17 May 2020 – Architecture firm Boogertman and Partners say they are awaiting approval from government to go ahead with plans to convert Joburg’s FNB Soccer City stadium into a state-of-the-art field hospital.
“At this stage, we’ve submitted our proposal to the Department of Health through our partners, Afribiz and BlueIQ, and we are currently waiting for feedback,” the firm’s director, Jean Grobler, told the Saturday Star this week.
Grobler and his team, together with a team of professionals comprising architects, hospital-design specialists, interior and urban designers sent a proposal to government two months ago for the 2010 World Cup final venue to be utilised as a coronavirus treatment centre.
The stadium will join the Nasrec Expo Centre, situated a kilometre from the stadium, as a location earmarked to accommodate Covid-19 patients, should the health authorities not be able to manage the number of patients in existing health facilities.
With Covid-19 cases on the rise, and South Africa yet to hit its peak in cases, it has become increasingly likely that the stadium will be utilised as a field hospital.
Should they be given the go-ahead, Grobler and his team say they are ready to transform FNB’s Soccer City stadium.
“Due to the fact that the infrastructure already exists, the construction time associated with this project is very short,” said Grobler.
“The first phase can be erected within three to four weeks, and ICU facilities operational within five weeks. However, procurement of medical equipment such as ventilators, which are in high demand, could affect the operational dates.”
The final proposal submitted, comprises a patient-flow process from admission to treatment and escalation to ICU wards if needed, right through to mortuaries and provisions for the safety, protection and rest areas for medical staff.
It accommodates a minimum of 1500 beds, engineered for the best safety possible while accommodating the high volume of patients, medical specialists, support staff and vendors of up to over 4500 people daily if the facility runs at full capacity.
Provision of facilities for patients was divided into three categories of risk with the appropriate shielding and cubicles used for those at the highest need of care and incubation with beds and less intensive medical facilities provided for patients who needed to be monitored to assess their level of response to the Covid-19 infection.
Low-risk patients with a high likelihood of returning home would be accommodated in tents in the parking area, and patients with a medium risk would be escalated to a higher level of care located in tents at the concourse level of the stadium.
High risk or seriously ill patients in ICU would be accommodated in tents inside the stadium on the field or in ICU units in VIP suites.
Grobler believes FNB stadium serves as the perfect option for a field hospital.
“A modern, world-class sports stadium presents a viable opportunity for conversion to a temporary treatment centre,” said Grobler.
“This is because the flow for the various constituent bodies like staff, media personnel, VIPs, VVIPs, spectators and players is already organised in a series of separated routes which ensure exclusion of one stream of users from the other.
“In the case of Soccer City, in particular, which has been designed to a Fifa World Cup final standard, the levels of separation are very defined.
“In the conceptualising of this treatment centre, we have used these already separated flows of access to our advantage to try to maximise the quickest possible refurbishment of the stadium into a working medical facility.”
Grobler says the primary critical function of the field hospital is to ensure that those who test positive for Covid-19 are identified as soon as possible.
“Those who do not, are taken off-site immediately, or as soon as possible with little risk of being infected by the sick.
“Those who test positive are then assessed for their condition.
“These patients are allocated to the different portions of the site, depending on their level of infection and the resultant care that they will require.
“We have three different areas: Type A is low-risk patients, Type B is medium-risk patients and an ICU section, which is for high-risk patients,” said Grobler.
“It is important to ensure that infected patients and non-infected medical and other service staff can move parallel to one another without unprotected interaction.
“It is crucial to the success of this sort of facility that the medical staff have adequate spaces to rest, eat and recuperate outside the infected zone during and between shifts so that they can deliver an optimum level of care at all times.
“As such, we have assigned each of these a flow as per the typical functioning of the stadium.”
While they managed to execute a design in under 72 hours, to the deadline they were given, Grobler says there were many challenges they faced when coming up with the design of the field hospital.
“The biggest challenge was to implement a very specific workflow diagram designed for hospitals to assist patients’ wellbeing and medical staff’s work processes and protocols, to an existing complicated structure.”
The costs of such a hospital is expected to be high.
Grobler said the designers’ proposal had managed to keep the cost at “around R500000 a bed” – or R750m for 1500 beds.
He said the ratios of medical staff would be quite high, with as many as 3000 people working there.
“It’s extremely expensive because of the equipment being so expensive.
“To give you an idea, a ventilator costs about R600000.
“So, if you want to have 1000 ventilators, there’s half your budget just on ventilators at R600m.”
Grobler says that while he hopes such a facility won’t be needed, should they be called upon to build a field hospital, they would be proud to be of assistance to the country.
“We are very excited to be part of such an initiative, and we are proud that we are able to utilise our skill sets in a manner that could save lives.
“We are aware this is a measure that needs to take place if the current healthcare system cannot cope with the influx of infected patients.
“We sincerely hope that such a facility will never be needed.
“However, we will assist where we can to put measures in place, pro-actively and with haste to ensure the South African health care systems are adequately prepared for the assumed pending crisis.”
Grobler confirmed his firm had developed a design and logistics proposal for an alternate site, Loftus Versfeld in Pretoria.
“Both schemes would follow the same design thinking and implementation.”