The New Normal

Prioritizing Public Health To (Re)Shape Our World

The New Normal

With states such as Georgia and Florida rapidly resuming their pre-COVID-19 routines, many are anxious about what awaits them in a post-pandemic world. As our teams provide immediate services to combat this epidemic, internally we are discussing the changes we need to make in order to prevent future outbreaks.

In conversation with Phil Walker, AICP, Associate Principal and one of our Global Urban Planning Design leaders and Tiffany Fitzpatrick, MPH HBSc, an incoming CIHR Banting Postdoctoral Fellow for the Public Health Modeling Unit at the Yale School of Public Health, we discussed the relationship between past pandemics and our current reality to make some educated assumptions about what a new normal might look like. Our discussions explored three scenarios: Back to NormalA Cautious New Normal; and A Brave New World.

Scenario 1: Back to Normal

In the first scenario, our temporary accommodations of social distancing, working from home, online education, and isolation of vulnerable populations end, and we go back to business as usual. The desire to go “back to normal” is easy to understand. Already, we are seeing a backlash to social distancing measures. Protests across the country are calling for an end to these guidelines. History shows this is a common reaction, but also shows why these guidelines work.

Tiffany: “In Philadelphia during the 1918 flu, people didn’t really practice social distancing. For example, they had a parade, and consequently experienced the pandemic worse than most other cities. In St. Louis, where they cancelled all parades and told everyone to stay inside for about 60 days… their death rate was half that of Philadelphia.”

Phil: “Protests also occurred during the response to the 1918 flu. As the influenza pandemic stretched into 1919, an ‘Anti-Mask League’ in San Francisco rallied to pressure the city to lift what some felt were restrictive guidelines. The protests resulted in an easing of health ordinances that included rescinding the mandatory mask order. As a result, influenza cases resurged in the city. With a population of 500,000, at the end of the epidemic 45,000 San Franciscans had been infected and 3,000 died, becoming one of the hardest hit cities in the United States.”

The uncanny resemblance between our current situation and the backlash against preventative measures in 1918 make both Tiffany and Phil agree that our collective memory is very short when it comes to lessons from the past.

Tiffany: “The thing with public health is everyone tends to forget what happened until the next thing happens. Social distancing was strict during the 1918 flu, but it was not on everyone’s mind a few years later.”

Tiffany predicts, however, that over the coming decades these epidemics will become more common. “There is more interface now between the human and animal experience due to environmental impacts like deforestation. The more contact humans have with animals allows for a higher probability of infection crossover…these have tended to be more virulent infections.” She continues, “Worldwide travel also contributes to this. Where originally these viruses might be contained to small villages, now they can travel the world overnight.”

Due to our interconnected world and our environmental impact, is it even possible to go back to normal? We face a far more vulnerable future than in 1918. What we do now will affect what our tomorrow looks like.

The New Normal 1

Scenario 2: A Cautious New Normal

In this scenario, we recognize and adapt to COVID-19’s effect on the world. While we go back to commuting to work, taking our kids to school, and going out to sporting events, theaters, concerts, restaurants, and bars, we approach these routines with far more caution than in the past. We see small but lasting changes, from the places where we live to how we behave.

Phil: “Even before the pandemic, it was common courtesy in Japan and other countries to wear a mask if you were sick. This custom has a long history, related to both prior health crises and more current environmental and urban concerns over air quality. This practice likely contributed to Japan’s low rates of infection from COVID-19. In the US, we may see our public habits change — more people wearing masks and gloves, more elbow bumps and fewer handshakes…plus a lot more handwashing.”

Tiffany: “The handshake gained increased prominence as an alternative mode of greeting during the great plague. Prior to this, it was a common tradition in cultures such as Ancient Rome and France to greet with a kiss on the cheek. It wasn’t until a few centuries later that the traditional kiss-greeting began to re-emerge in some cultures, like modern-day France.”

If cultural behavior changes with concerns over public health, what changes in design might mimic these new concerns?

Phil: “In the near future, architects, planners, and designers may need to produce new design guidelines with public health and wellness in mind. For higher education, dorms may be redesigned for single rooms; hotspots such as nursing homes may be redesigned to be more resilient to future epidemics; workplaces may adapt permanent work-from-home polices; cities may invest in more accessible green spaces; arenas and restaurants may enact new capacity and/or density laws.”

