The word ‘pandemic’ derives from the Greek, pan (all) and demos (people). We have seen the global impact of Covid-19, a pandemic nobody expected to spread so quickly, nor be so destructive, catching all systems off-guard leading many healthcare providers to act quickly and requiring overnight solutions to cope with the sudden influx of patients.
Entire countries, and high population cities in particular, are facing new and increasing challenges from natural and man-made pressures.
Cities must learn to adapt and thrive in the face of these diverse challenges. We must learn how to build resilience in an uncertain world, physically and operationally.
Recently Bill Gates announced a viral outbreak similar to Covid-19 will likely happen every 20 years or so. So, what can we do as healthcare architects, planners and designers to play our part, in creating a resilient city?
The way resilience manifests itself plays out very differently in different places. Commonly cited, most notably in the Rockerfeller Foundations’ study, the “City Resilience Framework”, four common themes have emerged:
- People: The health and wellbeing of individuals
- Place: The way in which infrastructure and ecosystems protect, provide for and connect urban citizens
- Organisation: The social and financial systems that enable urban populations to live peacefully, and act collectively
- Knowledge: The importance of informed decision making, and having empowered stakeholders.
At the moment the term ‘city resilience’ isn’t very widely used, but it’s central to the wellbeing of urban communities, the natural and built environment and economy. We can’t underestimate the importance of building resilience.
With epidemics like MERS, SARS, Ebola and H1N1 in our recent history, there are some valuable case studies we can refer to for how best to develop resilient healthcare infrastructure.
In 2012, I had the good fortune of being appointed project director for one of the largest new hospitals in Singapore, a 1,000-bed facility, covering 385,000 sq m of floor area, with an additional 200,000 sq m available for back of house, public support spaces and future expansion.
This new facility was being built to serve the north east population of Singapore and build additional resilience as a result of the SARS epidemic, which took place in 2002 to 2003, effecting more than 8,000 people across 29 countries and at least 775 people died worldwide.
Along each step of the design process, we were asked to challenge ourselves and consider scenarios for natural and man-made disasters, making sure the hospital design could be flexible and adapted at short notice, without disrupting the facility.
It is worth mentioning that in order to arrive at a resilient strategy, huge collaboration was required between various government departments and key stakeholders. Full resilience requires full integration and connectivity, as being prepared requires teamwork, across all sectors, and this was very evident at SKGH.
Going forward the creation of country-specific Resilience Task Forces, made up of experts and dedicated to future pandemics would serve citizens and economies well. Other inclusions for healthcare institutions to become resilient include:
- Stress Test the System: Chronic and acute situations followed by solution designs
- Use AI for predictability modelling
- Be Prepared: Run trial scenarios for various situations and model the outcomes
- Lessons learnt: From Covid-19 and other COVID epidemics with a focus on healthcare and emergency services
- Looking Forward: Ensure the migration from awareness to action.
Resilient cities are cities that have the ability to absorb, recover and prepare for future shocks; resilient cities promote sustainable development, well-being and inclusive growth.
Ultimately the message is to prepare for the next pandemic by developing resilient cities; in the words of renowned Microbiologist Louis Pasteur who discovered the principals of vaccination, fortune favours the prepared.