How to Build a Hospital in Nine Days: Pandemic Emergency Architecture | Art and design


AA strange mechanical buzzing has joined the usual backdrop of tweeting birds and the roar of the North Circular at Wanstead Flats in London. The sound comes from behind a large wooden fence, recently erected on large fields opened by Epping Forest, where a group of long white marquees stings above the tree line. It sounds like the stuff of a beer festival, but the reality is much darker: the buzz is not from the beer taps, but from a generator that will be used to maintain a fleet of storage units at 4C for the next few weeks – the temperature required to prevent human corpses from decomposing.

Covering an area the size of two football fields, this new complex is a temporary morgue, one of many such structures that are being erected at lightning speed across the UK to cope with the growing number of dead of the coronavirus pandemic. This East End outpost is conveniently located next to the City of London cemetery and crematorium, and just three miles from the new NHS Nightingale hospital at the ExCel convention center – a strategic location for the mayor of Newham, Rokhsana Fiaz, described in a letter to local residents as “A halt before a respectful and dignified cremation or burial can take place to send a loved one on their last trip.” It is a storage depot that bereaved relatives will of course never be allowed to visit.

“Breakpoint” … a makeshift morgue under construction at Wanstead Flats in east London, one of 200 temporary morgues under construction in the UK. Photography: Alberto Pezzali / AP

The Wanstead facility is one of nearly 200 temporary mortuary complexes built in the United Kingdom and Ireland in preparation for what the Cabinet Office described as “the worst reasonable scenario”, when tens of thousands of bodies could exceed the capacity of existing buildings. morgues. There was no plan for such a crisis, so each region responds according to the facilities and available space. In Devon, refrigerated trucks have been installed on empty land near Torbay hospital. At Milton Keynes, an ice rink was co-opted for this task, its cooling infrastructure making it well suited to the task. In Dublin, the Irish Museum of Modern Art (housed in the former Royal Hospital Kilmainham) will regain a clinical function, housing a morgue on its grounds, while an aircraft hangar at Birmingham Airport is being transform into a morgue that can accommodate up to 12,000 bodies.

From mobile mortuaries to driving test stations and ephemeral intensive care rooms, the coronavirus epidemic has experienced one of the largest mobilizations of temporary infrastructure in peacetime. This is an Olympian effort of scaffolding, marquees, inflatable tents and portable cabins, as the existing buildings were redeveloped in a matter of days. With construction having to start before plans are finalized, in many cases, architects, engineers and builders react at a speed that essentially leaves time. It’s emergency architecture at its most basic.

Workers outside a hangar at Birmingham Airport, which is being transformed into a large mortuary.

Workers outside a hangar at Birmingham Airport, which is being transformed into a large mortuary. Photography: Jacob King / PA

Portakabin, the York-based company that has been synonymous with prefabricated buildings for 60 years, has been on the front line since mid-February, providing numerous emergency facilities. They started by building assessment modules and isolation units in hospital parking lots, and are currently working on the government’s national morgue program.

“We were contacted by the sales management of the Cabinet Office to ask them what we could do around the” storage buildings “,” explains the director of the company, Robert Snook. “It quickly became clear what it meant. Portakabin has a form of refrigerated storage, with the previous prefabricated modules erected to store everything from exotic orchid bulbs to fine wines. However, the shelving and shelving systems of the morgues were a new challenge. The bulk of the company’s work to date has been to provide large amounts of overflow space for hospitals, so that rooms with low risk patients could be moved to free up more space for those who have Covid-19 in the main hospital buildings. Snook says everything is as usual for a company used to rapid response, having delivered an emergency hospital to the Falkland Islands during the war in the 1980s, and built an entire secondary school in nine weeks after the fire in Grenfell tower. “For us, this is all standard,” says Snook. “The main challenge was actually getting enough FFP3 face masks for our workers to wear in the factory.”

While companies such as Portakabin have supplied standard modular shells as usual, factories operating at full load, some situations have required more personalized solutions. One of the most technically demanding temporary structures to date has been the transformation of the ExCel convention center in the Docklands region of east London into an emergency field hospital, the NHS Nightingale, which can ultimately accommodate 4,000 patients. Gargantuan exhibition halls have hosted a diverse range of functions in the past, from the Crufts dog show to international arms fairs, but this incarnation extended the building’s flexible nature to the limit.

A queue at a driving test station for NHS staff at Wembley Ikea.

A queue at a driving test station for NHS staff at Wembley Ikea. Photography: Anadolu Agency via Getty Images

Completed in nine days, it, like all other parts of the national response to Covid-19, was developed on the fly. The location was settled in mid-March, after other large gyms and warehouses were considered. The ventilation system is equipped to handle a large number of people, the floors are riddled with mechanical service boxes and there is a readily available supply of modular partitions and teams of technicians accustomed to mounting exhibits overnight.

“The strategy was to use as much existing infrastructure as possible,” said James Hepburn of the architects BDP, who led the project design team. “On the first day, it was clear how difficult the supply was going to be, as many factories closed. We used the partition walls with a little extra stiffening to create the headboards, and then ran the electricity, water, drainage and medical gas for a long period of service behind, reflecting the bays on each side. Visibility between bays was essential, as doctors will each be responsible for many more patients than usual.

Entrepreneurs transform ExCel center in east London into NHS Nightingale hospital in late March.

Entrepreneurs transform ExCel center in east London into NHS Nightingale hospital in late March. Photography: Stefan Rousseau / AP

The site has become a 24-hour production line, coordinated by army personnel, seeing the vinyl floor laid, the partitions erected and teams of electricians assembling prefabricated dado chutes to be screwed onto the heads of reads as soon as they were in place. The central boulevard between conference rooms, which usually houses networking delegates, has been transformed into a controlled area where doctors don and remove protective clothing, while waterfront cafes have become their essential rest. Of course, there is also a morgue. “It is interesting to note that when the military sets up a camp with a field hospital, one of the first things it does is build the morgue,” said Hepburn. “There is a psychological element to this – if you are in a war situation, knowing that this aspect is being dealt with is actually quite reassuring. “

Building on their experiences, BDP has produced a “how to” guide, drawn in the clear schematic style of an Ikea furniture construction manual, to assist other projects. Similar emergency hospitals are underway in Bristol, Harrogate, Birmingham and Manchester. Despite the rushed intensity of the process, could the whole experience offer lessons for the future?

“If someone asked you to design a hospital like this, you would normally say that you need six months and a huge team of carefully selected people, not a group of people gathered over a weekend Says Hepburn. “Here, there was neither the usual” design responsibility matrix “nor any of the administrators who muddled everyone. It was a very liberating, free-form collaborative approach, and it shows what is possible when everyone really comes together with a common goal. “

“If we ever get back to normal,” he adds, “projects will get very frustrating when someone says no.”


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