How did China build a hospital in eight days?

What can the UK construction sector learn from China’s reaction to the killer Coronavirus

The new hospital in Wuhan was built in less than two weeks. Image by Jason Goh from Pixabay

The planning and construction of hospitals in the UK is not a speedy process.

It can often take more than a decade from the initial business case being put forward to doors opening – a timescale that means once well-thought-out facilities no longer meet the needs of patients and staff by the time they are completed.

But in the last few weeks, China built a hospital to deal with those affected by the killer Coronavirus in just eight days.

A team of more than 7,000 workers built Huoshenshan Hospital – a name that means ‘Fire God Mountain’ – on an empty site in Wuhan, where the disease was first identified.

A mean feat

With an estimated 1,000 beds, the hospital utilises prefabricated units and is based on the design of Xiaotangshan Hospital, which was built in Beijing in 2003 to help contain the Sars virus.

That hospital took 4,000 people just seven days to build.

But what can the UK learn from this feat?

They say that necessity is the mother of invention, and the extraordinary feat of constructing a hospital within two weeks in response to a healthcare emergency demonstrates just how true that is

According to Yanzhong Huang, a senior fellow for global health at the Council on Foreign Relations, China’s reputation for building huge structures fast helped in this unforeseen situation.

He told the BBC: “This authoritarian country relies on this top-down mobilisation approach.

“They can overcome bureaucratic nature and financial constraints and are able to mobilise all of the resources.

“They have records of building skyscrapers at speed and, while this may be very hard for westerners to imagine, it can be done.”

But UK experts say the project is unlikely to have any major impact on the way hospitals are currently built in this country.

Simon Kydd, head of healthcare at WSP, said: “I think it is easy for the media to say ‘look isn’t this amazing; we must take learning from this’. But it is not a usual situation.

“What they are building isn’t strictly a hospital. It’s a field hospital like the Army builds in war zones and it’s unlikely that it would meet UK HBN standards or be efficient in terms of pathways. And it’s not biophilic or therapeutic design.

There’s much more than a knee-jerk response to an urgent need involved in creating a hospital of this size and scope in such a short period of time; so we must assume that there was a significant level of readiness to implement an existing plan, should the need ever arise

“It’s there to serve a purpose in an emergency situation.”

He adds: “Potentially there are probably things we can learn from it in terms of reacting to certain emergency situations, like in the case of an epidemic or terrorist situation, or for large sporting events. But, in terms of taking any learning into how we design hospitals in the UK, it’s limited, if any.”

A modular approach

And the modular approach China used, while increasingly popular in the UK healthcare construction sector, is also failing to gain enough traction to overtake conventional techniques for the delivery of large hospital facilities, he said.

“Modular options have been fairly limited in take up,” he told BBH.

“We have had lots of experience doing ward blocks and extensions, but the NHS doesn’t tend to turn to modular facilities for things like maternity wards or A&E, which are still largely traditional buildings.

Potentially there are probably things we can learn from it in terms of reacting to certain emergency situations, like in the case of an epidemic or terrorist situation, or for large sporting events. But, in terms of taking any learning into how we design hospitals in the UK, it’s limited, if any

“It’s good for very-specific applications, but individual NHS trusts still want to do things their own way and are often constrained by existing building stock, so I don’t see this project changing things to any great degree.”

Burkhard Musselmann, managing principal and healthcare architect at the UK office of architectural practice, Stantec, agrees. He told BBH: “They say that necessity is the mother of invention, and the extraordinary feat of constructing a hospital within two weeks in response to a healthcare emergency demonstrates just how true that is.

“However, there’s much more than a knee-jerk response to an urgent need involved in creating a hospital of this size and scope in such a short period of time; so we must assume that there was a significant level of readiness to implement an existing plan, should the need ever arise.

Burkhard Musselmann

Site selection

“First of all, on a project this size, ground conditions for the site must have been pre-established because land surveys alone can take weeks to carry out and process.

“Site selection has also been critical to achieving the two-week build programme as it must be assumed that the site used was selected to allow for a minimal cut and fill requirements, and the topography and ground conditions would have enabled a fast installation and rapid curing foundation solution.”

And, basing the design on that of the 2003 Sars hospital also helped to speed up the development of the new facility.

“Clearly, it has been designed specifically for a large-scale, emergency response hospital, because it has not required construction of any support structure and has been designed to allow modules to be stacked on top of each other like a giant Lego project,” said Musselmann.

It’s good for very-specific applications, but individual NHS trusts still want to do things their own way and are often constrained by existing building stock, so I don’t see this project changing things to any great degree

“The off-site modular construction elements have probably been built and commissioned in advance, then stored ready for deployment an emergency.

Resilience planning

“The resilience planning involved in this is, in itself, impressive. However, given the size of the facility, the planning involved in producing and storing so many modules in advance is even more extraordinary.

“I would estimate that all of the design, and 90% of the construction were done in advance, but this should not detract from the achievement of creating a functioning hospital in two weeks.

“If anything it’s a testament to what can be achieved when designing and preparing for a very-specific scenario and demonstrates that lessons have been learned from the SARS epidemic.”

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