At the onset of the COVID-19 pandemic, Meritus Medical Center was in urgent need of a regional infectious containment (RIC) unit to handle the growing health crisis. WSP USA was part of the team that delivered the facility in four months.

That was 16 months sooner than a similar design/bid/build process would have taken without the expedited design and construction process used for the critical expansion of this Hagerstown, Maryland medical facility.

WSP was contacted in the middle of March 2020, just as the pandemic was taking hold of the country, to join a team of consultants and contractors who could quickly design and build the 20-bed, 12,800-square-foot infectious containment unit. It was designed to handle the anticipated surge in COVID-19 patients, but also to adapt to alternative medical uses once the pandemic subsided.  

“The challenge to construct such a facility in less than four months was made even more difficult when our entire office was forced to transition to a fully remote work environment on March 23, with almost no notice,” said Mike Lamdin, principal-in-charge for the project. “WSP immediately accepted the challenge and began virtual meetings with the physicians, nurses, and hospital administrative staff that same week.”

Under normal conditions, a single-story addition of this size and complexity would have required 6-9 months in design and 10-12 months in construction to complete. But on July 30, 2020, the acute care facility was opened to the public. It not only provided COVID-19 patients with isolated, safe treatment space equipped to serve their needs, but with a separate entrance and exit, it protected the hospital’s general population from infection as well.

The new addition was constructed on the backside of the facility connecting to a corridor that leads to the outpatient and administration wing. The negative pressure and ventilator-capable area is located adjacent to Meritus Medical’s wound center and features entrance and exit ante rooms, respiratory therapy space and support spaces required for a medical/surgical facility.

For successfully designing and building a lifesaving regional infectious containment unit on an accelerated schedule, the WSP design team was selected as the WSP 2021 Project of the Year award winner for projects under $3 million.

Completing the $12.5 million facility in four months demanded swift action by the design and construction team, which included Matthei & Colin, architect of record; Gilbane, construction manager; and Frederick, Seibert & Associates Inc., civil engineering, land surveying and landscape architecture. All of these companies were involved with the construction of the Meritus Medical Center building more than 10 years ago, including Leach Wallace, now a WSP company.

“The biggest challenge with this project was that the design process was almost inverted compared to normal design practice,” Lamdin said. “At the same time, there were new procedures everyone had to learn in order to be productive and safe in a remote environment.”

Due to long lead times on equipment, the team used an inverted design approach, which required WSP to select major equipment such as air handling units, exhaust fans, supply air terminal units, plumbing fixtures, panelboards and lighting fixtures before the architect had finalized the floor plan. This required Andrew O'Brien, the project manager and mechanical/plumbing lead; and Jacek Grabowski, the electrical lead, to make necessary engineering judgments based upon their previous experience to select the correct equipment.

“In the end, all long lead items were used and no equipment needed to be re-ordered,” Lamdin said. “This approach succeeded because of extensive medical design experience and seasoned judgement of WSP’s mechanical, electrical and plumbing engineers.”

He said the entire design and construction team adapted to the new approaches required to meet the demands of an accelerated timeline. WSP held daily team huddles via the Skype and Microsoft Teams platforms to keep track of progress and tasks. Those calls, which included the construction manager, design team, project owner and the Washington County code officials, were essential to keep the design process on the fast track.

While it is unusual to involve code officials at this stage of a project, this approach ensured thorough understanding on all sides of the project’s objectives and requirements. This resulted in smoother permit submissions and on-site inspections that would’ve otherwise required considerably more time to complete.

The heating-ventilation-air conditioning (HVAC) system designed by WSP for the RIC unit included a critical care quality air handling unit capable of providing 100 percent outdoor air with dual supply fans for redundancy and high-efficiency particulate absorbing (HEPA) filters in the final filter position. The unit is served by the existing campus chilled water, steam and hot water distribution systems. 

“The dedicated, fully redundant exhaust system consists of two high velocity, high plume discharge exhaust fans equipped with bag-in, bag-out HEPA filter assemblies on the roof with bubble tight isolation dampers,” Lamdin said.

The new HVAC system provides the facility with two distinct modes of operation – a “normal” mode where the suite acts as a typical medical/surgical patient floor and an “infectious” mode where all 20 patient rooms will operate under negative pressure and maintain a minimum of 12 air changes per hour.

“Each patient room and the entrance/exit ante rooms are equipped with room pressure monitors to maintain pressure requirements when needed, which keep staff and patients safe from cross-contamination,” Lamdin said.

The medical gas systems are designed to allow for 20 ventilators to operate simultaneously, and all critical functions are served from the emergency power generator plant serving the hospital.

Most of the work could be performed remotely, but it was still necessary to have feet on the ground to assess the progress. So once construction started, Tommy King, a member of WSP's construction administration division, consistently walked the site to provide field reports and general construction oversight.

“As one of our more experienced construction administration employees, Tommy has a detailed understanding of our MEP system designs and the experience to provide direction in the field to keep the project on schedule,” O’Brien said.

King had to go through safety and health checks before he was admitted to the site. In addition to standard PPE gear for construction sites – a hard hat, safety vest, safety glasses, boots and work gloves – he also had to wear face coverings specifically to prevent COVID transmission.

“He was willing to visit the site even when the transmission of COVID was not fully understood by the general public,” O’Brien said. “He went above and beyond to make the project a success.”

As one of the first permanent, totally new facilities in the U.S. specifically designed and constructed for COVID-19 treatment, the WSP team understood the importance of the project … and answered the call to get it done quickly and completely.

“This project was specifically designed to assist in treating patients afflicted by the worst pandemic to hit the world in 100 years,” O’Brien said. “Our project team adapted to a new reality and still provided an expedited design that has been in service to treat COVID-19 patients since July 2020. It is very satisfying for every member of our team to know that we were able to respond to this worldwide crisis in an efficient manner and do our part to fight COVID-19.”

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