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Observations | Design and Disease

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The Architect’s Ultimate Responsibilities - Shaped by Health

Look around you. The built environment is full of design artifacts from the evolution of public health. As ideas of public health evolve, architects and planners thoughtfully design the way we live to keep us healthy with sanitary interventions like indoor plumbing to public parks.

During the early 20th century, after identifying the correlation between disease and hygiene, cleanliness became an indicator of social status, good character, and a key component in managing the spread of disease. Public baths were built to clean the masses while wealthier individuals retreated and relied on their private homes for sanitization. Built after the 1918 flu pandemic and World War I, Paris’ famed Maison de Verre used cleanliness and isolation as guiding principles. Tucked away in a private courtyard behind a blind glass block façade, Architect Pierre Chareau designed this doctor's office and residence for Dr. Dalsace, a Parisian gynecologist, and his family.

The key planning concept, the building’s circulation, is carefully crafted between its three major functions: doctor’s office, residence, and service. Patients are guided from exam room to exit using specialized door hardware designed for social grace and isolated use by the doctor. The doctor can access his home office and medical office without traversing shared residential spaces. Moving wall partitions allow the family space to expand while remaining isolated from the medical practice. Double-sided cupboards allow service staff to replenish household items without entering private bedrooms. Throughout the building, everyday items and furniture can be folded or put away to produce clean, uncluttered space.

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A sketch from Kara’s notes of the door handles at Maison de Verre. The long curve of the handle required that Dr. Dalsace bow gracefully as he opened the door for his patients.

Glass block facades provide access to light while obscuring views in. Operable metal panels and garden-facing, sliding train windows provide ventilation. Modern materials such as the rubber floors, steel columns, metal screens, and glass materials can easily be wiped clean, and architectural elements such as stair treads are removable for sanitization. Even though other early modern houses such as Villa Savoye in the Paris suburb of Poissy prominently feature sanitation equipment, Maison de Verre is unparalleled in this regard with five bathrooms, four water closets, and several additional sinks.

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Detail image of the glass block facade photographed by Principal Robin Whitehurst.

The push to sanitize and isolate is seen again today – but rebranded as “Wash your Hands” and “Social Distance.” Instead of the sink in the front hall of Villa Savoye, we see hand sanitizer stations and sanitary wipe dispensers. With the arrival of COVID-19, we have entered into another Sanitary Awakening.

Design evidence of this re-awakening is already visible. Restaurant vestibules are now the interstitial space between a controlled environment and the public, which can be monitored and sanitized; our front halls have turned into de-gowning areas moving into our private domains; and the grass alongside our neighborhood sidewalks are worn to mud to allow the CDC recommended 6-foot passage distance between pedestrians.

As for future trends, once the COVID-19 virus’ rate of decay on different surfaces is identified, the architectural use of these materials will certainly change. Materials with inherent anti-microbial properties will likely become more commonplace in our public lives. Our homes have turned into full-time offices so future homes will have to accommodate work/life function more so than ever.

Our built environment will continue to evolve, as it always has, for our health, safety and welfare. And if Dr. Dalsace were here, he’d be reminding all of us to wash our hands.


Kara Johnston is a designer and historic preservation professional at Bailey Edward. With a BS in Architectural Studies from the University of Illinois at Urbana-Champaign and Masters in both Architecture and Historic Preservation from the University of Maryland – College Park, Kara has a wealth of experience working on Frank Lloyd Wright homes and residential design.