Healthy by Design – or designed for future infections?
By Lars Münter, Head of International Projects at the Danish Committee for Health Education,
and Administrative Director of the Danish Council for Better Hygiene
Photo by Romina Amato/Red Bull Content Pool, Wonderful Copenhagen
Corona heralds new tasks for urban planning and design across Europe - and the world. With cholera forgotten, it’s time for an upgrade to 21st century microbiology.
What is the most effective vector for infectious pathogens? Humans. Who do we usually cohabitate with, in our modern dwellings? Humans. Does this mean we have done what we can to reduce the risk of transmission between us? Not quite - much to our current chagrin. So, what does this mean for cities and spaces in coming years? In the US, cities from New York to Seattle are asking similar questions, while planners in and around Asia are also grappling with these issues.
With schools, public transport, workplaces, restaurants, and more – much more – closed to prevent the spread of a deadly virus, a relevant question appears; are these institutions and spaces actually fit and safe for purpose? Obviously we’ve done a lot to ensure fire safety and structural integrity, but we have to realize that while we were looking to build better, safer, and stronger cities and buildings, we more or less forgot that humans used these facilities to mingle – and thus needed us all by design, planning, and actions to also ensure that basic infection prevention was hardwired, supported by systems and constantly encouraged.
Why, you may ask? Well, aside from the obvious challenge at the moment, consider how you typically solve common challenges; How do you perform hand hygiene – let alone hand wash, when you buy food on the go? Has your workplace ever talked to you about hand hygiene? Or the company policy on staying home with fever, cough or cold? How are your children’s school faring in toilet facilities – or sinks? Have you ever wondered how to leave a public toilet without touching the door handle? Or found the soap dispenser empty - again? Have you ever experienced crowded trains or buses in a cold season? Or indeed the actual flu season?
From the point of view of facilitating hygienic and healthy living, our cities and societies are a bit too ripe with cases of poor design, lack of planning, little investment, deficient education, and too little interest in preventing infections. So instead of designing our urban world to prevent accidents from happening, we’ve managed to ignore a number of epidemiological pieces of advice and warning signs too.
Now is a better time than ever to opt for design solutions for our cities and societies that help us live more hygienic and healthy lives, and that help steer potential victims out of harm’s way.
Inside as well as outside
So, what does this mean? Well, it means actual rebuilding to enable good practices. Redesigning to enable other uses. Rethinking to enable other users. And yes, it also requires us to change habits or try new things, but just as we learned to endure changing airport safety measures, learned to use the (required) seatbelt in cars, or recently learned to respect rules about distancing, this is possible too. Indeed, in the UK, both design of cities and offices are being questioned and revisited.
It involves a wide range of issues. It means e.g. redesigning doors/access to skip hand-touch where possible, going all-in on no-touch faucets, installing data-sharing and nudging soap dispensers, ensuring access to hand hygiene in public spaces (airports and train stations included), invest and redesign to optimize cleaning, but also rethinking waiting areas to ensure distancing, upgrade video (and audio) conferencing facilities in offices.
It may also mean rethinking public transport. Using staggered pricing to incentivize users and reduce peaks. Using data and real-time information to allow users to find and choose less crowded trains or busses. Investing in bike lanes and dedicated bike roads to move people from indoor to outdoor transport types.
It definitely also means redesign of education – in buildings, and rooms, as well as curriculum. Perhaps have classes shift from online to classroom every two weeks for older classes – and perhaps make sure smaller classes do not count more than 20 pupils.
New data and investments
All of this cost money. A lot. But not acting is also very expensive.
Not only are we faced with risk of continuous waves of new threats: corona, regular flu, avian flu, SARS, MERS, Ebola, West Nile virus, and so much more. But in addition, this exacerbates the other existing problem of antibiotic resistance, because these waves of infections will further deplete our pools of effective antibiotics (directly or indirectly), and thus combined this could render a long range of other surgical treatments impossible – effectively breaking our healthcare systems.
Photo by Curtis MacNewton on Unsplash
And it’s therefore also obvious that different data models are needed. These have to merge data on health and social affairs – from air, water, food, greenery, and exercise to employment, transport, commerce, culture, and more. The Social Progress Index have e.g. begun exploring how to integrate social resilience into their data model. In Scotland, the Place Standard tool would similarly need to take the quality of infection prevention into account to continue to make sense – how else measure “feeling safe” or “sense of control”?
In turn this will also drive new investments. Safer buildings and places, resilient to withstand infections, will better enable people, shops, offices, families, and communities to thrive and survive. From local to regional or national, resilient solutions – with the data to prove it - will naturally be more attractive for people and businesses. And for investors too.
Buildings, places and cities don’t just happen. They are built and designed; So let’s remember to update our design guide for the coming years, roll up our sleeves, and ensure our new designs will fit with an updated survival guide for Homo Metropolis.
Lars Münter, health communications professional dedicated to sustainability, interdisciplinary, and cross-sector collaboration. Leading international health projects for the Danish Committee for Health Education and a dedicated champion for self-care & hygiene. Engaged in Nordic and European projects on empowerment, community engagement, and self-management at both practical and policy level.