Vital Circulations – Biomes, Bodies and Buildings
An online Symposium
6th January 2022
A White Rose Vital Circulations Network Symposium
Universities of Leeds, York and Sheffield
This one-day symposium explores fresh perspectives on the biotic life of buildings. It will hear contributions about the changing way the built environment has been shaped by differing and competing architectural priorities and infectious disease events/discourses.
The symposium will bring together contributions from the sociology of health and medicine, medical humanities, engineering, design, architecture and microbiology.
This symposium asks:
What will it mean to rethink architectural spaces as multispecies environments, in a way that takes more account of the microbiological?
How has the built environment evolved in tandem with the evolution of pathogens?
How is it that different disciplines and stakeholders align or not around biotic priorities?
How might we rethink the significance of air, atmosphere, surfaces, materials and layouts to mutually accommodate the microbial and the human?
How might we envisage a future research agenda that learns from the present and the past to rethink the future of building design?
Architecture has been lastingly configured microbially. Modernist influences have been understood to be steeped in late C19th pre-germ theory miasmic theories of disease. Progressive building design sought to banish torpid airs, stagnant dark corners, elevating buildings away from damp ground.
The resulting emphasis on larger volume, open designs placed a premium on the free movement of sunlight and fresh air. The use of terraces, glazing, ventilation and other features had intentionally transformed healthcare buildings into therapeutic medical instruments.
The advent of antibiotics and vaccination arguably diminished the importance of building design to control infectious disease. Covid-19 (and antimicrobial resistance) however has radically reinvigorated the place of spatial design and the built environment in creating safer and liveable biotic environments.
The symposium will be organised around short contributions from a wide range of disciplines with lots of opportunity for discussion and debate. The event will take place on Zoom. After you register for the event, you will receive the zoom link before the event.
10.00 Jieun Kim (University of Leeds) ‘Vital Circulations’
10.10 Nik Brown (University of York) ‘Bodies, Biomes and Buildings’
10.30 Richard Beckett (University College London) ‘Probioticities’
11.00 Hayley MacGregor (Institute of Development Studies) ‘Clinic design, patient flow and the organisation of care: responding to Tuberculosis transmission in primary care facilities in South Africa’
11.30 Discussion & Questions
12.00 Lunch break
12.45 Nick Fox (University of Sheffield) ‘Coronavirus, capitalism and the built environment: a more-than-human analysis’
13.15 Robert Walker and Craig Fenton (DataInnovationAI) ‘Modelling biorisk in the built environment’
13.45 Daryl Martin (University of York) ‘The architecture of risk: the design of clinical space in a post-antibiotic age’
14.30 Discussants and open discussion: Ros Williams (University of Sheffield) and Sangeeta Chattoo (University of York)
15.00 Ros Williams (close and final wrap up)
Richard Beckett (University College London)
The talk will outline a body of research developed over the last 4 years towards developing a ‘probiotic’ approach to the design of buildings and urban environments. The work rejects the modernist notion that healthy environments should be defined by the absence of microbes. Instead, new ways for designing buildings are developed through the contemporary understanding of disease and the human microbiome that recognise the essential role that microbes play to healthy bodies and environments. The work develops living materials containing beneficial bacteria that can limit exposure to pathogens but also restore environmental microbes missing from buildings and cities.
Richard Beckett is an Architect and Associate Professor of Bioaugmented Design at the Bartlett, UCL. He is Director of RC7 on the BPro Architectural Design master’s programme and leads Studio 3 on the Landscape Architecture course. His research is focused on design operating at the intersection of computation, biofabrication, and microbial ecologies in buildings and cities. His research on Probiotic Design won the RIBA Presidents Medal for Research in 2020. He has built numerous projects and has been exhibited internationally including Archilab – Naturalising Architecture, The Pompidou Centre and Nature – Cooper Hewitt Smithsonian Design Museum.
