Author: John Bailiss, Structural Futures Committee
It has, somehow, been over five years since the Covid-19 pandemic began. There has been much reckoning in the period since about what we can learn from it, and those investigations are ongoing - the UK Covid enquiry is not yet finished, and scientists warn that it is a case of when not if we will need to apply those learnings again.
Wuhan, China, is known for being the epicentre of the virus, but it was also the epicentre of the early response. In January 2020, when news footage was beginning to circulate around the world about the novel Coronavirus, the Chinese state built two new hospitals, to relieve the overwhelmed existing facilities. Footage of the warp-speed hospital construction, synchronised diggers and tens of cranes, was captivating to watch. Looking back now, how was this achieved? Undoubtedly, the political, cultural and infrastructural context in China enabled parts of this process in a way that is unlikely to be replicable elsewhere, but we can still learn interesting lessons from it.
Leishenshan Hospital in Wuhan - a 1,600-bed facility across 79,000 m² - was designed and built in just 12 days. The first phase was operational in 10.
While parallels can be drawn with emergency facilities such as NHS Nightingale London (500 beds delivered in 9 days within an existing structure), Leishenshan was built from scratch.
Structural design approach
The structural concept was heavily informed by prior experience with the 2003 Xiaotangshan SARS hospital. A fishbone layout was adopted, featuring a central services spine with ward modules extending laterally. This arrangement supported infection control by separating patient and medical staff circulation.
Design and construction phases overlapped entirely. A base layout was confirmed within 12 hours; construction commenced on day two. Drawings were developed and largely finalised within 60 hours, after which the design team remained on site, modifying plans in parallel with construction.
Modules were based on existing factory output and standard specifications. The primary structural units were fabricated from cold-formed steel beams and columns with steel composite insulated wall panels. Intermediate wall studs were spaced at 500–1200 mm centres. All units were fully welded and designed to withstand local wind and seismic conditions.
Prefabricated modular units—3m × 6m × 2.9m and 2m × 6m × 2.9m—were deployed in ~3,000 units. Ward units consisted of twin bedroom modules flanking a prefabricated bathroom, with separate external and internal corridors for patients and staff respectively. Structural integration of MEP systems, including ventilation ducts and concealed drainage, was addressed at the module fabrication stage.
Non-modular structures
ICU and central spine areas required greater spatial flexibility and were constructed using lightweight steel framing, infilled with steel composite panels. These areas were modelled in Tekla Structures, with the same model used for coordination, structural analysis, and shop drawings. To accelerate fabrication and reduce coordination complexity, only five structural member types were used across the non-modular frame.
BIM and coordination
BIM (LOD 350) was employed to coordinate building systems and construction sequencing. The model integrated spatial layout, logistics planning, and modular unit tracking. On-site deviations—inevitable given the pace—were manually documented and incorporated into the BIM model retrospectively.
Site and foundation considerations
The hospital was sited on a levelled car park previously used for the 2019 Military World Games. The 300 mm reinforced concrete base required minimal remediation. Where needed, supplementary slabs were cast to support higher load-bearing areas.
The site was divided into five zones, allowing simultaneous workflows. Modules were delivered by road and assembled on site using a basic production line approach. At peak, 10,000 personnel and 1,500 machines operated concurrently.
Staff accommodation
A separate 2,300-bed staff facility was also constructed using prefabricated container units. These were built on lightweight truss platforms to integrate with existing drainage infrastructure, reducing the need for new foundations.
Completion
The hospital began to treat patients on 8 February and was completely operational by 20 February 2020. By 14 April 2020, the hospital had been cleared of patients having treated 2011 and discharged 1,900 after 10 weeks of operation, withstanding the test of the epidemic.
This hospital, as with others, has now been stood down. Ultimately, the building was built quickly from lightweight, prefabricated modules not meant for this use, or durable enough to be sustained in use.
So, what can we learn?
The construction of Leinshenshan was a great success in terms of achieving its objectives quickly and fully. Thankfully, it did not need to be used again after the initial phase of the pandemic. The huge effort to make it happen brought together a supply chain, skill base, and power to act quickly that it is hard to imagine many nations have. However, there are lessons we can learn about how Wuhan used its existing strengths to the advantage of this project during an emergency:
- Use what you know, and what you have: prefab modular housing is more common in Chinese construction. These simple building blocks were quickly modified for use for the vast majority of the built area.
- Plan based on your supply chain: designing based on availability in factories enabled materials to reach site quickly and efficiently.
- Collaboration between design and construction: few projects would need to be erected this quickly, but when they do, merging the design and construction phases, having designers on site, and continuing to be flexible once construction was already underway enabled this lightning-speed process.
- BIM allowed products and processes to be trialled and tracked at every point of design and construction.
- Draw on experience - and after one emergency, plan for next one: China had experienced the SARS epidemic and its lessons were applied at Leinshenshan. Hopefully the UK, and the rest of the world, can take crucial lessons from Covid-19 to better prepare us all for future pandemics.
References
This article was written with the kind help and aid of Mr Yuang and Ms Zhou From CSADI, the Central South Architectural Design Institute Co. Ltd. Founded in 1952 it is one of the earliest comprehensive architectural and engineering design institutes in China, and lead designer of the Wuhan Leishenshan hospital.
Additional information was used from Hanbin Luo, Jiajing Liu, Chengqian Li, Ke Chen, Ming Zhang, Ultra-rapid delivery of specialty field hospitals to combat COVID-19: Lessons learned from the Leishenshan Hospital project in Wuhan, Automation in Construction, Volume 119, 2020.