The more than seventy days of confinement have made me reflect on the relationship between health and architecture. More than seventy days in which our houses have become aseptic fortresses where we spend the 24 hours of the day, and where we try to combine the different activities of all family members in a small space. Balconies and windows were our links to a city accustomed to social contact, from which, suddenly, we were deprived of. Deserted and silent for a few months, but also freed from traffic jams, noise or contamination. The empty city and the homes from which we contemplate it, without being able to live it, become a new opportunity to rethink our spaces; not only those that we inhabit, but the urban space itself.

How can a pandemic influence the urban design of a city? In the 19th century, the time of the Industrial Revolution, the city was considered an incubator for diseases due to its high density, poor housing conditions, and poorly developed sanitation and garbage collection systems. Georges-Eugène Haussmann cited reasons of beautification and sanitation to tear down the walls of Paris in 1853. The narrow, zigzagging streets of the old medieval city did not let in enough light or air, so he drew boulevards ruthlessly through previously overpopulated areas, widened streets and sidewalks, modernized sewers, built large green areas and laid the minimum foundations for homes with a better level of habitability. Around the same time, London suffered a cholera outbreak from water pollution that wiped out much of the population, prompting its government to build a modern sewerage network and to channel the Thames in order to improve water flow. The same happened in Buenos Aires in 1871, the year in which the works for sanitation and running water networks began throughout the city, after several outbreaks of yellow fever. This disease caused the displacement of industries such as meat salting and cured meat factories to the periphery.

The impact of these 19th century urban epidemics shows the conditions to which societies were exposed and at the same time helps us understand how modern states have evolved in the construction of a new social order.

Architecture and health

In the 20th century, tuberculosis would influence modern architecture, in particular, the therapeutic environment of nursing homes. Theorist Beatriz Colomina maintains that “what united many figures of the modern movement was a demonization of an earlier, ‘unhealthy’ architecture, and what separated them was their varied proposals for architecture to perform as a medical instrument.”

Improving the sanitary conditions of buildings was one of the concerns of the architects of that time, as can be seen in many projects. Le Corbusier promoted the use of pilotis to isolate the built floor from the humidity of the ground and of rooftops to have a space to sunbathe and exercise. Frederick Kiesler designed egg-shaped structures to try to alleviate anxiety in people. Others like Jan Duiker or Richard Neutra proposed an architecture with generous openings, wide terraces and many open spaces, convinced of the benefits of sun and air for a healthy body. The Lovell Health House (1927-29), built for naturopathic doctor Philipp Lovell, had porches for sleeping, open spaces for sunbathing in the nude, an outdoor gym, windows that let in UV rays, and a kitchen designed for a strict vegetarian diet. Neutra used the techniques of psychoanalysis in the conceptualization of his designs, to better understand the needs of his clients. On the other hand, the Open-Air School for the Healthy Child (1928) that Duiker built in Amsterdam, was one of the first functionalist buildings of the time, with a design directly related to the promotion of hygiene and health. Like Le Corbusier’s buildings, Duiker’s school included rooftops to promote outdoor activities in addition to a gymnasium, and windows provided maximum openness, flexibility, and transparency.

But it is another work by Duiker, the Zonnestraal Sanatorium (1925-27), that influenced Alvar and Aino Aalto in the design of another hospital center in southwestern Finland. At the Paimio Sanatorium (1929-33), the Aaltos made a more humanistic interpretation of functionalism that soon became a model for modern architecture, a more minimalist architecture and with the “visual hygiene” of its white painted concrete walls, mass-produced components such as metal windows and smooth doors, accompanied by anthropomorphic furniture such as recliners, carefully designed at an angle of 110º to aid breathing and with a built-in footrest to separate the legs from the coldness of the floor. The balconies, terraces and roofs were essential for the recovery of the patients, because these facilitated their integration with the natural environment. These “salutogenic” design features, capable of creating an environment of well-being, were the model for new homes in the European suburbs, features that Florence Nightingale had already detailed in her 1860 work Notes on Nursing.

In recent times, the ability of architecture to prevent diseases such as malaria has been investigated. Jakob Brandtberg Knudsen from Ingvartsen Arkitekter has built several Malaria House units in different villages in Tanzania after a study of the types of housing, the environment and how these can influence the transmission of the disease.

However, the new pandemic that is raging us now is an invisible enemy. And it challenges us to return to these spaces of the twenties. The confinement has made us value the natural light that enters through large windows that allow us a closer relationship with the outside; it has made us regret having closed that terrace to gain interior space; or choose between having more flexible spaces to accommodate a multitude of uses or more limited spaces for privacy. It has also made us consider the possibility of incorporating home automation systems and new technologies into homes and small offices, while at the same time suggesting a return to more sustainable construction.

From this experience, our homes are offices, schools, gyms and bedrooms, all in one. The house has become an operations center where the private becomes public. Teleworking or distance education are here to stay, and if so, homes have to undergo a transformation that is neither simple nor immediate and has costs.

On the other hand, how can we talk about adapting our homes to the new situation if 2% of the world population are homeless, and 20% do not have decent housing? How can a part of the population be confined if they have nowhere to do so? Is it okay to provide them with temporary shelters like the various proposals from Shigeru Ban and his Voluntary Architects Network? Their emergency architectures have proven to be efficient in the face of natural disasters such as the earthquakes that took place in Kobe (1995), L’Aquila (2011), Tohoku (2011), Christchurch (2013), or the tsunami in Sri Lanka (2004). There are also many more initiatives around the world to alleviate homelessness and the lack of sanitary facilities. CURA (Connected Units for Respiratory Ailments) is an open source project so that anyone could reproduce the plans for the adaptation of containers to intensive care units. WTA Architecture + Design Studio founded by William Ty, has built several Emergency Quarantine Facilities in the Philippines to serve as low cost and fast building containment units. Sekolah Indonesia Cepat Tanggap has converted modular units designed after the 2018 Lombok earthquake to isolation units for coronavirus patients who do not require intensive care. Globally, fairgrounds, exhibition centers, or convention halls have doubled as field hospitals or temporary shelters.

