If you should make lemonade when life hands you lemons, what should you do when life hands your big project a pandemic lockdown?

Make ventilation.

“We had broken ground and one week later everything shut down. We literally put up a (construction) fence and a week later took it down,” said Chris Fogg, vice president for Bond Building Construction, contractor for the $24 million wing added to Elliot Hospital’s emergency department. As it turned out, the delay allowed the project to be redesigned to better deal with a world that had suddenly become much more wary of contagious airborne disease.

“We reconvened and said, what have you learned and how can we improve this emergency department from what was previously designed?” said Fogg.

Before we go into details, is there a lesson for those of us who aren’t rebuilding our homes and offices? Yes and it’s simple: Airflow is our friend.

Improving ventilation can be as simple as opening more windows – although that isn’t totally simple because it raises air conditioning and heating bills – or as complicated as trying to figure out where to install filtered fans (unless you do a smoke test, which you probably won’t, it’s mostly a matter of guesswork) or as expensive as redoing your entire heating-ventilation-air conditioning system.

The goal is to reduce the chance that you’ll inhale what another person just exhaled, in case that person is exhaling viral or bacterial unpleasantness.

“Airflow and air changes … keeping the air circulating. That’s the key,” said Fogg, who has an appropriate last name for this topic. Is this a case of nominative determinism?

I know folks who carry portable CO2 monitors when going into public spaces to determine how stale the air is. People exhale CO2 so if there’s a lot of it floating around, the chances are higher that a lot of potentially contagious aerosols are floating around, too. If they’re at a restaurant and the CO2 registers a high figure, usually taken to be 1,500 ppm or more, they’ll put on an N95 mask.

The Centers for Disease Control has advice about ventilation including an “interactive ventilation tool” at www.cdc.gov. With COVID showing signs of a possible fall resurgence, as I noted in yesterday’s column, you might want to check it out.

As for Elliot Hospital, Bond and e4H Architecture made a series of changes to reduce the chance of accidental disease spread, and not just expanding air filtration, adding UV disinfection to the air handlers or increasing air flow. They changed layouts to reduce the chance that a person coming to the emergency room with a broken leg would share space with a suspected respiratory infection, added an extra exit to the rapid triage and treatment area so patients don’t have to go back to the main lobby to get discharged, and created zones within the emergency department that could be self-contained if another pandemic hits.

The value of quickly creating isolation rooms with negative pressure that keeps floating viruses from entering, a form of ventilation control to the max, was one of the lessons hospitals learned when the pandemic hit.

All this added about $750,000 to the design and construction cost, which isn’t something to sneeze at. On the other hand, that’s only one-third of one percent of the total cost for the huge project, which added 22,000 square feet to the existing Emergency Department and should allow 8,000 more patients to be treated annually. That seems a reasonable investment in our ever-more-disease-ridden world.

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