, WE INTERVIEWED

PEOPLE, AND THEY COULD THEN PEER

IN.

AND THAT ALLOWED US TO DO, MAKE

THE OBSERVATIONS INCREDIBLY

QUICKLY.

>> Reporter: WHAT WERE SOME OF

THOSE KEY DATA POINTS THAT YOU

LEARNED FROM THIS STUDY AS IT

RELATES TO THE DESIGN OF THE

HOSPITAL?

>> INFECTION CONTROL PROTOCOLS

USUALLY ARE USED TO PROTECT,

THEY'RE TO PROTECT PATIENTS.

IN THIS SITUATION, WE HAVE TO

PROTECT EVERY ONE-- PROVIDERS,

THE PEOPLE THAT DO ENVIRONMENTAL

SERVICES, THE PEOPLE THAT WORK

MOVING IN AND OUT, THE CLERKS

AND THINGS LIKE THAT.

THERE'S A LOT OF ADMINISTRATIVE

SUPPORT STAFF.

SO IT'S A WHOLE DIFFERENT

MINDSET.

>> Reporter: THE SHIFT IN

MINDSET MEANT MAKING STRATEGIC

DECISIONS THAT COULD WORK WITHIN

THE STRUCTURE OF DECADES OLD

BUILDINGS.

I.V. MACHINES THAT TYPICALLY SIT

INSIDE A PATIENT'S ROOM WERE

MOVED OUT INTO HALLWAYS TO

MINIMIZE MEDICAL STAFF

INTERACTING WITH INFECTED

PATIENTS.

FOR CONTAGIOUS DISEASES LIKE

COVID-19 THE STANDARD OF CARE IS

NEGATIVE PRESSURE ISOLATION

ROOMS.

BUT HOSPITALS TYPICALLY DON'T

HAVE VERY MANY.

DURING THE SURGE OF COVID-19

PATIENTS MOUNT SINAI CONVERTED

260 REGULAR ROOMS TO SPECIALIZED

NEGATIVE PRESSURE ISOLATION

ROOMS.

>> WE'RE ALSO ABLE TO SEE WHERE

CLINICIANS WERE ALSO PUTTING

TAPE ON THE FLOOR, PUTTING UP

VISUAL CUES TO TRY TO ARTICULATE

TO STAFF WHEN THEY'RE WALKING

INTO A RED ZONE, IN A

CONTAMINATED ZONE, WHEN THEY

WERE LEAVING THAT ZONE, SO THAT

WE COULD BE MORE COGNIZANT OF

THE AMOUNT OF P.P.E. THAT WE

WERE WEARING.

AND THOSE SIMPLE SPATIAL MARKERS

ARE REALLY ESSENTIAL NUDGES THAT

COULD ALLOW US TO, YOU KNOW,

REMIND OURSELVES, HEY, WE'RE

ENTERING A MORE DANGEROUS ZONE,

BE MORE PROTECTED.

>> Reporter: MASS DESIGN GROUP

HAS WORKED IN THE MIDDLE OF

EPIDEMICS IN THE PAST.

IN 2015 IT DESIGNED A HOSPITAL

TO HELP FIGHT THE CHOLERA

OUTBREAK IN HAITI.

AND DURING THE 2014 EBOLA CRISIS

IN WEST AFRICA THE FIRM

DEVELOPED A SET OF NATIONAL

STANDARDS FOR HEALTH

INFRASTRUCTURE DESIGN IN

LIBERIA.

MURPHY SAYS THESE EXPERIENCES

INFLUENCED THE WAY HE THINKS

ABOUT PHYSICAL SPACE AND HOW IT

IMPACTS HEALTH.

WHAT CHANGES HAVE BEEN MADE

SINCE YOUR STUDY?

>> ONE OF THE FUNDAMENTAL THINGS

THAT'S CHANGED IS NOT JUST FOR

HOSPITALS, BUT FOR ALL OF US, IS

THIS INCREDIBLE SPATIAL

AWARENESS.

ARE WE GOING TO BE CONTAMINATED

BY LEAVING OUR HOUSE?

ARE WE GOING TO CONTAMINATE

OTHERS?

AND THAT INCREDIBLE SPATIAL

COGNITION THAT THE SPACES AROUND

US ARE POTENTIALLY INFECTIOUS OR

POTENTIALLY HEALTHIER IS A

SIGNIFICANT PARADIGM SHIFT IN

THE WAY WE THINK ABOUT THE WORLD

AROUND US, I THINK, AND SHOULD

AND WILL SHAPE, THE WAY WE

DESIGN HOSPITALS A LITTLE MORE

DELIBERATELY IN THE FUTURE.

AND HOW WE CAN DESIGN FOR TRUST

ARE GOING TO BE CRUCIAL FOR

EVERY ONE OF OUR PUBLIC SPACES.

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