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COVID-19 Centers for Excellence

Bronx, Brooklyn and Queens, NY, USA

Three first-of-their-kind health facilities are designed and built in less than a year for patients suffering from long-term effects of COVID-19 in New York’s hardest-hit communities.

New York City quickly emerged as the epicenter of the COVID-19 crisis in early 2020 after the disease—initially undetected—tore through its diverse and densely populated boroughs. Minority neighborhoods were disproportionately affected, and amidst its high casualty rates, there was an emerging population of COVID-19 patients who were experiencing chronic symptoms long after they recovered from the virus. Given these urgent circumstances, NYC Health + Hospitals, along with Gotham Health, moved to create permanent clinics for “long hauler” patients in the city’s hardest-hit communities.

COVID-19 Centers for Excellence

“As we continue to learn more about the long-lasting health impacts of this pandemic, we’re being proactive to create medical homes for New Yorkers. This site will not only provide critical health support to those still recovering from COVID-19, but also provide new opportunities for this community to access high-quality, ongoing primary care.”

– Mitchell Katz, MD, President and CEO of NYC Health + Hospitals

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The health systems were forward-thinking despite an extremely expedited schedule, blending urgent short-term health needs with long-term primary-care goals for these underserved communities. The ribbon-cutting at the Bronx clinic was held in December 2020, seven months after work began. The Queens clinic opened two months later, and Brooklyn followed soon thereafter, making all three operational in less than a year. They now serve as satellites of H+H’s hospital network with a spectrum of COVID-19 services from testing and treatment to the management of long-term symptoms, which include pulmonary and cardiac care, radiology and diagnostic services, and mental health services.

The clinics are also hubs of generalized healthcare services, offering cancer screenings, dental and vision care, women’s healthcare, diabetes management, podiatry, adult medicine, pediatrics, and other basic exams and procedures.

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As the teams at Perkins Eastman and Gilbane Building Company set to work, the biggest challenge they saw lay in retrofitting existing, non-medical sites to provide mechanical, electrical, and plumbing systems that would meet rigorous healthcare and COVID-ready requirements. That meant changing existing rooftop equipment and installing emergency generators for additional power. Exam rooms used for post-COVID treatment required HEPA filtration for supply air, exhaust air, and negative-pressure exam rooms. Medical gases such as oxygen, vacuum, and medical air had to be supplied for the clinical areas, and protective systems had to be installed for the radiology equipment. These myriad requirements demanded oversized duct work, additional fans, and filters throughout the program. And because no established building codes for COVID-19 facilities existed, the design and engineering teams had to pioneer these new networks and systems at the same time health officials were still trying to understand the challenges facing long haulers.

The city’s Department of Design and Construction streamlined its permitting process so the new centers could open as expeditiously and safely as possible, frequently approving permits within a highly atypical twenty-four hours of submittal. Meanwhile, our design team was giving new sets of documents to the builders in real time, with design and construction taking place simultaneously at all three sites and crews working up to eighteen hours a day, seven days a week.

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“So many unique factors made this project successful. 24/7 communication, transparency and problem-solving with everyone at the table, all ideas considered, and rapid decision-making allowed us to be flexible and maintain the design intent. These projects could not have been realized within their timeframes and with the results achieved without the immense team effort and collaboration.”

—Rachel Birnboim, AIA, LEED AP BD+C,
Associate Principal & Project Manager

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Because of the aggressive schedule, waiting on design elements that had long lead times was not an option. In some cases, the designers and builders had to go to local retail stores for things like doors, hardware, and lighting. As a result, the interiors couldn’t be too custom or luxurious, but details such as suspended, circular LED lighting, white marble-looking floor tiles, and patterned cultured-stone reception desks add a dash of hospitality to an otherwise straightforward clinical setting. Designers specifically placed exam rooms along the buildings’ perimeters to invite ample daylighting, which has been shown to promote tranquility and healing. Bathrooms were all designed as single-user, with finishes that intentionally de-institutionalized and eliminated the stigma associated with public-health standards and settings.

Other key strategies included clean, bright lighting; flooring layouts to define zones for circulation vs. waiting areas; signage limited to single-focus walls to maintain a calm environment; translucent screens for privacy and separation between waiting areas and clinical spaces; and colorful furniture to create dynamic moments.

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Throughout the process, all eyes remained on the singular goal of serving the needs of long-haul COVID-19 patients who would be visiting the clinics several times a week into the foreseeable future. “The interior design and the welcoming aspect to it were really important to us, to make sure that people felt that it was safe and non-threatening,” Jeff Brand, Perkins Eastman’s Healthcare Practice Leader, told Fast Company magazine. “It’s basically saying, ‘We will take care of you. You are a long hauler, you are not contagious, but this quadrant in this clinic is for you.’ Everything is there. It’s a one-stop shop.”

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“Our approach to this important project was to design for the diverse communities that have been hardest hit by the pandemic—to create approachable, supportive, efficient, and dignified settings for patients and their families, with longer durations of COVID-19 treatment and often with myriad health issues.”

—Jeff Brand, AIA, Healthcare Practice Leader and Principal-in-Charge