For thousands of years, humans have turned to physical space in an attempt to treat and cure disease. The built environment has long been viewed as a means to control the spread of pandemics, and people have redesigned cities, infrastructure and architecture, all with the purpose of reducing the spread of infectious disease. As we face the current COVID-19 pandemic, it is becoming essential to find methods of reducing transmission rates. With social distancing regulations in place, it is once more necessary for us to reimagine the way in which we occupy spaces in order to mitigate the spread of the virus.
Pandemics have afflicted civilizations throughout human history, with the earliest known outbreak occurring in 430 BC amidst the Peloponnesian War. Historic pandemics have had a transformative impact on society, not only killing large percentages of the global population, but also causing seismic changes in the built environment. When reflecting on the aftermath of previous outbreaks, it is striking to consider the way in which humanity tends to emerge strengthened, refocused and better equipped to tackle future issues. Pandemics possess a redefining nature, and the waves of innovation that tend to follow them reveal what human ingenuity is capable of in the face of adversity.
Looking around many countries today, there is evidence of how humans have responded to previous infectious diseases by redesigning our physical spaces. London’s streetscape itself still shows signs of its previous battles with disease, such as seemingly random patches of open land or car parks in densely packed areas of the city, which are believed to have been plague pits. Interestingly, Covent Garden was originally conceived by the 4th Earl of Bedford as housing for an elite population, located away from the diseased and crowded streets of the city. Many famous streets including Oxford Street, Park Lane and St James’s Street do not contain a number 13, supposedly a result of superstitions regarding exposure to death and disease.
The natural survival instincts of humans drive us to distance ourselves from risk. As early as 400 BC, Hippocrates speculated that poor physical environments such as dirty water and poor air quality caused illness and disease. The conclusion drawn was that going to areas with fresh air and water would therefore improve health. In fact, the word quarantine, defined as restricting the movement of people or goods, is rooted in a Latin term meaning ‘forty days’, a reference to preventative measures taken during the Middle Ages to stop the spread of the bubonic plague. Ships arriving in Venice from areas affected by the Black Death were required to anchor for 40 days before the crew could disembark. The Black Death outbreak of 1348 killed 40% of London’s population. These outbreaks continued for several years, with England’s last major pandemic being the Great Plague of 1665-66.
In the 18th Century, the Industrial Revolution led to the rapid growth of cities, and streets became polluted and overcrowded, providing the ideal breeding ground for diseases, particularly in densely populated cities like London and New York. As these cities grew, outbreaks of typhoid and cholera became major public health issues, as it was typical for raw sewage to flow out of buildings and directly onto city streets.
Whilst unsanitary waste including animal manure and human excrement flowed freely into drinking water sources, it was in fact the odour they produced that was blamed for spreading disease. The prevailing theory was miasma, the belief that infectious diseases were spread through contact with ‘bad air’, or noxious vapours emanating from rotting organic matter. The fear of miasma had a significant impact on the built environment, driving massive infrastructural initiatives including the installation of underground wastewater systems. It was deemed essential to introduce better ventilation, drainage and sanitary practices to rid cities of foul-smelling and supposedly disease-causing air.
Leaders in New York responded to cholera outbreaks by banishing 20,000 pigs from the heart of the city and constructing a 41 mile aqueduct system that delivered clean drinking water from north of the city. This in turn led to a sanitary reform movement, creating drinking water and sewage infrastructure. There was a worldwide shift to straighter, smoother, and wider streets, to install underground pipe systems and to ensure that any waste could be washed away to prevent the emission of miasmic gases. Marshy areas of cities were also filled in, encouraging the expansion of industry and housing.
London’s streetscape shows signs of its previous battles with disease, with seemingly random patches of open land or car parks in densely packed areas of the city.
Leaders in New York responded to cholera outbreaks by banishing 20,000 pigs from the heart of the city and constructing a 41 mile aqueduct system that delivered clean drinking water.
Recurring cholera outbreaks and the belief in the medicinal qualities of green space also influenced the design of more than 100 public parks and recreation grounds.
Following COVID-19, public spaces will move towards increased automation to mitigate transmission. For example touchless technology, such as hands-free light switches and temperature controls, automatic doors, voice-activated elevators, and advanced airport check-in and security.
One particular space that is set to undergo a significant transformation is the office. In the short-term, it seems likely that many people will remain working from home, even after government restrictions begin to be lifted.
The pandemic has also accentuated the need for healthier buildings, particularly in terms of better ventilation and improved indoor air quality.
