The role of the built environment in slowing the spread of COVID-19 and helping people cope with the pandemic and its aftermath was discussed by healthy building experts convened by ULI for a March 31 webinar on the impacts of the coronavirus.

The event, “Confronting COVID-19: Healthy Buildings, Optimizing Mental Health,” was the second in a series of webinars offered by ULI’s Building Healthy Places Initiative to explore how various aspects of the real estate industry are being affected by the virus and the industry’s response.

The webinar is free to access at ULI Knowledge Finder.

Webinar panelist Joseph G. Allen, assistant professor at Harvard University’s T.H. Chan School of Public Health, noted that society in general appears to have reached the acceptance phase of the crisis, which he said is the point at which people feel empowered to combat it.

“We are all in a position to do something, and we have to bring buildings into this fight. This is an all-in moment like we have never seen. We need everyone in on this, working to solve this challenge,” he said. (Allen has written several commentaries on COVID-19 as well as publications on healthy buildings, which are available at forhealth.org.)

Allen listed several global “megachanges” that will alter how people relate to the built environment and how buildings will be operated, including changes in the following: population, cities’ growth, cities’ resources, climate, the role of the private sector and public/private partnerships, attitudes about human health and the health of buildings, workplaces, technologies, and values. “As a result of this pandemic, people’s expectations of how their buildings are performing will change forever and fundamentally,” Allen said.

The three types of virus transmission—person-to-person, fomite (contaminated surfaces), and airborne—all have implications for building health and safety, with physical distancing and surface cleaning being the main ways to address the first two and improvements to air quality being the best way to address the third, Allen said. While airborne transmission has not been identified as the dominant form of spreading coronavirus, each method of transmission is related, and each can inform control strategies that can be applied to buildings, such as increasing outdoor air ventilation, improving filtration of recirculated air, and raising air humidity levels to hamper growth of the coronavirus and other infectious diseases.

“The reality is we are not going to know for a long time which mode of transmission dominates, so we should assume all are happening, and we should throw everything we have at this, including protection across all three modes of transmission,” he said.

Buildings, Allen said, are the first line of defense in the three stages of combatting disease—response, which is immediate action; recovery, which is the stage in which buildings are repopulated; and resilience, which involves lasting changes in how people experience buildings over time. Until a vaccine is available for the coronavirus, a “new normal” for building use and disease mitigation will be necessary that includes healthy building strategies for mechanical systems, as well as operational practices such as “de-densifying” to increase distance between people, limiting in-person meeting attendees, extending building hours, and staggering arrival times.

Allen listed nine foundations of a healthy building that drive human health and building performance—ventilation, air quality, thermal health, moisture, dust and pests, and safety and security—which he said would be immediate concerns, as well as longer-term concerns such as water quality, noise, and lighting and views. “People will be asking questions [about building health] that they have not asked before,” he said. As a result, regular building “checkups” to benchmark and track health performance indicators and manage health promoting practices will become more important than ever, Allen noted.

He pointed to the emergence of a virus-fighting plan to save lives and the economy that is based on converging insights by health experts worldwide. This plan involves comprehensive implementation of seven actions:

  • virus suppression via social distancing;
  • widescale testing;
  • national mobilization of health care workers and supplies;
  • economic relief programs;
  • serological testing for virus antibodies, which would allow people with proven immunity to return to work;
  • contact tracing, isolation, and self-quarantine; and
  • the “end game,” including a vaccine and other scientific breakthroughs such as plasma transfusion and repurposing old drugs.

“This will only work if it is a united plan; it cannot be ad hoc,” Allen said. “Buildings have to be part of the plan, because the decisions we make today regarding our buildings will determine our health now and our collective health for future generations.”

Webinar panelist Joanna Frank, president and chief executive officer for the Center for Active Design in New York City, discussed the impact of the built environment on mental health. Pointing to actions taken in that city as early as the 1800s to use the built environment to combat the spread of disease, she said that more than a century of research makes a strong case for buildings as solutions rather than contributors to health problems.

“The current pandemic has caused a lot of mental stress, and it is important to understand the role that buildings can play in mitigating those mental health issues,” Frank said.

The Center for Active Design operates the global Fitwel building certification system, which is based on 5,600 peer-reviewed public health studies and was initiated as a program for federal buildings managed by the U.S. General Services Administration. Based on research that continuously informs the Fitwel certification system, the center has identified elements of the built environment that affect overall health as well as individual health, such as design that reduces absenteeism, instills feelings of well-being, promotes social equity for vulnerable populations, provides healthy food options, promotes occupant safety, and increases physical activity. Each strategy that makes up the Fitwel certification can be weighted to show which ones have the most effective health impact on a particular building type, she noted.

Because poor mental health—reflected in anxiety, stress, and depression—is the largest contributor to disease globally, it is even more critical now, given the stress induced by the coronavirus, to design spaces to promote optimal mental health, she said. Building design and operational strategies that have a direct impact on mental health in the near term are of paramount importance, including access to high-quality green space, healthy outdoor air as well as indoor air, natural daylight, and views of nature, Frank noted. Equally important—particularly in today’s stay-at-home, work-at-home environment—is the need to combat sedentary tendencies by taking frequent work breaks, getting exercise, and safely interacting with others.

These practices will also be key as people start returning to the workplace, she said. “Preparing the workplace for tenants and employees to come back to a building is very much about mental health and building trust,” she said, adding that the preference of most job seekers and existing employees for healthy buildings will be even stronger post-coronavirus. “Best practices [such as hand washing, cleaning protocols, and air quality commitments] will be even more important,” she said. “Communicate what you [real estate professionals] are doing to promote health in a way that resonates with your audiences, and be vigilant in implementing your operational strategies. Otherwise, people will be quick to distrust that you are not following through.”

Both panelists were asked how the coronavirus crisis might affect the future of compact, dense development in urban areas, in terms of reversing the densification movement in place for the past two decades. According to Allen, it is important to disentangle the densification of city life versus densification inside buildings, and to distinguish what is necessary for the short term versus the long term.

“Densification is good and necessary for cities to accommodate population growth. I don’t see that changing,” he said. “In the short term, it will be necessary to de-densify inside buildings by physical distancing. We are going to have to get creative as we repopulate our buildings, because people will have to spread out,” he said. “We will need to draw on evidence [about sustainable development and growth patterns] to make good decisions on dealing with the COVID world and post-COVID world.”

Frank pointed to the benefits of designing the built environment to increase social interaction, create public spaces that bring people together, and address social inequities in urban areas. “De-densifying the built environment—to say we should no longer share public space or live in close proximity—is absolutely not the outcome that we will support going forward,” she said. In fact, some of the world’s densest cities, such as Hong Kong, Singapore, and Seoul, have been among the most effective at slowing the spread of the virus, Frank noted. The real estate industry needs an “informed and strong” argument regarding the negative consequences of creating more urban sprawl, including the long-term impacts on environmental sustainability, she said.

The webinar was moderated by ULI leader Elizabeth Shreeve, principal at SWA Group in San Francisco, and a supporter of ULI’s Building Healthy Places Initiative, created in 2013 to leverage the power of the Institute’s global networks to shape projects and places in ways that improve the health of people and communities. The goal of ULI’s webinar series on COVID-19 is to help members understand the role they can play in helping to slow the spread of the disease, help them navigate the long- and short-term impacts of the crisis, and help them understand how they can play a role in minimizing adverse impacts on vulnerable people.

For more information related to COVID-19 and real estate, visit COVID-19: Industry Insights at Urban Land Online.

TRISH RIGGS, former senior vice president of communications at ULI, is now a freelance writer based in Falls Church, Virginia.