The Covid-19 pandemic has unquestionably highlighted the pressure placed on our healthcare systems through the rapid increase in the number of patients requiring intensive care. It has clearly evidenced the lack of available hospital beds and support services that are available at short notice in a pandemic, and has indirectly highlighted how many hotels are underutilised within those same set of circumstances. Typology could be the solution to hospital bed spaces in times of crisis, with multiuse facilities such as medihotels.
The now well-recognised mantra of ‘flattening the curve’ has been expressed as a result of limited hospital capacity, of course seeking to minimise the number of cases associated with the virus. As architects and engineers, this raises the question for us that if hospital capacity could be increased quickly in response to a pandemic, it is likely that we would assist the flattening of the curve, and a shortening of the duration of the onset of the virus and the resultant economic downturn.
Hospital Beds vs Empty Hotel Rooms – are Typologies the answer?
In the midst of a crisis such as the Covid-19 pandemic, we have seen the concurrent disparity between full hospital beds and empty hotel rooms. And pretty quickly, hospital beds become a resource of scarcity, of discernible value. While on the other hand, hotel rooms remain largely empty and representing little value.
Though increased at last count, it was reported that there were only around 2200 ICU beds (in public and private hospitals) in Australia in 2018, roughly equivalent to 9 beds per 100,000 head of population. Consider this for a moment in contrast to the disproportionate number of hotel rooms in Australia, which recently surpassed 300,000 or around 1170 rooms per 100,000 head of population.
The disparity here presents the obvious opportunity for convergence.
Federal Health Minister Open to ‘Medihotel’ Concept
This week, it was reported that Federal Health Minister Greg Hunt was “very open” to a “medihotel” concept where patients with Covid-19 could be quarantined instead of at home, as a measure to prevent family members and housemates from being infected and ensuring compliance with isolation requirements. And there have been numerous examples of the ‘conversion’ of existing spaces into makeshift hospitals.
It was also reported this week that Western Australia’s first “medihotel” would form part of the proposed Murdoch Health and Knowledge Precinct, expecting to divert up to 500 patients undergoing treatment and recovery from hospital emergency departments annually.
While necessary patient support seems to have been provided through the establishment of temporary ‘medi’ hospitals and the like, including the use of existing hotels and convention centres, imagine the significant savings available (in time and cost) to only have to change out (say) furniture and fittings in order to change the functional use of a room or an entire building. Could rooms or floors be converted within 24 hours, providing arguably the most rapid patient support in the event of a crisis?
While the utilisation of hotels is incredibly helpful to provide the necessary care to (non-critical) patients including those required to be in quarantine, what we otherwise envision as healthcare architects and engineers is the inherent ‘future-proofing’ of buildings to better deal with these emerging situations, and provide fundamentally deeper support mechanisms within the design of built form.
It’s clear to us that what’s necessary is the embrace of a new paradigm.
Hotel Rooms and Hospital Rooms are Fundamentally the Same
Hotel rooms and hospital rooms may be considered in some aspects to be fundamentally the same – different enough that the respective typologies may be clearly differentiated, but similar enough that the two may be considered equivalent in significant measure. We see that there is considerable value framed by manner of the adjustment of each of the typologies to effectively ‘merge’ with each other.
Developed through the observation of the commonalities in these building typologies, a new typology emerges through this multiplicity – the “HOSPITEL” if you will. Simply put, a hotel is quickly able to be ‘become’ a hospital when required (and vice versa).
HOSPITAL + HOTEL = HOSPITEL
For example, standard class ‘S’ hospital rooms (being class isolation used for isolating family units capable of transmitting infection by droplet or contact routes) can be grouped into wards with a station on each floor, with a common triage at the reception and ‘hotel-like’ rooms sized for family units that are supported by the likes of larger lifts, wider doors and additional hand-basins. Such buildings would sit in immediate adjacency to transport hubs, perhaps with convenient emergency access via a helipad.
When used as such, ‘hospitels’ could also be used to shift regular nursing and elective surgery recovery away from hospitals, to make space available for an increasing number of patients requiring critical care, effectively as a means to ‘buffer’ operational capacity during a pandemic. This is already achieved in some manner in common practice, as shown with the Murdoch Health and Knowledge Precinct.
Testing of the concept could start immediately with the modification of existing ‘end of life’ hotels identified as opportune for reclassification, through the retrofitting of the existing spaces where possible. Of course this must be considered within the constraints of the building regulations with respect to ‘use’, including changes to the (Amendment 1) of the NCC 2019 such as new requirements for child care centres within multi-storey buildings. And further to these ‘physical’ strategies, complementary techniques could be employed such as training hotel staff in the procedures of fundamental hygienic practices, to merge their own skillsets with those of an operational hospital.
So with this new shared typology and within the governance of building regulations, mixed-use buildings are also more greatly enabled, providing very fluid translations that allow architects and engineers to “flexibly adapt building uses as times change.”[i] One floor of a building for example may be repurposed as offices, with residences to upper floors or with a medical centre of independent consulting suites, essentially therein providing more socially-integrative building models.
A new design paradigm invariably then represents the sustainable utilisation of precious space, in lieu of singular buildings, returning perhaps to age-old concepts of the derivation of place-making in ancient times. And so through the creation of an archetypal solution, there exists significant opportunity to engender buildings with much greater value in their deeply sustainable lifecycle. One might go so far as to reference Darwin’s mechanical terms in that buildings are able to be “better designed for an immediate, local environment.”[ii]
The HOSPITEL may provide a novel adaptable typology at low marginal cost, allowing rapid and cost effective reassignment from “hotels” to “hospitals” – or moreso somewhere in between. This is achieved economically through first principles design, without excessively increasing the construction cost of the building, and wholly offering in turn financial benefits to all stakeholders.
Contact PharmOut to keep the conversation going…
[ii] “Stephen Jay Gould, Darwin’s Untimely Burial“, 1976; from Philosophy of Biology:An Anthology, Alex Rosenberg, Robert Arp ed., John Wiley & Sons, May 2009, pp. 99–102.
[iv] ANZICS 2018 CORE Annual Report