Infection control measures could save up to £23 billion annually

So says a new report from the National Engineering Policy Centre (NEPC), Infection resilient environments: time for a major upgrade, which adds that ‘infection control must also be coordinated with efforts to improve energy efficiency and fire safety, to support the three goals of safe, healthy, and sustainable buildings’.

According to an economic assessment that informed the report – thought to be the first such analysis following the COVID-19 pandemic – another severe pandemic during the next 60 years could have an annual ‘societal cost’ to the UK  of £23 bn. ‘Even without the extreme circumstances of a pandemic’, the report estimates seasonal diseases cost the UK as much as £8 bn annually in disruption and sick days. The NEPC says improving ventilation, air quality, and sanitation in buildings could minimise transmission, reducing the number of people infected, thereby saving lives, and reducing ill health and its societal impacts.

Commissioned in 2021 by the Government’s Chief Scientific Adviser, Sir Patrick Vallance FRS FMedSci, the NEPC research, led by the Royal Academy of Engineering and the Chartered Institution of Building Services Engineers (CIBSE), set out to identify the measures needed in the UK’s built environment and transport systems to reduce infectious disease transmission. While ensuring that buildings and transport systems are ‘designed, operated, managed, and regulated for infection control’ is critical to minimise transmission, the report says the pandemic has highlighted that many UK buildings are not being operated according to the current air quality standards, ‘because they were built to previous standards or before standards’ introduction, have been modified over time, or are not operated as originally intended’.

Alongside reducing the impacts of future pandemics, seasonal ‘flu, and the associated economic and social costs, the report identifies additional benefits from improving infection resilience. For example, improved ventilation has been proven to reduce infection risks, boost productivity, and alleviate asthma and general exposure to air pollutants that can contribute to ‘sick building syndrome’. The Centre adds that ‘no-touch’ technologies, such as sensor-operated doors, help prevent infection on surfaces, but also help support building users in wheelchairs. The report suggests any system used within a building design should be considered from an infection perspective, ‘to identify if and where there are wider opportunities to improve experiences and duty of care for building users’. 

The report’s eight recommendations ‘to enshrine infection resilience in building regulations, and improve the health of our indoor environments’, include:

• Establishing best practice – the British Standards Institution (BSI) should convene the relevant expertise and develop meaningful standards embedded into existing design and operational practices.
• Promoting building health – the UK Health Security Agency should promote the benefits of infection resilience and good indoor air quality to building and transport owners and the public through signage and ratings.
• Ensuring buildings operate as designed in terms of infection resilience – industry bodies and public procurement must ‘drive improvements to the commissioning and testing of building systems at handover, and subsequently over the buildings’ life’.
• Establishing in-use regulations with local authorities by 2030 to maintain standards of safe and healthy building performance over the building lifetime.
• Ensuring Government departments such as BEIS, DfT, and DLUHC, consider incorporating infection resilience into major retrofit programmes designed to meet the commitments of the Net Zero Strategy.

Professor Peter Guthrie OBE FREng, Vice-President of the Royal Academy of Engineering, and Chair of the NEPC Infection Resilient Environments Working Group, said:  “If the built environment is not equipped to limit the spread of infections, there will be direct health costs from severe illness, long-term sickness, or death. These will be further compounded into economic and social costs as health costs disrupt businesses, education, and our daily lives.

This is not simple, because the developers who commission and fund new buildings will not directly benefit from including health provisions at design stage. Changes to regulation and standards are thus needed for the scale of change required. The public has a right to expect that buildings and transport will be designed and managed to control infection and minimise the impact of both seasonal diseases and future pandemics.”