With the outbreak of the Covid-19 pandemic, the hospital bed capacities in both private and public health facilities were of great concern. Especially with the expected surge in Covid-19 patients, there was a need to create bed and treatment facilities very quickly.

Osmond Lange Architects was involved in various proposals on how to create alternatives in the public and private healthcare sector. This included its East London office investigating the conversion of an existing warehouse into a Covid-19 facility and new Covid-19 wards at Sonstraal Hospital in the Western Cape.

Containers and prefab units as treatment facilities

Containers and prefabricated units offered the potential of quick assembly, transport to remote areas, and demounting and relocating. The shipping containers could be joined to form clinical spaces and the conglomeration of these modules could form a Covid-19 treatment centre.

Publications by the World Health Organisation (WHO) and the Council of Scientific and Industrial Research (CSIR) had indicated that Covid-19 care sites would be needed to cater for the treatment of a range of acuities, namely moderate, severe and critical. Containers could be the answer, as they can be demounted and moved to remote areas and used for specific functions to serve the clinical load, depending on the severity of the area. The layout of an intensive care unit (ICU) room can ideally be constructed using existing containers.

Jubilee ICU Hospital

The tender was for ICU hospitals for which an EPC consortium (under an NEC EPC form of contract) would be appointed to design and construct a 300-bed ICU Hospital, using alternative building technologies. The appointed team comprised of Concor (PTY) LTD (the Main Contractor), That Interesting Company (Project Managers), Osmond Lange Architects South Africa (PTY) LTD, Dihlase (Mechanical and Electrical Engineers) and CivEng (Civil and Structural Engineers)

The focus and requirements of the contract were to design, construct and commission a hospital facility consisting of 300 to 500 beds. Before Covid-19, alternative building technologies had mostly been used on staff housing and small clinics. This concept is based on the WHO proposal of a field hospital combined with IUSS regulations regarding ICU patient room sizes and the required medical support facilities to ensure the proper functioning of an ICU.

The proposal

The tender, with the design, was submitted by the team on 15 May 2020. In this proposal, 25m² ICU rooms and cubicles were proposed, as this is the required space for an ICU room as defined by IUSS. Alternative care sites would be needed to cater for the treatment of a range of acuities, namely moderate, severe and critical, with the anticipated level of acuity as per the table below.

The layout was then workshopped with the Department of Health and the ICU unit was agreed upon, with the three patient wings reduced to two wings, but with the central nurses station and clinical support facilities wing remaining. As per the layout, the sluice rooms were kept at the extremities of the layout, with their exit, to prevent any cross-infection.

High-care unit concept

The high-care units (HCU) followed the same concept as the ICU in terms of the configuration of the central nurses station, clean utilities and stores, as well as the dirty utility areas that are located on the extremities of the module. The difference was in the configuration of the patient rooms (two- and four-bed modules).

Modules could be re-configured to a variety of bed-ward configurations, that would suit different Covid-19 acuities. So, the benefit of a modular prefabricated system was that, if it could follow the base module of clinical space, it could provide future flexibility.

Site plan

The agglomeration of the different modules for the Covid-19 hospital was based on two clusters of ICU and HCU wards that run from north to south, with a central covered hospital street that runs through the two-ward block precincts, from north to south. The location of the facility allowed for Covid-19 patients to arrive by ambulance and enter the facility from the north, without having to enter through the main hospital.

In this slide, you can see the arrangement of the central covered walkway, which is flanked by the ward modules.

The team opted for a light-steel-frame structure (a system that would be constructed by Futurecon) that would fall under the conditions of SANS 517 light-steel-frame building and therefore not require an agreement certificate.

One of the main features of the light-steel alternative building technology was all the component parts. To plan for the healthcare facilities, the components were modelled virtually. The exact modelling also helped on site for the planning, as a fly-through for the contractor could be done so that details could be planned. The 3D modelling also assisted in communicating the proposed plan and assisted in understanding the result.

Wall protection

Polyflor SA was proud to be associated with this project to help make a difference and supplied the corner guards and SureProtect Endure PVC-u protective sheeting.

For more information, contact Osmond Lange Architects South Africa (PTY) LTD:
Tel: +27 11 994 4300
Email: info@o-l.co.za
Website: www.osmondlange.co.za

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