COVID-19 Screening Strategies for Urban Spaces

As COVID-19 continues to reshape our communities, our priorities and our work, the outbreak has highlighted the need for new approaches to patient evaluation and testing.

To address this need, our team has been developing Patient Screening Booths that serve as an urban “walk-thru” alternative to the “drive-thru” model adopted in suburban and rural parts of the U.S. We’ve deployed a prototype at hospitals here in New York City and gained valuable feedback from frontline medical practitioners. We have also been looking to innovative approaches piloted in other parts of the world from South Korea and India to Israel and beyond.

Patient Screening Booths

Each booth is equipped with a transparent acrylic window that separates spaces for the medical practitioner and the patient. Durable elbow length gloves are sealed onto the partition, allowing evaluation and testing of patients to be conducted without direct contact. The window allows use of various equipment for evaluation (e.g. stethoscope, pulse-ox, O2 sat, etc.) as well as testing (e.g. nasal swabs). The medical practitioner's side of the booth opens to a controlled space reserved solely for medical staff, thereby reducing the need for already scarce personal protective equipment (PPE). On the patients’ side, the booth is decontaminated between examinations to mitigate exposure for the next user.

Distributed Screening Strategy

While much of the current testing is geographically linked to hospitals and clinics, we are proposing to complement this approach with a distributed network of smaller satellite sites. These booths are designed to be easily and quickly deployable to a range of sites allowing this approach to scale in relation to where it is needed most or moved to new locations as needs change. By situating these clusters across a range of urban spaces, from parks and plazas to ball fields and parking lots, distribution can be focused at the neighborhood level.

Circulation and wayfinding is being designed to facilitate queuing management: our team is currently collaborating with New York hospitals and transportation engineers at Arup to support queuing safety, clarity and efficiency for both patients and medical staff. Ultimately, we believe establishing new satellite locations for testing will help mitigate the volume of exposure at hospitals, while at the same time reducing the exposure of one patient to another as they are waiting to be evaluated or tested.

This strategy anticipates the need to significantly ramp up the quantity of and access to testing across NYC and other urban environments as a necessary step toward lifting restrictions. As has become painfully clear, COVID-19 has affected different populations of the City differently. Many of the most affected communities cannot access drive-thru testing and commuting by public transit puts them at greater risk. Strategic placement of testing sites within walking distance of dense residential areas could align testing volume with those areas in greatest need—an essential step in ensuring accessibility for all. Actively monitoring anonymized geospatial data documenting new cases and admittances along with the invaluable anecdotal feedback from medical practitioners and community organizers is information that could be used to inform placement and scale of booth deployments.

We welcome any feedback, questions and suggestions on this work—or even introductions with policymakers and medical teams working on related relief initiatives. Please contact us at relief@situ.nyc.