How We Can Redesign Cities to Fight Epidemics

A heat map analyzing the ventilation between urban buildings.

Architecture can be the Secret Weapon To Combat Infectious Diseases
Throughout history, disease outbreaks have forced new innovations in urban design. Fighting cholera epidemics in the 1800s, for example, necessitated the building of new plumbing and sewer systems and the devising of new zoning laws to prevent overcrowding. As the new coronavirus lays bare the need for broader changes across our economy, such as widespread paid sick leave, it might also influence how cities and buildings are built.

One part of that might mean designing public spaces and buildings that can quickly switch to a different use in the case of an epidemic or another type of disaster. Architects have been looking at redesigning public spaces so that they can also work as logistics and treatment areas in cities in the event of epidemics. Architects are also studying how urban design affects the current outbreaks given that the spread of epidemics is related to the physical design of cities, especially population density.

Virus-Free Transit
Better design could also help reduce crowds where viruses can easily spread. At airports, for example, security screening could be done differently so that passengers aren’t forced to wait together in crowded lines. New and upgraded airports are being designed to increase security screening lanes and reduce pinch points in passenger flow. This, along with automated screening lanes, will in future reduce passenger wait time, congestion, and person-to-person contact.

Another avenue under investigation is that passengers might ultimately be screened when they board autonomous vans headed to the airport rather than at the airport itself.  Inside airports, improved space planning could help reduce the size of crowds of people queing at gates to board.

Buildings Can be Designed to Better Combat Infectious Disease
While it’s hard to eliminate crowds once people are on an airplane, the biggest risk comes from sitting near someone who is sick – the onboard air is both well-filtered and continuously discharged, thus effectively limiting a contagion’s ability to circulate further. That level of air quality treatment should be happening in other places. This is something that architect’s must think about, because as a society, even in normal times, we spend 90% of our time inside buildings.

Newer technology is making it more cost-effective to make air much cleaner. UV-C light, for example, can eliminate viruses in air treatment systems while simultaneously making equipment last longer. Traditional air filters add costs partly because it takes more energy to push air through them. Bringing fresh air into buildings is also important. If fresh air is continuously brought in, that will minimize the time that the occupants are exposed to transmissible agents. Future technology will be able to do more—sensors that detect viruses on surfaces in real time can be used to warn building occupants or trigger mechanical air scrubbing.

Some buildings are also beginning to deploy temperature screening to identify people are potentially ill. China and several other countries are currently measuring occupant’s temperatures prior to entering a building using an infrared thermometer, or alternately, utilizing thermal imaging. This was quickly deployed to mitigate the spread of COVID-19. This is not considered a positive test for COVID-19 or other viruses, but either technology can be administered externally in order to minimize the risk of infection or the need to wear masks or other protective equipment.

Typically, when people have a fever, they are at a very contagious point in their illness. With temperature-monitoring technology, those individuals can be made aware and directed to the appropriate avenues of testing and potentially quarantine in order to minimize person-to-person transmission. We are starting to see this technology in some hospitals in the United States, but some schools of thought suggest that is monitoring should be considered as one of our first lines of defense in all buildings, not just hospitals.

Hospitals Designed for Outbreaks
Hospitals, of course, can also be better designed to handle outbreaks of infectious diseases. The hospital at Rush University in Chicago has an ambulance bay that is designed to be closed off so that patients can be safely evaluated there before entering the hospital. Inside, negative pressure zones that can isolate the spread of the virus can be activated to isolate multiple areas. Finally, its common knowledge that hospitals and clinics are adding purpose-built tele-health centers making it easier for doctors to treat patients remotely, thus avoiding person-to-person contact as a potential spread of a virus.

Parks Help Cities Breathe
More holistic approaches to making cities and buildings healthy can also impact future epidemics by making it less likely that people get sick, and more likely that they avoid the most serious consequences. Access to outdoor space is important – a significant percentage of Americans are vitamin D deficient, and some studies have linked higher vitamin D levels to a reduced risk of acute respiratory tract infection.

Similarly, easy access to parks encourages people to spend time outside. Parks also encourage people to exercise, and they reduce air pollution. Polluted air is linked to health problems such as asthma, high blood pressure, and diabetes, all of which are associated with a higher risk for patients contracting the novel coronavirus. Walk-able neighborhoods, by contrast, are linked to a lower risk for problems such as high blood pressure. The idea that parks can clean the air isn’t new; it was used as justification for building New York’s Central Park and other major city parks in the 1800s.

Handwashing Everywhere
Some potential changes in cities could be relatively simple. In Kigali, Rwanda, the city recently rolled out temporary hand-washing stations at bus stops and started asking riders to wash their hands before boarding. The portable sinks are also in place at retail stores, banks, and restaurants. While the U.S. has done something similar to a limited extent near homeless communities, it’s possible to imagine that this type of infrastructure could become permanent at key places such as public transit hubs.

For inhabitants of a city having very few to, in many cases, virtually nil public restrooms and thence very limited opportunities to wash their hands, people will be forced to take unnecessary risks they shouldn’t otherwise be forced to take.

Accordingly, in terms of urban design it might make sense to take cues from hospital design, where sinks are deliberately placed to make people more likely to wash their hands.

None of these changes in infrastructure and design would replace the need for other changes in public health, such as a commitment to respond and test much more quickly in the case of an outbreak. But as environmental changes make future epidemics more likely, and as the population ages and cities continue to grow denser, it makes sense for buildings and urban design to also change. Seeing the devastation in countries such as Italy may be enough to convince more U.S. communities to invest in solutions that had been considered as only optional, up until the recent past.

2 thoughts on “How We Can Redesign Cities to Fight Epidemics

  1. gasstationwithoutpumps

    For architects, better design of bathrooms in public places would help—there should be no touching of the door handles after washing hands, and there should be a place to discard paper towels right by the door. Way too many restrooms are designed to maximize recontamination of the hands after washing.



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