Rehabilitation and Humanization of Basic Health Units

The pandemic caused by COVID-19 highlighted the importance for health systems and, above all, for the well-being of the population - the prioritization of health will happen at all levels. In view of the demand for care solutions for the Coronavirus, the countless initiatives in the architectural field show emergency medical shelters around the world, fast lift hospitals made of recycled transport containers and inflatable fabrics, low-cost mobile facilities, hospital ships and spaces for personal protection for doctors (VHL.Architecture cooperated with Da Nang Architecture University to design a model of Mobile Hospital; Weston Williamson proposes hospital ships ;. the Field Rescue Center (FRC) was created as a concept of a mobile TEU containers FRC; CNC- Medical Emergency Module KOTKO. The proposal to build field hospitals (costly and unnecessary if using idle private beds), as well as the idea of ​​revitalizing public beds (could have started long ago). Among the alternatives of adaptive reuse (stadiums, parking lots, convention centers) and emergency shelters, we believe that the revitalization of public health buildings presents significant opportunities to reduce operating costs through the improvement of the project, better management of the facility , the adoption of technologically more efficient equipment and changes in users' habits. The implementation of new projects and / or sustainable rehabilitation of buildings and the urban environment is an odd opportunity that arises at this difficult time. Resilience related to climate change is something we have been focusing on more recently, and we have also been focusing on issues of social inequality. Certainly, COVID-19 has drawn additional attention to this, in terms of low-income populations being affected more dramatically by the virus than higher-income populations. Work at home is here to stay, after Coronavirus more digital connections will be created, so buildings should have safe spaces, (less dense layouts, more fresh air, better air filtration systems, more sunlight and more interaction with the outdoors), as well as city spaces, to welcome citizens back because people are attracted to everything that cities offer. People will need to be able to feel that the spaces are clean, and they will need to be able to see workers cleaning buildings, mitigating contagion across surfaces, and control for airborne infection, preventing, diluting and removing contaminated air so that users are more comfortable inside. In this context, a more systemic analysis approach is advocated, which addresses the building and the city in all its complexities. The energy approach should not prioritize the technical analysis of the equipment, just as the analysis of the degree of sustainability cannot give up the technological strategies that aim at energy efficiency. Therefore, an integrated analysis of environmental problems is advocated. The prevention of highly contagious diseases involves improving the environmental quality of all environments, especially healthcare spaces. In this sense, an in-depth analysis of Hospital architecture is supported by several scientific and technological discoveries throughout history, such as, for example, the overthrow of Miasma Theory by nurse Florence Nightingale, the practical application of Pasteur's Germ Theory, the development in the areas of diagnostics and surgery, the change in plant typology and the concept of hospital humanization. Hospital Architecture has undergone considerable evolution, making that recovery environment more humanized and concerned with the patient (CARVALHO, 2014; BICALHO, 2010, MIQUELIN, 1992). The Integrated Environmental Assessment (AAI) (Romero et al, 2016) comprises a bioclimatic view of the built environment that is fundamental for a more sustainable conformation of places. AAI is of fundamental importance for the reduction of the environmental impacts that the building promotes since its design phase, passing through its implantation, maintenance, and that accompanies it throughout its life cycle. Under this guidance, the terms of cooperation were made by the LaSUS research team from FAU-UnB, .48 / 2010, 140/2011, 146/2012, 408/2013, 15/2014 and 00038.1740001 / 14-004 that had as their object research: Elaboration of Reference Models for Future Buildings of the Humanized Health Network, training of technicians and the elaboration of a study and research project aimed at adapting the physical structure of the set of buildings that make up the HEMORREDE NACIONAL that allowed us to work this optics in seven different states (CE, PA, AM, RJ, SP, RS and DF) with the elaboration of a reform plan with the Rio de Janeiro building as a model for the 2014 Olympics (link). According to specifications of RDC - ANVISA No. 50 of February 21, 2002, in its chapter for Environmental Conditions and Infection Control, the finishes of walls, floors, ceilings and benches, must, for critical and semi-critical areas, be resistant to washing and the use of disinfectants, according to the Ministry of Health's Manual of Procedures for Articles and Surfaces in Health Establishments. A health unit, which requires its users to remain for a prolonged period, requires special care: prioritize the humanized treatment. To make the space solutions for a permanence unit, a minimum understanding of the conditions under which it takes place is necessary, of their functional and clinical motivations. With the pandemic, many concepts widely adopted by the pleasant environment line have to be revised, especially those dealing with the use of natural materials and cladding, such as beam handrails, bronze locks and sisal fiber rugs. In addition to immunization, environmental comfort can be improved by seeking to reduce stressful factors such as noise, inadequate lighting and ventilation, excessive use of colors, etc. In view of the studies already carried out to date, the sustainable environmental rehabilitation of health buildings represents proposals for improving the conditions of service provision, increasing the quality of work for employees, optimizing the processes developed, the environmental comfort of users and occupants of the building and the reduction of environmental impacts through the efficiency of the component systems of the built space. Currently, there are mechanisms that help to create environments that make use of natural ventilation as a method to obtain comfort and air quality, as in computer simulation software (Computacional Fluid Dynamics - CFD, for example) that simulate the effects of winds in certain objects and internal environments, but there are also CFD software for checking internal quality in hospital environments that use the passive ventilation strategy (AGUIAR, 2017)