Carlo Ratti

Carlo Ratti calls for redesign of "dinosaur" hospitals and universities for the post-coronavirus era

Hospitals and universities are "dinosaurs" that need to be redesigned in the wake of coronavirus, according to architect Carlo Ratti.

"I think we got two kinds of dinosaurs in society today," Ratti told Dezeen in a live interview last week as part of Virtual Design Festival.

Hospitals are "this kind of centralised machine where you get out sicker than when you go in," he said. "Redesigning the interface with the medical system is going to be very, very important."

"We need to reinvent the university system"

"And the other dinosaurs are universities," said Ratti, who directs the Senseable City Lab at Massachusetts Institute of Technology and is founder of architecture studio Carlo Ratti Associati.

"I'm telling you this as someone who's been involved with universities all my life, but I think we need to reinvent the university system."

Shipping-container intensive care unit installed at Turin hospital
Carlo Ratti Associati's Cura project features intensive care units in shipping containers

Ratti made the comments after giving a short presentation of recent projects including Cura, a pop-up intensive care unit made of shipping containers. First unveiled in March, a prototype was installed at a hospital in Turin, Italy, last month.

Ratti claimed that Cura was a better solution than turning convention centres and other large buildings into temporary hospitals for coronavirus patients.

Ratti's intensive care unit controls air flow

Patients with infectious respiratory diseases such as coronavirus can be treated in negative-pressure environments, which prevent virus particles from escaping. However, this is hard to achieve in large, open-plan interiors.

"The way the people have been doing [temporary] intensive care units [for coronavirus patients] is mostly to take a big convention center and turn it into a makeshift hospital," Ratti said.

"However, one of the issues is that you get a lot of contamination of the air," he added. "You cannot do biocontainment. That's why we saw so many healthcare professionals who got sick. To do negative pressure you need a box."

A two-bed intensive care unit within a shipping container, designed by Italian architects Carlo Ratti and Italo Rota, has been built at a hospital in Turin and is being used to treat patients fighting the coronavirus. Named Connected Units for Respiratory Ailments – or CURA, which is the latin word for cure – the intensive care pod was installed to increase intensive care unit (ICU) capacity in northern Italy. Designed by Ratti and Rota to treat two patients requiring intensive care, the unit has been installed at a temporary hospital built within the Officine Grandi Riparazioni complex in central Turin. The first patient was admitted earlier this week on 19 April.   Connected Units for Respiratory Ailments (CURA) intensive care  shipping-container pod by Carlo Ratti and Italo Rota   Built within a 6.1-metre-long shipping container, the intensive care pod contains two beds along with ventilators, monitors, intravenous fluid stands and syringe drivers. According to Ratti the pods combine the benefits of tents with permanent isolation wards as it has a ventilation system that generates negative pressure – a common technique used in hospitals to prevent contaminated air from escaping. The designers say the unit has been designed to comply with Airborne Infection Isolation Rooms (AIIRs) standards. "CURA strives to be as fast to be mounted as a hospital tent, but as safe as a regular isolation ward to work in, thanks to the comprehensive biocontainment equipment," said the designers.   The pod  It is extractor creates indoor negative pressure to comply with the standards of Airborne Infection Isolation Rooms. Two glass windows carved on the opposite sides of the containers are meant for doctors to always get a sense of the status of patients both inside and outside the pods. Also, this would potentially allow external visitors to get closer to their relatives in a safer and more humane setting.   "CURA aims to improve the efficiency of the existing design solutions of field hospitals, producing a compact ICU pod that is quick-to-deploy and safe to work in for medical professionals." The pod in Turin is the first CURA pod to be built, but further units are already under construction in other parts of the world including the UAE and Canada. CURA has been developed as an open-source project, with its tech specs, drawings and design materials made accessible for everyone online on https://curapods.org/open-source-files.   The pods are designed to work as single units, as the one in Turin is set up, or combined to create larger field hospitals.   Photography is by Max Tomasinelli. Project credits: Design and innovation: CRA-Carlo Ratti Associati with Italo Rota Medical engineering: Humanitas Research Hospital Medical consultancy: Policlinico di Milano Master planning, design, construction and logistics support services: Jacobs Research: MIT Senseable City Lab Visual identity & graphic design: Studio FM milano Digital media: Squint/Opera Safety and certifications: IEC Engineering Logistics: Alex Neame of Team Rubicon UK MEP engineering: Ivan Pavanello of Projema Medical consultancy: Maurizio Lanfranco of Ospedale Cottolengo Medical equipment supply: Philips Painting products: Gruppo Boero Support: World Economic Forum Covid-19 Action Platform, and Cities, Infrastructure and Urban Services Platform
Shipping containers allow negative-pressure environments to be created around coronavirus patients, Ratti said

Ratti's Cura solution uses shipping containers to create individual intensive care units that can easily be sealed to create the negative pressure needed for biocontainment. The containers can then rapidly be moved to different locations according to need.

"Containers are all over the world, we can move them very quickly," said Ratti. "So we can fit them with negative pressure. They can be pre-assembled with all the medical things so we can move them from one city to another city."

Containers "ideally suited for this"

Ratti defended his decision to use containers, which have been getting a bad press recently due to their widespread use in architecture projects despite being ill-suited to many applications.

Containers are "almost like ideally suited for this," he said. "If you'd asked me last year if I would ever do a container project, I would say no. But in this case, it makes sense."

"People think this is another student project, you know, an architecture second-year architecture student project," he added. "But you know, even the most trite solution can sometimes also be the right one."

Last month Dr Sam Smith told Dezeen that hospitals "desperately need designers" to improve equipment and services. "We need designers at every turn, but they are so infrequently consulted," said Smith, a clinical physician at Massachusetts General Hospital in Boston.

"In the end, most physicians burn out early because, in part, we are lacking well designed cognitive and physical spaces to help process the information smoothly."

Universities are "too expensive"

Universities similarly need to be radically rethought, Ratti said. With campuses shut down due to the pandemic, teaching has moved online.

"This has forced a lot of people to fully embrace digital and it can even be better for giving feedback to students," the Italian architect said, adding that the traditional university campus could be replaced by smaller physical hubs for students and teachers to meet in person, with most lessons conducted digitally.

"The reason I'm saying that it's a dinosaur is that it's too expensive, especially in the United States," he said. "We cannot continue this way. We can find a better way to get maybe not a hundred per cent by 95 per cent of what an amazing Ivy League education is today, but for 10 per cent of the cost."

Universities have changed little since the first one was founded in Bologna in 1088, Ratti said. "I think there's something magic about campuses," Ratti added, saying they would never completely be replaced by digital solutions due to the importance of chance encounters that can only happen in the physical world.

"Serendipity will still need us to create these kinds of places where we can come up with new ideas that we're not looking for," he said. "But maybe not all the students and all the professors need to be in Cambridge [where MIT is based] all the same time."

"Maybe we'll be able to share knowledge in a different way."