Disaster preparedness was on the minds of everyone involved in the design of the new emergency department (ED) and hospital expansion at the University of Virginia (UVA) in Charlottesville. But, at the time, they were thinking more along the lines of a 9/11-type attack or an Ebola or flu outbreak. No one could have predicted a pandemic of a virus never before seen in humans. COVID-19 forced a last-minute change of course.
Though the ED, located in the base of the building, had been operational for some months, the six-story, curving, glass patient bed tower had yet to open. “We planned on inaugurating the tower by June, but opened part of it for treatment of coronavirus patients in early April,” recalls Kevin Fox, director of facilities planning and capital development at UVA. The new hospital was never overwhelmed—it treated a steady volume of 25 to 30 infected individuals at a time before cases in central Virginia plateaued in late spring. To do so, it underwent some speedy but significant modifications. Says Fox, “We already had three airborne-infection-isolation (AII) rooms on the third floor, but we were able to utilize a smoke-evacuation system and cobbled together some ductwork fairly quickly to create 12 additional rooms that have the static pressure equivalent of AII.” As a second phase of the response, the hospital procured three high-velocity fans that were installed in the mechanical space on the roof to create negative-pressure rooms for the rest of the third floor and all of the fourth floor. In these rooms, lower air pressure allows outside air into the segregated environment. Any contaminated air that flows out of the room is rerouted away from other patients and hospital staff or passes through a filter.
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