Across the world, increasing bed capacity to deal with the surge in COVID-19 patients is a central challenge. With a critical shortage of intensive care and ward beds, the need for a new, more flexible solution is clear. Hospital campuses are typically constrained sites, and any solution must mitigate the risk of further virus transmission.
Arup’s CareBox is a series of design guidelines for scalable, modular and rapid solutions to solve this problem. It can be quickly transported, deployed and implemented to provide additional capacity in a range of settings, from existing healthcare campuses to conversion of existing facilities. With the high probability of further waves of infection, and an effective vaccine still in development, CareBox will prove valuable until the pandemic passes.
Adaptable treatment
We have designed CareBox to be adaptable, to suit a variety of spaces and contexts, so that it can address the widest range of challenges faced by different national healthcare systems. These include:
CareBox in low resource contexts
COVID-19 is particularly challenging for poorer countries or regions with little existing health infrastructure. We have developed CareBox Low Resource, an adjusted specification suitable for contexts with limited access to mechanical equipment and other construction supplies, providing alternative ways to deliver vital oxygen to patients.
We have designed the document to work in conjunction with the WHO’s manual on setting up and managing a Severe Acute Respiratory Infection Treatment Centre. CareBox Low Resource provides guidance on how to achieve the design criteria stated in the WHO document and covers spatial requirements; it highlights the importance of assessing risk to natural hazard; it also specifies water quality requirements, environmental controls, electrical supply factors and how to provide medical gases.
Working with our partners, we have used these principles to assess their proposed tented field hospital which may be used in a variety of countries and situations ranging from remote rural to urban. Our specification has been used on the conversion of a stadium in Kampala, Uganda, into a Covid-19 treatment facility. We evaluated the availability of natural ventilation, assessing options and providing guidance on a mechanical ventilation system where needed. The team drew on the breadth of expertise within Arup in the design of these systems, to provide accessible and appropriate advice on their implementation.
Helping the Rohingya
In many parts of the world, refugee camps are those most vulnerable to the pandemic. Working with partner organisations in Bangladesh, we have provided advice on two existing sites within the Cox’s Bazaar Rohingya refugee camp which they were converting into Covid-19 isolation centres where those presenting symptoms could stay to limit spread within the community. We also supported them in providing structural design advice on a new 60 bed treatment facility they constructed in the camp.
Future of Healthcare Ecosystems
The demands of an ageing population, a changing workforce and new technologies will shape the future of healthcare ecosystems. New models of healthcare delivery and changing users' needs will fundamentally change healthcare systems and infrastructure – from the hospital to the home.
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