Recurring cholera outbreaks also left an enduring mark on cities in the form of wide boulevards and parks, transforming several major cities into the iconic metropolises we know today. Frederick Law Olmsted, a landscape architect and miasma theory devotee, advocated for the healing powers of parks, which he believed could act like urban lungs as ‘outlets for foul air and inlets for pure air’. He used public health concerns to convince the governors of New York City to build Central Park, and his belief in the medicinal qualities of green space also influenced the design of more than 100 public parks and recreation grounds. Similarly, under the direction of Baron Georges-Eugène Haussmann, French authorities tore down 12,000 buildings, built tree-lined boulevards and parks, erected fountains and installed an elaborate sewage system that transformed Paris into the modern day ‘City of Light’.
Whilst the theory of miasma had a transformative impact on the built environment, it was nevertheless incorrect, and it took many years for it to be deemed obsolete. In 1849, John Snow, a London-based physician, published a paper entitled ‘On the Mode of Communication of Cholera’, in which he proposed that cholera was transmitted not by bad air, but by a water-borne infection. Following the third cholera outbreak in 1854, he published an update to his theory, with statistical evidence showing a cluster of deaths attributed to cholera around a public water pump in Broad Street. He was able to convince local officials to remove the handle of the pump, but his ‘germ’ theory of disease was not widely accepted until the 1860s. Following years of disease and unsanitary conditions, The Public Health Act of 1975 became a significant step in the advancement of public health. This enforced laws regarding slum clearance, the removal of ‘nuisances’, and the provision of sewers and clean water.
Whilst using the built environment to treat epidemics remained a prominent method for many years to come, as scientific research continued to progress, the focus on buildings and infrastructure began to decline. With advancements in science and medicine, antibiotics and immunisations quickly became the most effective way to treat infectious diseases.
However, with new diseases like COVID-19 emerging, and with no vaccines or medicines currently available to treat them, using space as a way to address epidemics has regained importance. We are being forced to return to an almost medieval spatial response to disease control; social distancing, quarantine, isolation, and adaptations to our cities and buildings. Whatever happens in the months to come, and even if a vaccine does become available, it seems inevitable that the COVID-19 pandemic will have a long-lasting impact on the built environment.
Seemingly overnight, our way of life has changed completely, as we have been encouraged to stay at home and avoid interaction wherever possible. While social distancing is a necessary short term measure, it is reasonable to believe that concerns about future viruses may change the way in which spaces are designed. It seems likely that there will be long term implications regarding how we gather in large public spaces, including airports, hotels, hospitals, gyms, and offices. Going forwards, these areas will need to be designed to enable and encourage people to spread out.
It is inevitable that public spaces will move towards increased automation to mitigate transmission. COVID-19 has fast-tracked the development of various types of touchless technology, such as hands-free light switches and temperature controls, automatic doors, voice-activated elevators, and advanced airport check-in and security. It also seems likely that designers will make increasing use of antibacterial fabrics and finishes, including those that already exist, like copper and Airlite paint, and those that will inevitably be developed.
Certain elements of construction that are already standard in healthcare may also find application in other public spaces, such as reducing the number of flat surfaces where germs can collect, and installing more advanced ventilation systems.
One particular space that is set to undergo a significant transformation is the office. In the short-term, it seems likely that many people will remain working from home, even after government restrictions begin to be lifted. A staggered workforce may become standard, with smaller groups coming in on alternate days and shifts that aim to avoid transport rush-hour peaks. There will need to be a range of temporary measures aimed at boosting employee confidence, including the provision of masks, perspex screens, and perhaps even testing. Value may also be found in private sector led contact tracing platforms such as HB Reavis’ Symbiosy. Many are now predicting the end of the open-plan workplace and the return of small, private offices. However, it has been noted that the cellular office plan has limited benefits for workplace culture, communication and collaboration.
Whilst considering how specific types of buildings may change is undoubtedly interesting, it is perhaps more important to consider the larger shifts that could potentially take place. In response to previous pandemics, there have been a range of temporary measures used to resolve the immediate problem. However, tracing outbreaks throughout history highlights the fact that there have also been many seismic long-term changes that have transformed the built environment for good.
The COVID-19 pandemic has accentuated the need for healthier buildings, particularly in terms of better ventilation and improved indoor air quality. Going forwards, the built environment will need to be designed with a clear focus on the health and wellbeing of occupants. Even once this pandemic ends, memories of the devastation it has caused will remain, and the fear of future infectious viruses will be a concern. Perhaps when people reflect on the current pandemic, it will be seen as the catalyst for making indoor environments healthier for generations to come.