As communities across the country are evaluating strategies to minimalize the spread of COVID-19, it seems likely that we will experience long-lasting shifts in our society and built environment. Social norms are changing, and work environments are evolving. The way we obtain our food, services and goods have been impacted. Undoubtably, these societal changes will affect the buildings we use.
With a potential increase in telecommuting, it is possible that office space will be converted into another use. Grocery stores may evolve into distribution centers where food orders are processed and delivered. Only time will tell. However, it should be acknowledged that our response to the new coronavirus is not the first time an infectious disease served as an impetus for change.
Tuberculosis, which had been a scourge throughout known history, was largely eradicated after an effective vaccine became widely available following World War II. Over the last 75 years the bearing of that disease on our culture, in both subtle and significant ways, has become largely forgotten.
Commonly referred to as consumption or the White Plague, tuberculosis is an infectious bacterial disease which can occur in any organ of the body but is most commonly associated with the lungs. Typical symptoms include a persistent cough, spitting up of bloody matter, fever and weight loss. Tuberculosis did not manifest as an epidemic, rather it was a chronic condition that existed in all places at all times.
In America, few diseases shaped the contours of daily life more dramatically than tuberculosis, which claimed between one seventh to a quarter of all who died during the first half of the nineteenth century. The prevention and treatment of tuberculosis became a national obsession. Educational material was disseminated to shift how people interacted with one another. For example, spitting on the floor, sharing food, and frequent kissing were discouraged. These public health recommendations likely had varying degrees of permanency in our society, but other remedial endorsements influenced building design in several ways.
Before a vaccine was developed, many in the medical field found that therapeutic exposure to fresh air and sunshine, preferably at high altitudes with low humidity, could save lives. As a result, sanatorium complexes, which served as health spas, dotted the American landscape. These institutions were established so patients could be separated from the larger community while receiving therapeutic rest and fresh air.
Many sanitoriums, including the old Maryland Tuberculosis Sanatorium in Sabillasville, MD, employed the “cottage plan,” consisting of a large administration and hospital building surrounded by private and semi-private accommodations known as “cure cottages.” These wood frame structures were typically limited to a single story and featured a simple, linear plan with a low-sloped roof, lots of windows and long porches. Unfortunately, many of these buildings have been lost over time, including the cure cottages in Sabillasville.
Incorporating architectural elements that provided access to air and light were not limited to sanitoriums. Galvanized by the idea that fresh air could be had at home, Americans embraced verandas and sleeping porches, with the ideal anti-tuberculosis veranda extending around three sides of the house. The porch would be wide enough for a chair or entire bed to be wheeled along it to follow the sun or breezes. Americans could also purchase kits to build porch additions, lean-tos and other airy structures to aid a consumptive patient. Many of these features can still be observed in historic homes today.
One unique example is the home built by Ammon and Helen Cramer on Linden Avenue, off the Golden Mile. This structure highlights the relationship between tuberculosis and architecture. This prefabricated building, constructed around 1936, from the E.F. Hodgson Co., provided two living compartments, and allowed Hellen, who was ill, to be close but separated from her family. This single-story, wood-framed house was designed with two front entrances and multiple porches. It features an unusually large number of windows and has a striking resemblance to the cure cottages typically associated with tuberculosis sanatoriums. Like many sanitoriums, it was constructed on a high elevation with access to clean, fresh air.
It is unknown to what extend that our lives will change because of the new coronavirus, but we are undoubtably watching history unfold.