By Jake Katzenberger, Mark Chrisman, and Russ Murdock

Our healthcare system has been pushed beyond capacity by the ever-growing number of COVID-19 patients. The need for hospital beds, ventilators, PPE, and isolation rooms has vastly outstripped the available supply, and the country is looking for spaces to repurpose into healthcare service. Our team of healthcare experts, along with design experts across diverse building types and engineering disciplines, can help convert existing buildings such as hotels, convention centers, and arenas into temporary healthcare facilities. We understand not only the infection-control requirements needed to convert these spaces, but also the existing infrastructure and functional layout of them. Having knowledge of both is crucial for success when making modifications to repurpose these environments to care for the sick among us.

Many of these building types are not an obvious fit for a healthcare space. As we mentioned in our previous article on negative isolation rooms, there are specific airflow requirements in place to minimize the chances of cross-contamination to caregivers and other patients when designing infrastructure serving an infectious patient. Supporting patients suffering from COVID-19 requires even further design consideration since many patients may need ventilators. Ventilators require oxygen piped from a medical gas system and must have electrical systems provided by emergency power circuits to ensure they will continue to operate in the event of a power failure. The typical requirements for negative isolation rooms, medical gas, and emergency power are not always easy to implement in alternative building sites, but it is possible.

Below we will discuss convention centers being converted into temporary hospital spaces and address some of the challenges and opportunities that exist. In all situations, discussions with the owner-operator and design/construction team will be critical to understand the patients who will be in a convention center/arena/auditorium conversion and their needed level of care.

Convention centers and similar high-occupancy venues (enclosed arenas and auditoriums) are well-suited to convert to temporary healthcare facilities or command/control centers. Convention centers by nature are flexible, convertible spaces, and the architectural and systems infrastructure decisions made during design and construction are typically done to provide adaptability for the needs of a yet undefined clientele. There are several components of an urban convention center that might be re-purposed in various ways to suit the needs of the temporary facility.

Entry/Lobby/Pre-Function: An urban or community focused convention center is most often provided with multiple points of entry at varying corners of the same city block, or perhaps across several city blocks. The entries may be adjacent to bus drop offs, or mass transit, allowing for convenient ambulatory access. If repurposed to a temporary healthcare facility, entries could be zoned or tiered to focus on a particular patient need, relying on signage at the city corners and building exterior to direct the public or emergency personnel to various entry points. One entry point might be family access/registration, another may be emergency responder/staff/private access, and a third could be more medically focused and be configured as a screening/triage station. These spaces are typically open, provided with generous power provisions, and connected to all other portions of the center in such a way that an organized “traffic” pattern could be created from the point of entry to the next stop needed for a particular occupant.

Restrooms: Convention centers are generally designed (in the large public spaces noted herein) at nominally 7-10 square feet per person, so the accompanying infrastructure must be able to accommodate that density. Large banks of public restrooms are typically accessible from both the public side (lobbies/pre-function) and the event side (exhibit halls) of the facility. While these restrooms aren’t personal or isolated, they do offer needed capacity if isolation is not required.

Exhibit Halls: The centerpiece of most convention centers, exhibit halls can be expansive open areas with soaring ceilings, flat floors, and a flexibility that is not available in most other commercial/public spaces. Exhibit halls come in varying sizes and shapes, but as an example, might be a large, 200,000 SF open space that is sub-dividable with air walls into four smaller 50,000 SF spaces. In a conversion to a temporary healthcare facility, each of those sub-dividable spaces could be assigned a different level of acuity. Schematic layout of HVAC to infectious patient pods

Exhibit halls are typically provided with access to a loading dock, configured with ramp access for direct drive in, or perhaps accessible via oversized freight elevator. Most access is maintained, even when the halls are sub-divided. Exhibit halls are often provided with an electrical infrastructure that can adapt to whatever need may be present — a common configuration provides utility floor boxes at 30-60 feet on center across the open floor of the exhibit hall. The utility boxes are highly customizable, but often are provided with 100A of power at 208Y/120V — 3 phase. Utility boxes may be provided with water service (though it is generally classified as non-potable), drains, compressed air, and low-voltage (copper/fiber) connectivity. In addition, utility boxes may be provided with a “bail-out” system of empty conduits (perhaps 4-6″) that provide connectivity to each box and out to the loading dock.

