Over the summer, states across the U.S. began reopening their economies and their vulnerabilities to COVID-19 transmission. As patrons flocked to restaurants, bars, and other public spaces across the country, these areas saw a spike in virus cases, forcing many states to shutter their doors once again—a sobering reminder that our return to “normal” isn’t a linear path.
There’s still an urgent need to provide solutions for more efficient testing, tracing, and treatment, especially to those communities hit hardest by the virus. In dense metropolitan communities, from New York to London, under-served, lower-income, and homeless populations are being disproportionately impacted, both economically and medically, by COVID-19 and face greater challenges in accessing testing and treatment.
In March, I began discussing the alarming testing gaps with my colleague Enlai Hooi, an industrial designer working in Perkins&Will’s Denmark studio, Schmidt Hammer Lassen Architects. Together, we recognized the need for an equitable strategy to address testing gaps that upends the conventional paradigm of healthcare delivery by bringing care to the community. We wondered, “What if there was a mobile testing solution that could reach these populations, with the scalability to be implemented across the country, and even around the world?”
To begin our team identified six key parameters that would define our suggested response to this crisis: equitability, mobility, accessibility, flexibility, ease of implementation, and scalability. Guided by these principles, the design process culminated in a mobile lab concept that uses school buses to bring the sample taking and testing process into the community.
Across the Perkins&Will studio, we had sector experts in science and technology, healthcare, urban planning, and strategic planning join the initiative to provide their valuable expertise. Once our team developed a prototype for the mobile testing lab, we approached design group Arup to consult on the project’s companion app, designed to handle appointment scheduling and dissemination of test results.
We based the preliminary layout of the mobile testing lab around the Abbott ID NOW rapid molecular point-of-care testing technology and its approved COVID-19 test, which could allow access to vulnerable populations and enable isolated groups of people to be tested for COVID-19 and receive results quickly.
Ideally, the process would involve individuals making an appointment using the mobile app, so that appointments could be spaced out to allow for social distancing guidelines to be enforced and prevent crowds from congregating at the unit. In addition, geolocation technologies could help guide the route of the mobile testing lab, determining where outbreaks might be occurring in real-time. Of course, given the testing solution’s emphasis on equitability, smartphone access wouldn’t be a requirement to be tested. Walk-in appointments would be welcome and those testing could elect to wait to receive their results in person at the mobile testing lab.
Upon arrival at the mobile lab, patients would complete a brief check-in process with a PPE-clad technician underneath an exterior canopy. Technicians would complete nose and/or throat swabs and deliver the samples into the bus through an air-locked opening in the lab, which would be controlled as a negative pressure environment. Technicians would run patient samples through the testing machine housed in a negative-pressure environment to further protect testers from potential exposure.
Once completed, results would be sent electronically to a centralized database and samples would be discarded safely. For individuals with mobile app access, results would be sent through a phone notification, while those without a smartphone could receive results via more traditional methods such as phone call or in person at the mobile testing lab.
Our team is now actively looking for a partner to pilot the project and freely sharing this mobile testing solution concept with the hope that others can join in the collective efforts of closing the COVID-19 testing gap.
Living in New York, our team has witnessed firsthand the devastating impacts of COVID-19, especially on the more vulnerable communities within our society. As human beings, we cannot ignore these inequities; as architects and designers, we must try to take some form of action to help address them using our specialties and expertise. This mobile testing solution could help reduce the risk of contamination en route to or at a larger medical facility and put to good public use many of the school buses nationwide that are currently sitting idle. Ultimately, buses can provide the mobility to go into the communities that need it most, taking a step toward making public health truly public.
Mariana Giraldo is an architect and strategic planning specialist at Perkins&Will (New York). She can be reached at firstname.lastname@example.org.