An architecture of risk: how the past breathes in the design of future clinical space

This paper opens up questions of infection control, architectural atmospherics and embodied practices in clinical space today. Additionally, it traces how echoes of the past inform designs of clinical space for the future. Specifically, we review the example of Skane University Hospital’s Infectious Disease Unit, in Malmö in Southern Sweden. This is a building in which design becomes an articulation of infection control, its architects responding to shifting understandings of what clinical space might look like in a post-antibiotic era. It is also an example where future-proofing a clinical building is related to a longer view of medical practice and hospital design. Conceptually, we draw on theoretical writing from Sloterdijk, Yaneva, and others that relate architectural design to questions of air and immunity. Empirically, we use documentary sources and an interview with the building’s lead architect to trace the changing arrangements, organisational imperatives, and affective atmospheres of patient safety and ward design - all issues that are especially pressing in light of the challenges of the Covid-19 pandemic. Doing so allows us to explore how mutable spatial organisations enact changing ideas of disease management - from the control of space and air to tactically limiting contact between people through spacing protocols and strategies. Locating our contemporary case study alongside historical examples allows us to develop a greater understanding of the role of materialities, mobilities and design in the social construction of risk in a post-antibiotic age, and affords an understanding of how previous models of hospital design continue to inform present thinking about clinical space.