Configured as a temporary healthcare facility, the utility boxes would be the “hub” for the electrical needs, with a capacity to serve significant numbers of patient stations, or bed line-ups depending on the configuration. Similarly, the fiber/copper connectivity in each box can be used to create local monitoring and networking capability, as could the presence of Wi-Fi and DAS systems throughout the facility. If a bail-out system is available, it could be used to pull temporary medical gas hoses or water lines from infrastructure located at the loading dock. There is the possibility that if the water connections were all extended above the flood rim of the utility box that the water could be classified as potable and used for local handwashing and sanitation. The HVAC systems are often zoned by divisible space as well, providing some measure of isolation between adjoining rooms, and the occupant density of the spaces typically introduces the need for the HVAC to accommodate significant outside air volumes. In a conversion scenario, the electrical distribution is well-suited to accommodate local exhaust or filtration units as needed to create isolation or necessary pressure relationships, even if the mechanical infrastructure itself may need to be provided.

In some cases, exhibit halls are also outfitted with catwalk systems and “mega columns” that can deliver the same flexibility of services afforded by the utility boxes, perhaps even more so as “bail-out” services could be strung along the cat-walks and dropped down to the areas of the floor where they are needed below.

Meeting Rooms/Ballrooms: The desired flow of convention centers typically pushes/pulls event attendees from the exhibit halls to smaller breakout or plenary sessions in blocks of meeting rooms or a larger ballroom/multipurpose space. Though smaller in square footage and volume than the exhibit halls, the meeting rooms and ballrooms are designed with the same flexibility and sub-divisibility in mind. Power is generously provided in a combination of floor and wall outlets. Though not typically provided with the same power capacity as the exhibit halls, meeting rooms and ballrooms still generally have permanent power provisions (and temporary power provisions via company switches) to support a multitude of functions in a temporary conversion. Meeting rooms could be dedicated to high- or low-acuity patients, used as command and control space, or perhaps even as a respite zone for staff and emergency personnel. These spaces do not generally have the same ease of access to a loading dock and are typically connected to the dock through the vertical transportation systems. These spaces are often provided with carpet or similar sound absorbing materials on the floor, so provisions might be needed to temporarily remove those materials during a conversion.

Kitchen/Commissary: Given the frequency of banquet events in convention centers, many are provided with full cooking kitchens and commissaries. The benefit being they are well-suited to provide nutrition and meals to patients, families, and staff/caregivers as needed. Most kitchens/commissaries are connected via back of house service corridors and vertical transportation to the exhibit halls and meeting rooms/ballrooms, allowing for efficient and isolated delivery lanes to all parts of the facility.

Emergency Power: Convention centers are typically provided with emergency power in the form of diesel generator systems, and most are designed in accordance with Articles 700, 701, and 702 of the National Electrical Code (NEC). However, they generally are designed to support only emergency egress from the facility, not ongoing support of operations, especially for the HVAC systems, and most often only have enough diesel fuel on-site for nominally eight hours of operation or less. The loading docks do afford the opportunity to place mobile/temporary generators at the dock and provide temporary connections to the existing normal services as a means of ensuring continued operations on-site in the event of utility power failure.

Jake Katzenberger is Healthcare Technical Leader, Mark Chrisman is Healthcare Practice Director/Vice President, and Russ Murdock is Convention Center Practice Director/Vice President for Henderson Engineers.

By Beckie Liwacz

Across the past week or two, we’ve seen major conventions cancelled, tours postponed and seasons suspended. In preparation for all of these games, concerts, conferences, and other events, the food was already onsite and being readied by executive chefs and their culinary and/or concessions teams. With news of these cancellations, what happens to all that food?

Spectra, an international venue management and food services & hospitality company, has been working with its convention centers across North America to identify opportunities for food recovery, donating into the local community or among part-time staff. In many instances, Spectra is collaborating with Food Recovery Network, a national nonprofit that fights food waste, to locate the most appropriate place for the food donation.
A handful of examples include (we have many more):

Mayo Civic Center (Rochester, Minn.)—The multi-purpose convention center and event facility donated 300+ pounds to a local food bank and another 200+ pounds to venue staff.

Utah Valley Convention Center (Provo, Utah)—Delivered all the center’s perishables to the Provo-based Food and Care Coalition.

Owensboro Convention Center (K.Y.)—Donated all produce and dairy products to local Daniel Pitino and St. Benedict shelters.

Atlantic City Convention Center/Boardwalk Hall (N.J)—Donated all perishables to the Salvation Army, AC Rescue Mission, and the Boys & Girls Club of America.

Ocean Center (Dayton Beach, Fla.)—Scheduled pick-ups for local community organizations.

