As current and projected demand for added hospital beds to care for COVID-19 patients reaches dire levels in parts of the U.S., contractors are helping health care systems and governments explore a variety of ways to address the shortages.

As large field hospitals pop up in major metro areas, contractors are working with clients to fast-track existing projects, fit out shell spaces, reopen shuttered facilities, deploy modular structures and convert nonmedical facilities into usable health care space. As Gilbane Building Co. tracks 50 potential health care projects, it is in a “rapid response mind-set,” says Karen Medeiros, senior vice president and chief marketing officer. “We’re working in disaster-recovery mode.”

对额外床的潜在需求是令人生畏的。华盛顿大学卫生指标与评估研究所建议于3月下旬建议，全国54,000家医院床上有短缺，以满足未来几周和月份的预计患者数量。该研究所说，甚至更可怕，医疗保健设施可能是近14,000家重型监护室床。

The U.S. Army Corps of Engineers is leading most of the first wave of response, deploying field hospitals in areas such as New York City, Seattle, New Orleans, Detroit, Chicago, Dallas and Los Angeles (see p. 19). By the end of March, 1,000 beds were made available at the Jacob K. Javits Convention Center in New York to relieve hospitals fighting coronavirus. It is just one of several Corps projects in the area.

在长岛，特纳建设开展了一个三周的1,000床军团医院项目，位于石石溪大学。除了一名特纳高级副总裁史蒂夫堡外，该公司还与全国范围内的154名当前和前客户联系，讨论了特纳可以提供帮助的一系列方式，包括可行性研究，以扩大床容量或增加数量隔离房间或将壳体应急空间转换为Covid-19溢出和响应空间。“我们正在看看可以做些什么，”他说。

Fort sees several clients seeking to bring shuttered health care facilities back on line. Turner was awarded a contract by the Corps’ Chicago District to reopen the Sherman Hospital site in Elgin, Ill., which opened in 1898 and closed in 2009. At press time, the number of beds that will be added was being evaluated.

In Boston, Gilbane is working to temporarily reopen the decommissioned Newton Pavilion at Boston Medical Center. It would have as many as 250 beds for a range of needs, including a focus on supporting the city’s homeless people.

在大多数情况下，野外医院和其他临时解决方案专注于提供核心呼叫“替代护理设施”的临时解决方案，该公司旨在减少既定医院和医疗设施的负担。DPR建设中的国家医疗保健核心市场领导者Sean Ashcroft表示，大多数系统都需要将低敏锐和非Covid-19感染患者移动到这些设施中，以减轻现有医院的负荷。“卫生保健系统正在努力看看这一点，因为他们担心分开他们已经有限的员工和设备，”阿什克罗夫特说。

Hospitals are also looking at cafeterias, conference rooms and boardrooms as spaces for beds. “Maybe those areas are where the low-acuity patients go,” Ashcroft says. Several owners and contractors are considering using hotels, dormitories and other nonmedical facilities to house patients. Plaza Construction and Central Consulting & Contracting joined forces in March to offer fast-track services to health care providers in the Northeast, the mid-Atlantic region and Florida. Brad Meltzer, Plaza Construction’s president, says the team’s initial push has been to help fit out existing health care spaces, but it is also studying converting nontraditional spaces into temporary health facilities.

To help meet demand for more high-acuity spaces, contractors such as L.F. Driscoll and Balfour Beatty are accelerating projects. Together, the two firms are expediting portions of Penn Medicine’s $1.5-billion Pavilion project in Philadelphia to deliver 119 rooms for COVID-19 patients by mid-April—15 months early. In late March, Turner accelerated delivery of an emergency department at Johnson Memorial Health in Franklin, Ind., putting 22 beds online for COVID-19 patients. That is one portion of a $47-million ongoing expansion project.

Contractors are also being asked to expedite fit-outs of existing shell spaces. In Baltimore, Mercy Medical Center is fast-tracking 32 acute-care beds, fitting out a floor of shell space at the Mary Catherine Bunting Center. The project was approved the day after Maryland Gov. Larry Hogan (R) called for an increase in hospital beds in the state. Whiting-Turner, the contractor, is also providing short-term financing for the $12.5-million, 75-day project, allowing work to move forward immediately.

Modular solutions could speed delivery of acute and non-acute-care spaces. Plaza Construction and Central Consulting & Contracting are working with FullStack Modular to create complete modular rooms inside shipping containers. Roger Krulak, CEO of FullStack Modular, says some clients are considering camps of modules in surface parking lots adjacent to hospitals. “Once we mobilize in a couple of weeks, we could get 200 to 300 units out per week,” he says.

For now, the team says the fastest solution is for contractors to provide non-acute beds and other facilities, which require less infrastructure. Krulak says modular ICUs can be produced, but would take longer. “For a second wave of facilities, we could provide an ICU solution, but it’s not something we can provide three weeks from now,” he adds.

DPR’s Ashcroft says another option is splitting up trailers for transport and combining them to make larger spaces. Overall, he says, there is no one-size-fits-all approach, so DPR is presenting a wide range of solutions to owners. He says, “There is a ton of information sharing and a lot of great ideas from some great minds.”