Clinic design, patient flow and the organisation of care: responding to Tuberculosis transmission in primary care facilities in South Africa.
Hayley MacGregor, Karina Kielmann and Sanj Karat
In contexts with an ongoing high burden of Tuberculosis (TB), a concern with reducing airborne transmission of microbes in health facilities long predates the COVID-19 pandemic. In South Africa, infection prevention and control (IPC) as a key consideration for the design of primary care facilities gained added impetus due to shifts away from specialist inpatient units for TB, to decentralised care. Nosocomial transmission of TB is not only an occupational risk for health care workers; it is also of particular concern for those who are HIV positive, who are at risk of co-infection and have come to constitute a significant proportion of people attending regular outpatient visits. Dominant discourse as to why TB IPC is poorly implemented in health facilities has tended to blame healthcare workers for poor compliance with mask wearing or the opening of windows. Standard interventions have proposed technical changes to material infrastructures, such as extractor fans, windows and outdoor waiting areas. We discuss findings from Umoya Omuhle or ‘fresh air’, an interdisciplinary project that approached the reduction of TB transmission in primary care clinics in South Africa from a ‘whole systems’ perspective. Ventilation measurements, assessments of patient ‘flow’, a prevalence survey and infection transmission modelling were combined with interviews, clinic ethnography and systems dynamic modelling methods to identify a suite of cost-effective interventions that could provide fresh insights into addressing a seemingly intractable problem.
In this presentation we unpack the concept of ‘flow’, a composite of space, time, and the numbers and movement of people in relation to each other. These elements are influenced not only by the design of buildings, but also by social, managerial and care infrastructures as they manifest within clinics. Interviews with government architects and engineers revealed that they must balance multiple and at times competing priorities in building design. Moreover, shifts in clinic populations and in policy – such as the ‘ideal clinic’ initiative – rapidly change ‘patient pathways’ on the ground and create new bottlenecks for ‘congregation’ and transmission. Yet policy shifts can also open opportunities for synergistic action to improve IPC, such as through appointment systems instituted in response to concerns about long waiting times. We examine the opportunities and challenges posed by the intersection of microbial, infrastructural and policy dynamics and consider the implications of this learning for South African clinics in the COVID era.
Hayley MacGregor trained clinically in South Africa and is a medical anthropologist at the Institute of Development Studies at the University of Sussex.
Karina Kielmann is co-principal investigator of the Umoya Omuhle project and a medical anthropologist with training also in public health and expertise in strengthening health systems for TB and HIV care. She is a professor of health systems and policy research at the Institute of Tropical Medicine in Antwerp.
Sanj Karat is a TB epidemiologist based at the London School of Hygiene and Tropical Medicine. His research includes clinical and health systems interventions to reduce morbidity and mortality in people with HIV and/or TB and methods used to estimate mortality in resource-limited settings.
Coronavirus, capitalism and the built environment: a more-than-human analysis.
Nick J Fox, University of Huddersfield, UK
The coronavirus pandemic has highlighted how the spaces that humans inhabit have contributed to social class, ethnic and gendered inequalities in Covid prevalence. For instance, meat processing plants in Australia, UK, US and elsewhere have been sources of localised community outbreaks of Covid-19. Other risky working environments such as food packaging and ‘sweat-shop’ garment manufacturers have also been implicated as Covid hot-spots.
I shall argue that these associations between workplace built environments and social inequalities may be understood via a more-than-human analysis of the ‘pandemic assemblage’. This reveals that when coronavirus gained the capacity to infect human cells, it also gained the ability to piggy-back on the social relations of capitalism. This assessment explains both Covid’s rapid global spread *and* the class, ethnic and gendered inequalities in prevalence and death rates. For instance, a demand for cheap food and an international trade has driven down margins in meat processing, so that manufacturers depend upon low paid and precarious labour (often drawn disproportionately from BAME groups). Hygiene facilities in factories may be poor; while workers in some plants are housed in crowded and poor quality accommodation. All these ‘tiny disadvantages’ increase the chances of Covid-19 incidence and hence prevalence within such environments. By contrast, many workers in non-manual and professional jobs have safer work built environments, or have been able to avoid workplaces altogether by working from home during coronavirus restrictions.