Columbus Convention & Trade Center (Columbus, Ga.)—Donated produce to SafeHouse Ministries, an organization that serves homeless, addicted, and/or incarcerated men and women as they transition back into the Columbus community.

Beckie Liwacz is a Communications Publicist with Spectra.

By Kristina Lankow

In response to the COVID-19 pandemic, the Swiftel Center full-time team recognized the on-site kitchen as an asset to support local community programs. The team connected with the Inter-Lakes Community Action Partnership (ICAP) and Brookings (SD) Area United Way. Through this collaboration, the Swiftel Center catering is preparing more than 400 frozen meals that will be distributed by ICAP throughout the Brookings community. This is the first week of the collaboration, with all parties recognizing that the need for additional frozen meals may grow as the community continues to navigate the changing conditions due to COVID-19.

Following the direction from the City of Brookings, the Swiftel Center facility is currently closed to the public. However, even while the doors are closed, the full-time team is continuing to carry out the mission of the facility “…to enhance the quality of life for the citizens of the region…” The full-time team is continuing to work and find ways, like this catering collaboration, to serve Brookings.

Frozen meal packs are available to any 60’s Plus Dining clients. Quality, balanced, nutritious meals are flash frozen in specialty sealed containers. These frozen meals can be heated in a microwave or oven, and provide one third of daily recommended nutrition amounts. For each seven-day meal pack, clients can select seven frozen meals from the ten available options. In addition, each seven-day meal pack includes a small loaf of bread, fruit juice and a half gallon of milk. Packs are offered for a free will donation; the suggested amount for each seven-day meal pack is $27.

Adults who would like to place a seven-day meal pack order can contact the 60’s Plus Dining program manager Julie Scubelek at 605-692-1407 and jscubelek@interlakescap.com. Families who would like to place an order for a loved one are also encouraged to contact the program manager. There are also volunteer opportunities available including meal delivery volunteering. Contact the program manager for more information.

Kristina Lankow is Sales & Marketing Manager for Swiftel Center, managed by VenuWorks.

By R.V. Baugus

The City of San Diego shared in a press release that the San Diego Convention Center will be utilized as a haven to protect homeless individuals during the ongoing Coronavirus pandemic. The plan will create more space to serve people experiencing homelessness and allow for adequate physical distancing within current shelter facilities.

“San Diegans from all walks of life right now are struggling as we cope with the impacts of COVID-19. We’re only going to get through this pandemic by taking care of one another and working together,” Mayor Kevin Faulconer said in the release. “San Diegans are wondering how they’ll pay rent and small businesses are trying to stay afloat while some of our most vulnerable living on the streets seek protection from this virus. We’re turning plans into action to get all San Diegans the relief they need.”

Already, 55 families moved from the City’s Bridge Shelter on the upper level of Golden Hall operated by Father Joe’s Villages to two motels using some of the 200 rooms that were secured by the County for the Regional Task Force on the Homeless for homeless individuals. Additional updates will be provided as they’re made available.

“We have an unprecedented multi-agency collaboration that is working very quickly to rebuild our system to prevent the spread of COVID-19 among our homeless population while at the same time continuing to provide top-notch service to residents,” Kohler said. “We are thinking creatively to stand up new shelters, expand our capacity and maximize our staffing resources to serve the needs of both our sheltered and unsheltered populations.”

Other IAVM convention center members are also stepping up to help their communities.

McCormick Place in Chicago will transition into a makeshift hospital to treat about 3,000 patients by April 24, with 500 beds to be available in the coming week, according to the head of the Army Corps of Engineers, Lt. Gen. Todd Semonite.

The venues Hall C, with assistance from FEMA, will treat 500 people, while Hall B will handle 750 patients, and Hall A would host some 1,800 individuals needing greater care.

“Somebody once said, ‘Let’s go build a hospital in the middle of a parking lot.’ You can’t do that in two or three weeks, and we don’t have any more time than two or three weeks,” Semonite said in a release.

“The city is working in partnership with the state of Illinois, the Army Corps of Engineers, FEMA and MPEA to develop capacity for a large quantity of hospital beds to serve residents in need of care as COVID-19-related hospitalizations are expected to surge in the coming weeks,” a Chicago Department of Public Health spokesman added in a statement. “The temporary health site at McCormick Place will function as a field hospital, providing a large quantity of beds, including 500 anticipated to come online in the coming week. We remain focused on working in partnership to build up resources and staffing for this site and across the system so that we can combat COVID-19, alleviate added stress to our hospitals and health care workers and ensure patients across Chicago receive the care they need.”

