Designed for a pandemic: Mitigating the risk of SARS-CoV-2 transmission through hospital design and infrastructure

Brendan Kennedy; Anushia Ashokan; Chuan Kok Lim; Diana Lagana; Marija Juraja; David Shaw

doi:10.1016/j.idh.2023.08.004

Designed for a pandemic: Mitigating the risk of SARS-CoV-2 transmission through hospital design and infrastructure

Infect Dis Health. 2024 Feb;29(1):25-31. doi: 10.1016/j.idh.2023.08.004. Epub 2023 Oct 6.

Authors

Brendan Kennedy¹, Anushia Ashokan², Chuan Kok Lim³, Diana Lagana⁴, Marija Juraja⁴, David Shaw²

Affiliations

¹ Infectious Diseases Unit, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Department of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia. Electronic address: Brendan.Kennedy@sa.gov.au.
² Infectious Diseases Unit, Central Adelaide Local Health Network, Adelaide, South Australia, Australia; Department of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
³ SA Pathology, Adelaide, South Australia, Australia.
⁴ Infection Prevention and Control Unit, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.

PMID: 37806908
DOI: 10.1016/j.idh.2023.08.004

Abstract

Background: To describe the new Royal Adelaide Hospital (RAH) design and infrastructure features that helped mitigate the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission within the hospital during the pre-vaccination and pre-antiviral period.

Method: The RAH infrastructure, design and initial pandemic response was assessed. A retrospective review of all confirmed or suspected coronavirus disease 2019 (COVID-19) patients admitted from 1 February 2020 to 30 May 2020 was also performed to assess risk of transmission. Outbreak response reports were reviewed to identify episodes of nosocomial COVID-19.

Results: Key infrastructure features include single-bed overnight rooms with dedicated bathrooms, creation of pandemic areas accessible only to pandemic staff, and sophisticated air-handling units with improved ventilation. A total of 264 COVID-19 related admission occurred, with 113 confirmed cases and 1579 total cumulative bed days. Despite a limited understanding of SARS-CoV-2 transmission, no vaccination or anti-viral therapy, global shortages of particulate filter respirators and restricted testing during this period, only one probable nosocomial COVID-19 case occurred in a healthcare worker, with no nosocomial cases involving patients.

Conclusions: The RAH design and pandemic features complimented existing infection control interventions and was important in limiting nosocomial spread of SARS-CoV-2.

Keywords: COVID-19; Hospital design and infrastructure; Infection control; SARS-CoV-2 infection.

MeSH terms

COVID-19* / epidemiology
COVID-19* / prevention & control
Cross Infection* / epidemiology
Cross Infection* / prevention & control
Hospital Design and Construction*
Humans
Pandemics / prevention & control
SARS-CoV-2