TEMPORARY HEALTHCARE FACILITIES | CAREBOX EMERGENCY CALL Arups modular emergency healthcare solution, CareBox, can be deployed rapidly wherever its needed. Phil Lattimore finds out how it works, and looks at how other designs have responded to increasing knowledge of how Covid-19 is transmitted I n the UK, the rapid conversion of conference centres into emergency Nightingale Hospitals such as at the ExCeL in London was one of the most visible healthcare infrastructure responses to the initial threat of hospital capacity being overwhelmed by a surge in Covid-19 patients. And now the second wave of the pandemic in the UK is upon us, some of these facilities are back on standby. While these emergency field hospitals were designed to address potentially critical shortages of ICU and ward beds at short notice, other projects have been under development that provide alternative models for temporary healthcare facilities. These are informed by incorporating the increasing knowledge of how the SARS-CoV-2 virus spreads into their building design principles. Two alternative design responses for temporary hospitals include the CareBox modular hospital system developed by Arup and, from University of Cambridge Professors Andrew Woods and Alan Short, a series of practical solutions to reduce the concentration of airborne virus experienced by patients and healthcare workers in buildings converted into makeshift emergency Covid-19 wards. CareBox CareBox has been developed by Arup as a series of design guidelines for scalable, modular solutions that can be deployed quickly in a range of settings to add emergency hospital capacity. It is designed to offer flexibility to expand critical care or ward capacity either at existing hospital campuses or through the conversion of existing facilities, such as multi-storey car parks or conference facilities. The modular solution was developed to be applicable to a number of different contexts as well as spaces, so that it could be deployed in a variety of national healthcare systems ranging from well-resourced European or American-type scenarios to low-resource base healthcare environments, such as in developing countries. A current example of the latter is Arups work with NGOs at refugee camps at Coxs Bazar in Bangladesh. To cater for these different scenarios, the CareBox design guidelines have evolved into four variants, which are free to download from Arups corporate website. These include a plug-in design for adding extra space to an existing hospital facility; a multi-storey solution for expanding capacity in confined spaces, such as car parks next to CareBox designs can evolve as understanding of potential airborne transmission of the virus increases Using an existing building is one of the fastest and safest ways of implementing temporary medical facilities, says Arup hospitals; an in-door design for adapting existing buildings such as convention centres or sports halls; and a low-resource model for regions with more limited healthcare facilities. Each contains specifications for building and fitting out the CareBox, with detailed design of building services and processes necessary to create a fully functioning emergency healthcare facility. The reference points we used in the design development were from our existing healthcare project portfolio, says Dan Moran, associate director at Arups buildings team in Dublin, Ireland. We incorporated sound engineering The wards are designed following the modern methods of construction and design for manufacture and assembly concepts WARD MODULE Three modules become an independent box of five oxygen-assisted beds 30 November 2020 www.cibsejournal.com CIBSE Nov2020 p30-32 CareBox.indd 30 23/10/2020 15:48