The vast majority of healthcare facilities in the United States were not designed to handle a global pandemic like COVID-19. While some master planning efforts may have considered the possibility of our current situation, the many variables involved in preparing for a pandemic would have made an accurate assessment of need difficult.

Can you justify the costs associated with preparing for future events of an unknown scale that may or may not occur, when there are so many other immediate or more critical needs?

Healthcare organizations worldwide are now grappling with rapidly changing needs that can’t be met with facilities as they are presently structured. In some cases, there are ways to retrofit existing areas for new uses. Ultimately, entirely new facilities may be required, but retrofitting solutions are needed now.

As we continue to grow our understanding of how COVID-19 is spread, hospitals have been seeking ways to process patients while keeping staff and other patients safe. The initial response at many campuses has been to set up tents within their parking lots to create a segregated process to manage testing the anticipated volume of assumptive COVID-19 cases. It may prove necessary to build temporary admission and testing spaces that are more secure and better protected.

Once a COVID-19 patient is determined to require treatment, he/she must be placed within an isolation room. Isolation rooms are designed to maintain a negative pressure association with surrounding areas to contain infectious disease and eliminate the risk of spread. The vast majority of healthcare facilities do not have enough of these rooms and must look for creative ways to increase bed count within areas that are capable of isolation from the rest of the facility.

Temporary wall systems and HEPA (high-efficiency particulate air) filtration is one way to handle the patient overflow. Some facilities have already taken steps to create isolation areas with whole floor conversions. When an area is utilizing its own air handling unit and exhaust, it’s mechanically “segregated.” This solution is an effective method for meeting the expected patient surge with minimal cost conversion.

An added step that hospitals have taken is the cancellation of elective procedures and appointments. Not only is this helpful for minimizing the number of people moving within the hospital campus, but it makes additional space available for patient overflow, particularly if these spaces are capable of being compliant.

As this crisis builds, other solutions may be needed. Design, construction, and related firms are offering expansion and conversion expertise to help hospitals quickly develop plans to manage the patient surge. Whether it’s architects offering design conversion support, mechanical contractors providing design build expertise, or wall system designers creating rapidly deployable prefabricated rooms to respond to the demand, the industry is united in a quick response and turn-around effort to meet the immediate demands on healthcare campuses.

And there are additional requirements to consider. New patient beds, whether temporary or permanent, require Department of Public Health (DPH) approvals. While DPH has currently suspended its on-site surveys, officials have been working closely with healthcare systems to prioritize review and approval of all projects supporting emergency response efforts.

In many locations, the construction of new buildings specifically designed to treat COVID-19 patients has already begun, and whether new construction or renovation, a significant consideration is the safety of the construction workers. Social distancing is a challenge within the tight working confines of a jobsite, and many tasks require the participation of two or more people to complete.

As we all know, frontline healthcare workers are having great difficulty securing vitally important personal protective equipment (PPE). Construction workers also require these items.

For now, while we work together to meet the extraordinary needs of this moment, let’s keep in mind the changes and improvements that will help us to address future crises more effectively.

The eventual ebbing of the pandemic will allow hospitals the chance to evaluate successes and opportunities for improvement and build into their master planning the emergency response measures that will thoroughly prepare them to pivot and address the next critical response event quickly.

We in the healthcare design and construction sectors also have an opportunity to rethink healthcare facility design, perhaps most importantly by considering building design and structural improvements that will allow more and faster flexibility in the use of existing spaces.

Sharon Jozokos is vice president, Healthcare, at construction firm Columbia. She can be reached at