This past week I spent two days travelling to Lloydminster and Saskatoon as I met with past Clients and some upcoming Clients, all within the health industries. It was an interesting time to go met up with Clients in person. With the recent WHO announcement and classification of COVID-19 as a pandemic, it made me realize why certain codes are so important and why I struggle to understand why some medical Clients do not see the importance of these codes.
My first meeting was with a prospective dental client who was nervous to shake my hand. Why? Well it was announced that just a couple days before there were at least two confirmed cases of COVID-19 during the recent annual Pacific Dental Conference in Vancouver, of which one confirmed case had flown back to Edmonton. Instantly many thoughts were running through my head, and at the top of that was HVAC systems in medical facilities. I'm not just talking hospitals, but your average doctor's office, physio office, dental office and more.
For the past 8 years our firm has started to specialize in medical environments of varying services and recently have started to create lunch and learns for leasing brokers and developers to help them understand the implications of these codes for their existing buildings and prospective medical Tenants.
Most codes and organizations relate back to CAN/CSA-Z317.13-17 (Infection control during construction, renovation, and maintenance of health care facilities). "Since its first publication in 2003, CSA Z317.13 - Infection Control during Construction, Renovation, and Maintenance of Health Care Facilities has revolutionized work practices in and around health care facilities. CSA Z317.13 provides guidance on preventive measures intended to protect patients, staff, and visitors from disease transmission and other health problems, such as allergic reactions, that can be produced during the construction, renovation, or maintenance of health care facilities." *
WHAT DO THE CODES MEAN?
These codes sound great, but what do they mean? Well to many Clients, they see it as cost. Just another cost governed by another city inspector trying to create challenges in construction. At first, seeing this being implemented in Edmonton in 2018, I agreed. That was only for a short bit though that I agreed.
But the truth is, and what COVID-19 is showing us is that the codes are designed to help mitigate the spread of air borne particles in a specific space. As a simple explanation, the CAN/CSA-Z317 codes requires additional air exchanges per hour, humidification of air and ducted return air from specified rooms. There is a lot more to the codes and implementation than that, but I think you get the idea. The more people in a room, the more risk there is on transfer of infection.
When this all started to come to light that the City of Edmonton was cracking down on this requirement, I can tell you there was a lot of fear in the industry. Not from virus, but form capital costs, delays in construction, etc.
It was too long into my 2nd project with this requirement that I just saw it as the beginning of more codes for health care facilities. It makes sense. You have a congregation of possibly ill people side by side waiting together to get better. But while waiting, unknowing they can be transferring illness to others. The last thing the patients are thinking about is: how much fresh air is coming in and is the "sick" are being expelled above me or is it being sucked away. And they shouldn't have to think about this.
As design professionals, we take an oath to provide public safety. That oath is not always based on designing corridors to provide proper evacuation in a fire, it also comes in the form of implement with our engineers proper ventilation systems. I hope that our medical Clients can look past the cost and look into their profession of helping others and that this is system designed to assist them in providing the best medical care possible.
WHAT WILL COME NEXT?
My prediction is that the COVID-19 pandemic will spawn the evaluation of HVAC in any building where the public congregates and that the HVAC in those buildings will be required to be engineered to meet or exceed what we currently do in your dentist's office. To me, that makes sense and is the next major step to helping mitigate the transfer of viruses.
Other technologies that I see coming into play will be more implementation of Ultraviolet germicidal irradiation (UVGI), where specific wavelengths of UV light are introduced into a space to kill bacteria. Wouldn't it be great if when a public washroom is closed for 10 minutes while special ceiling lights are turned on using specific wavelengths of UV light to kill bacteria. Wouldn't it be great to know that your child's daycare is sterilized 3 times a day with UV light? There are countless ways this UV light technology could be introduced. We are already seeing this technology for phone cases cleaners, portable water treatment. It's only a matter of time that this too will be a standard.
I also see perhaps more automatic door openers and the design of more public washrooms without the use of entry doors. Door levers are a contributor to the spread of viruses. For that you can use your imagination.
Another item I'd be curious about is faucets with integrated timers counting down from 30-0 seconds so you know you have washed you hands.
THE NEXT STEPS
There are countless other changes that I suspect we will see during the next National Building Code and well before then. Until that time, I believe our role as designers goes well beyond the aesthetic for our Clients and dive deep into the protection of life and to help mitigate the transfer of viruses. From the HVAC systems we work on with our engineers to the selection of materials and finishes which help mitigate the transfer of bacteria while being able to be disinfected to helping review IPC (Infection Protection & Control) standards for our Clients.
If you have enjoyed this blog and are interested in us coming to speak to your organization about Medical Design, please contact us: email@example.com
* 2017, CAN/CSA-Z317.13-17 Infection control during construction, renovation, and maintenance of health care facilities, CSA Group, https://store.csagroup.org/