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BMJ 2020; 368 doi: (Published 31 March 2020) Cite this as: BMJ 2020;368:m1298

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NHS Nightingale UK and Javits Center USA – COVID 19 should serve as a lesson for permanent future pandemic healthcare centres

Dear Editor

Too little too late are words being uttered by medical professionals in both the UK and US at the rising numbers of confirmed COVID-19 cases and fatalities. Healthcare architects and engineers certainly support these sentiments, given the frantic scramble for adaptive re-use of existing spaces to deliver care. Knowing weeks in advance of the global spread of this virus did little to spark momentum in both US and UK health systems to prepare early for what would lie ahead.

Now we face the consequences of timely infrastructure action. Delays in understanding how best to house patients and protect healthcare workers have prompted multi-faceted solutions for spaces and equipment to deliver effective care.

The rising numbers of confirmed cases have led to makeshift centres being erected at record speed. Centres that should have already existed.

Pandemics have long been known to be a concern for populations. The temporary centres we now visualize as salvage measures are being arranged at a time where many lives have already been lost. In an effort to support the pandemic response, architects and engineers are now working to consider build-outs of existing shell spaces, to repurpose existing buildings, to develop mobile modular critical care units that can be quickly deployed within existing arenas or installed in outdoor spaces, and to even use religious buildings to decant our hospitals to make room for infected patients.

We hope that when the next pandemic arises, example field hospitals such as the UK’s NHS Nightingale and New York City’s Javits Center have remained permanent features ready for action and not resurrected whilst we continue to observe the passing of the next pandemic sufferers. We certainly should not be waiting for the curve to spike to turn to makeshift hospitals to house our patients. Pandemic ready centres need to be considered essential for future generations.

Competing interests: No competing interests

07 April 2020
Neel Sharma
Clinician Academic in Gastroenterology
Diana Anderson (University of California San Francisco, USA)
Queen Elizabeth Hospital Birmingham, UK