Meanwhile, the Kay Bailey Hutchison Convention Center in downtown Dallas will be the site of Texas’ first pop-up hospital to treat coronavirus patients, Gov. Greg Abbott announced Sunday. With Dallas County representing the most virus cases in the state, the venue will set up 250 beds at the outset with the ability to increase. As of Sunday, the county reported 488 cases of the virus.

“Existing hospitals will continue to be the primary location to treat and care for those in need,” Abbott said at a news conference. “But we must prepare for the worst-case challenges as they arise.”

While that number of beds are not required yet, both the governor and an Army general said that the operation could house up to 1,400 beds if needed and that the Corps of Engineers has placed large-scale medical kits and equipment at the convention center ready for use.

The expectation is for the beds to be set up by Tuesday, while a homeless shelter is already in use at the venue.

By R.V. Baugus

Venue managers will tell you that they find their most sleepless nights happen when they worry about keeping their guests safe. When word came down from the National Basketball Association the night of Wednesday, March 11, that the season was being suspended due to the coronavirus outbreak, General Manager Dave Brown of the American Airlines Center in Dallas said he experienced one particular emotion: relief.

The Mavericks were playing the Denver Nuggets in what will be a historical footnote as the last game the league played before the season took a hiatus. Brown was at the arena for the game and had an opportunity to soak in a crowd mood that started in full throttle for a game between two teams that could have met in the playoffs to one that later became aware through news feeds on telephones what was about to happen, that the game was about to take a very real back seat to a virus that would soon consume the country.

“We couldn’t protect our guests anymore,” Brown said, noting that for the previous two to three weeks the venue had heeded best sanitation practices from the Center for Disease Control. “This had to happen for us to protect our guests. We were doing the things we were told to do and doing it to the best of our abilities but we know now that was not going to make that big a difference.

“I felt a tremendous amount of relief in terms of we don’t have to play that game anymore. We were resigned to the fact that our industry and our world was going to change. We don’t know how that’s going to play out but I feel a lot better sitting here in my office with nobody in the building than I did a week ago with 18,000 people in there that were in harm’s way because of this.”

While outside a full line of cars prepare to enter a drive-through screening process for the coronavirus, Brown shifts gears to talk about the good that can come out of this national pandemic.

“I think it’s a massive reset for our society,” he said. “I like to use the term, we’ve been so drama-driven the last few years and trying to find a little drama in every situation, good, bad, exploited one way or another. Well, we’ve got it now, and maybe folks will want a little less drama on a daily basis going forward.”

It is impossible to gauge the economic impact that the shutdown has on events at American Airlines Center, just as it is for any other venue in the country. It all depends, of course, on how long venues remain dark.

“It is devastating from the revenue side, but we didn’t cause this,” Brown said. “It’s not like we or our teams screwed up something. I think this gives us a tremendous opportunity to come out of this smarter and stronger and to be better prepared for anything like this in the future. It is such a shock to the system but I think it’s a good reset, as I said, to appreciate what we have and the good times a little bit more. When that first guest walks back in the door – whenever that is – that’s going to be the most important guest that we’ve ever hosted here.”

Had the basketball and hockey seasons played on, Brown’s team was tasked three days later on a Saturday to host a Mavs game at 1 pm and a Dallas Stars game that evening. Even with the NBA announcing the suspension, there was still thought that the league might play games with no fans in attendance. At the time, hockey was still operating as normal with fans. Dealing with both of those scenarios for that particular Saturday weighed on Brown’s mind.

“How do I do that?” Brown asked. “How do I do a closed arena at 1 o’clock and then tell all the employees and people who have to make this building ready when you have guests, OK, come in and let’s get this other show on the road. I couldn’t possibly have been able to do that. Thank goodness the NHL suspended or we would have had a real dilemma here.”

Brown is proud that the arena can help by offering the drive-through testing. He noted that American Airlines Center was not able to participate with relief during Hurricane Katrina in 2005 because “we were up and running, so Reunion Arena became a refuge and the convention center to some degree for a period of time. We couldn’t give back or do anything but this is there for us to help and make a difference to others.”

They are doing that in a way that forces Brown to hark back to his younger days in the industry.

“For logistics I’ve got to go back to my old event coordinator days,” he said. “We are coordinating with the City of Dallas and Dallas County, Parkland Hospital and the Federal government. It’s a big deal and I’ve been working on this since Mayor (Eric) Johnson reached out and asked if we would participate. We were happy we could do something during the crisis and continue to make a difference.”