But once the confinement is lifted, will the homeless have to go back to the streets? Would governments be able to provide them with permanent housing? Wouldn’t it be more reasonable to invest in social housing and avoid the risk of transmission than to take the risk and bear the health costs? Because housing is both a prevention and a cure against the pandemic, and in this situation, the right to housing has become a matter of life and death.

A new urbanism

Cities have always been an attractive place to live in, due to its proximity to points of interest, its connectivity with other neighborhoods, and the ease of transportation. However, many of the measures imposed by the confinement challenge the very essence of the city. The squares and parks, normally designed for congregation and interaction, have to impose physical distance. Public transport, previously advised, is now considered dangerous due to contact with other passengers.

Before the pandemic, we accepted traffic noise as inherent in city life; we tolerated the massive flow of tourists or the predominance of the built space rather than green areas. But the confinement has made us live an alternative urban environment – an environment where it is possible to walk and listen to the sound of birds, where you can ride a bike without thinking about the danger of coexistence with cars on the street, where the sky is cleaner and we breathe better –. Suddenly, another urbanism seems possible. In a matter of weeks, the city has been transformed to a human scale and the Earth seems to appreciate the slowdown that the world has experienced.

But environmental problems persist and we still have a long way to go to meet the objectives of the 2030 Agenda. Every day, cities grow unsustainably and with it come problems of stockage, informal urban planning or inequality – situations that have already been experienced in the 19^th century in the first urban societies – but are now accompanied by new concerns such as globalization, hyperconnectivity, excessive construction, lack of green spaces, dependence on the automobile or the incessant flow of people and goods across the planet.

The coronavirus crisis has served as a catalyst for many of us to want lasting change in the way we live, especially in cities, but what are we willing to give up? What changes can we expect? I believe that regulatory changes are a priority. The United States created the Department of Homeland Security after the 9/11 attacks. The government of José Luis Rodríguez Zapatero created the Military Emergency Unit after a tragic fire in Guadalajara in 2005. Thus, the strengthening of public services, well distributed in the territory, is essential not only to address incipient health needs, but to accompany subsequent measures. We must also consider older citizens, those most affected by this crisis. New models of production and consumption should be encouraged: support small local businesses and exercise an attitude of responsible consumption. It would be necessary to think about the redistribution of public space, the expansion of pedestrian zones or the rearrangement of traffic; think of a new mobility that considers the risk of transmission, access to public services and environmental impacts. Last but not least, restoring our ecosystems – rewilding –, to reverse the destruction of the natural world and reconnect people to the wonder of nature. At the end of the day this crisis puts in the focus of the debate what really is of value: life, health and care.

With all this, I cannot help but think about the “garden cities” that Ebenezer Howard proposed more than a hundred years ago, and that today seem more than valid: communities surrounded by a green belt, each with a residential, industrial and agricultural área in the same proportion. New urban proposals in relation to the pandemic revolve around this idea. Stefano Boeri’s studio has created a masterplan in the Albanian city of Triana, a smart “neighborhood city” with large green spaces, rooftop gardens, access to essential services at reasonable distances that promote physical activity. Boeri insists on the need to think about a new era, more ecological and with a different normality. Foster + Partners advocates a “tactical urbanism” – small urban interventions that can have a greater impact –, an active mobility scheme that enhances infrastructure for pedestrians and cyclists, and a diversification of activities in each neighborhood. Studio Precht (Fei Tang and Chris Precht) proposes houses with orchards to reconnect us with the process of growing our food, or a labyrinthine spiral-shaped garden with tall bushes to maintain physical distance on walks. Gabriel Ospina, Ernesto Salinas and André Velásquez of Habitable have proposed creating hyperlocal micro-markets to guarantee food access to a population without it being a risk for distributors, merchants and buyers.

Contemporary art projects have also come to mind that suggest actions or interventions that seem appropriate at the present time. Apolonija Šušteršič’s ephemeral Garden Service project (2007) addresses the peculiar situation of mixed public and private areas in the alleys of a neighborhood in Edinburgh, installing simple urban elements to encourage the use of space, especially by those neighbors who do not have access to a garden. The beehive-sculptures Api Sophia (2017) by Lucía Loren help activate urban beekeeping. Urban interventions such as those carried out by Patricia Johanson in Texas in 1969 was key to restoring the endemic ecosystem of a lagoon, with the incorporation of a series of sculptures based on natural elements.

In his book The City of the Future, Le Corbusier stated: “Hygiene and moral health depend on the design of cities. Without hygiene and moral health, the social cell atrophies”. But in order to achieve it, we must sacrifice some things from the old normal. Are we willing to give up certain “comforts”, habits or lifestyles? Are we aware of everything that can be gained from a change? The pandemic has provided us with an opportunity to reflect, rethink, and redo. What city do we want after the health crisis? To what extent will the current planning of our cities change? Will sustainability have more weight now in terms of the design of our homes and our modes of travel? Will it incite a return to rural areas? Will the community be strengthened or, on the contrary, will fear and selfishness prevail?

I have launched these questions on behalf of MUSAC to artists and architects whose concerns, practices, and research lie at the border between art and architecture.