This more-than-human approach supplies an alternative to the mainstream public health and scientific perspectives on the pandemic, with important implications for current and future policy on the built environment and microbiology.
Nick J. Fox is professor of sociology at the Universities of Huddersfield (part-time) and Sheffield (honorary), and has used new materialist and posthuman approaches to study sustainable development, climate change policy, social disadvantage and health, and materialist research methodology. He is the author (with Pam Alldred) of *Sociology and the New Materialism* (Sage, 2017).
‘Modelling biorisk in the built environment’
Robert Walker and Craig Fenton (DataInnovationAI)
The COVID-19 pandemic has revealed a class of risk that, while continuously present, has been overlooked until now. Just as structures where many people congregate potentially expose their occupants to fire risk, air quality risk, water safety risk, etc., it is now clear that any large, enclosed structure may pose a bio-safety risk to its occupants. There is currently no solution to assessing these risks, in fact we have lived with this for many years with flu alone contributing to more than 150 million lost productivity days in the over 50’s.
£130bn of commercial construction is commissioned in the UK each year and air flow in these buildings primarily focuses on the comfort of occupants, using people density as a direct measure of success. The complex interaction of pathogen modelling, facility engineering and human movement – and lack of regulation – has prohibited the development of standards. However, data driven techniques and high capacity computing are becoming commercially viable, creating opportunities for bio-safety assessment and mitigation.
Data Innovation.AI has developed a prototype, AI-driven solution to bio-safety assessment in the built environment. While we will have to live with COVID and other workplace transmissible infections buildings can now be designed to reduce the opportunities for infection to spread across its occupants.
Data Innovation.AI Ltd Bios:
Craig Fenton, Chief Operating Officer, With over 30 years of experience in the IT sector, Craig’s exceptional range of skills and experience includes software development, Telecommunications, Data Networks, infrastructure convergence, Data Centres and smart buildings.
Robert Walker, Chief Advocacy Officer, over 30 years technology and commercial experience gained in both start-up and large corporate environments. Robert has delivered leading edge technologies in Japan, the US and across mainland Europe.
The architecture of risk: the design of clinical space in a post-antibiotic age
Daryl Martin, University of York, UK
This paper opens up questions of infection control, architectural atmospherics, embodied practices and their intersections, in the contemporary accomplishment of clinical space. Specifically, we focus on the example of the recently opened Skane University Hospital Infectious Disease Center, located in Malmö and designed by CF Moller + Link Arkitektur. We do so in order to illustrate how recent strains of infectious disease are reflected in its architectural design, which uses open-air decking to enclose a central drum of patient space and an internal administrative core. We also explore how this design, in turn, shapes new experiences of illness, risk and care. This is a building in which design becomes an articulation of infection control, its architects responding to shifting understandings of what clinical space might look like when our antibiotics fail. Locating this building within a wider history of hospital architecture, we use documentary sources to trace the changing arrangements, organisational imperatives and affective atmospheres of ward design. Doing so allows us to explore how such mutable spatial organizations enacted changing ideas of disease management – from the control of space to the control of contact between people through space. Locating our contemporary case study alongside historical examples, and within geographical writings on architecture, and its affective atmospheres, allows us to develop a greater understanding of the role of materialities, mobilities and design in the social construction of risk in a post-antibiotic age.
Daryl Martin is Senior Lecturer in Sociology at the University of York, where he is also the Deputy Director of the Research Centre for the Social Sciences (ReCSS) and he co-directs the Centre for Urban Research (CURB). Daryl’s research interests are focused on the intersection of architecture, embodiment and health, and he has been working on a number of recent research projects in this area funded by a range of UK research councils.
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