MASS Design group is a team of architects, engineers and designers who advocate for architecture that promotes justice and human dignity. Based on their previous learnings on infection control, they issued some guidelines in this time of pandemic, when many communities around the world are responding to the quick escalation of COVID-19 by building temporary tent clinics outside hospitals. Inside the tents there is a high probability of contagion, mostly because the space is quite tight, and many people come and go. However, tent clinics should be designed in such a way that they do not become an instrument of further contagion.

MASS suggests following 3 best practices inside tent clinics:

LIMIT CONTACTS BETWEEN INDIVIDUALS

Since COVID-19 is transmitted via direct contact between respiratory droplets, it is essential to keep a 6 feet distance between individuals. More specifically, beds should be separated by an 8 feet high vinyl screen. This would help limit cross-contaminations between patients and guide the flow of contaminated air outside the tents. Moreover, there should be separate entrances for health care professionals who must always wear Personal Protective Equipment (PPE) before interacting with patients. Lastly, bureaucratic clinical work should be centralized in a specific area of the tent, in order to make it more efficient and limit contacts with patients.

MITIGATE CONTAGION VIA SURFACES

Also contaminated surfaces represent an easy transmission route for the virus. Therefore, they should be designed with the aim to minimize touching, or at least create obvious touch points. In addition, they need to be frequently cleaned and disinfected with proper disinfectants. Cleaning removes dirt and most germs, while disinfection kills germs. All cleaning supplies should be stored in a specific area of the tent, away from patients.

DECONTAMINATE AIR

Finally, MASS recommends planning and installing an airborne infection control and decontamination system. It requires specialized expertise and equipment, but it allows for an efficient recalculation of air within the tent. Alternatively, air can be diluted by adding fresh air from outside. Although it is a simpler and less efficient approach, it is still vital, in case there is no fan/filter portable unit. An efficient airflow strategy is key. Conversely, air remains contaminated within the tent and may heighten the risk of contagion.

Beyond curing patients, tent clinics act like shelters where dignity, comfort and security should never lack.  Therefore, it is suggested to provide patients individual lockable storage for personal items, Wi-Fi connection and charging points at beds, partitions between beds for privacy and access to streaming and other entertainment services on screen.

Kito Onlus follows these guidelines. The Kito-Hut medical facility for sanitary emergencies, active since 2014 in the Philippines, represents a great solution for screening and welcoming of patients. Kito-Hut has some interesting features: it travels as a container, it is expandable on site (it doubles in size), and it is self-sustaining becasue it is provided with solar panels and a battery storage system.

 

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