If COVID-19 sparks a change in our day-to-day behavior, it will certainly affect the way we design. How much we choose to implement public health concerns going forward will have a lasting effect on our future. Innovative design changes will be at the heart of repairing our world.

Scenario 3: A Brave New World

The COVID-19 pandemic may cause a powerful paradigm-shift in the way we live. In response to the devastation of our most fragile and vulnerable, especially our seniors, disabled, and impoverished, a new awareness of the importance that public health has on all aspects of life must influence all disciplines.

Phil: “How we move may change. Planes, trains, and automobiles, walking, and biking…we will become more intentional about public transportation. How we live may change. We may need to rethink our homes after spending so much time in them. How we learn may change. We need to study the costs and benefits of online learning, to consider an improvement in distance learning infrastructure.”

Our insular, stay-at-home lives might even bring us closer to nature.

Phil: “The positive environmental impact from COVID-19 protocols may cause sweeping changes in how we design. Even in the short span of several months, we have seen pollution reduction and air quality improvement. While maintaining social distance, many of us have had a chance to renew our appreciation for parks, trails, and public spaces. This newfound awareness, as well as our increased time at home, could radically shift how and why we design. It makes me think of Perkins Eastman’s Green Line proposal from five years ago. The ambition, to turn 40 blocks of Broadway into a continuous, linear park, definitely resonates today.”

The vision to close some of our city streets and connecting public spaces: Union Square, Herald Square, Times Square, and Columbus Circle, through a linear park and walkway in New York City, as in the Green Line proposal, is just one example of ideas that may receive serious attention as a renewed demand for accessible public spaces emerges.

These grand ideas may seem daunting, but there is ample precedent to show that sweeping change is possible.

Tiffany: “The widespread cholera and typhoid infections of the 1800s caused changes in urban design to alleviate the spread of bacteria by developing better infrastructure for managing waste. As a result, the creation of boulevards and large open streets in cities came into fashion as a means to accommodate sewage piping underground. Consequently, these wider streets exposed people to more sunlight and allowed more airflow, improving public health for city residents.”

A paradigmatic shift toward public health will most certainly influence design, changing how we view infrastructure, public space, our homes, commercial districts, industry, and more.

What Does Tomorrow Look Like?

Our future is uncharted, but we know that conversations around our “new normal” will continue to increase in the coming weeks and months.

National and state-level discussions of easing social distancing guidelines to get people back to work and the economy running again fill the airwaves and dominate headlines. With these discussions in mind, we asked workplace and healthcare design leaders, principals Connor Glass, IIDA, Mark Van Summern, AIA , and Jason Harper, AIA, along with Perkins Eastman co-CEO and Executive Director, Shawn Basler, AIA, (as quoted in Engineering News Record) about their predictions for a new normal:

“There’s an energy around reimagining future workplaces, future schools, future healthcare facilities, everything. We’ll see much more integration between physical environments and virtual environments.” – Shawn Basler, AIA, Executive Director and co-CEO

“Without a doubt remote working for most knowledge workers will be the new normal. The question is, what scale and frequency of remote work will be right for individual organizations and teams? Space type ratios of office environments will likely be turned upside down, with communal ‘third space’ settings for flexible co-working eclipsing individual workstations…Cleaning protocols, public policy, and indoor environmental quality guidelines will change.” – Connor Glass, IIDA, Workplace

“One of the most important things to foster when we return to work is the need for basic human connection. What we consistently hear from clients is that connection and interaction with our coworkers is paramount to our health and wellbeing.” – Mark Van Summern, AIA, Workplace

“As we slowly return to normal, we need to better prepare for the next outbreak. Hospitals scrambled to increase capacity to handle the unusual and rapid increase in infectious patients. Negative pressure patient rooms with 100% exhaust are the primary tool for hospitals to isolate people for treatment and to stop the spread of respiratory infections. The ability to rapidly increase this type of accommodation needs to be built in to all of our hospitals for this outbreak and the next one.” – Jason Harper, AIA, Healthcare

We at Perkins Eastman believe that a renewed interest in public health and wellness needs to be part of all innovative design solutions. The impact from the COVID-19 lock-down: 22 million Americans unemployed, hospitals overloaded with patients, an almost complete shutdown of the economy, shows the lasting damage already inflicted by this pandemic.

Now is the time to listen, learn, and act.