“For 40 years, we’ve been in the sick building era,” says Joseph G. Allen, director of Harvard’s Healthy Buildings Program and associate professor at the Harvard T.H. Chan School of Public Health. “We have not designed, maintained, or operated our buildings with health as the North Star. This has been well documented. But now with COVID, it became obvious that the way you operated your building determined whether people got sick or not and for many businesses determined whether they could stay open.”

As a result, Allen believes that healthy buildings have to become a core business strategy, so much so that he wrote a book about it with John D. Macomber, senior lecturer of business administration at Harvard Business School. In their book, Healthy Buildings: How Indoor Spaces Drive Performance and Productivity, Allen and Macomber share the nine foundations of a healthy building:

1. Ventilation
2. Air quality
3. Thermal health
4. Moisture
5. Dusts and pests
6. Safety and security
7. Water quality
8. Noise
9. Lighting and views

“These are the absolute basics that we know from decades of scientific research are associated with less sickness in the workplace, fewer absences and better cognitive function,” says Allen. “This is all really well documented, but the problem is that we haven’t thought of our buildings as a powerful HR tool.”

But creating a healthier work environment doesn’t have to equate to heavy spending, according to Allen. 

“Workers in buildings with good air quality are more productive and we estimated the financial impact,” says Allen. “The cost to achieve this is on average $40 per person per year. The benefits are in the order of six to $7,000 per person per year … We’re not asking people to spend hundreds of millions on overhauling their entire building. It’s about the basics.”

And changing everything overnight isn’t necessary either, he says, instead pointing to a report from the Lancet COVID-19 Commission that outlines the first four strategies to reduce COVID risk in buildings. The report recommends:

1. Verifying that building systems, such as heating, ventilation and air conditioning (HVAC), are operating as designed 
2. Maximizing outdoor air, either through an HVAC system or open windows
3. Upgrading air filters to minimum efficiency reporting value (MERV) 13 or higher
4. Supplementing with free-standing, plug-in portable air cleaners where needed

“It’s about employee health, employee wellness, employee productivity and business continuity,” Allen says of the need for healthy buildings. “We’ve seen a massive shift in the past couple of years where major organizations are rethinking their approach to commercial real estate … This is because the C-suite has started to really pay attention to the key role that buildings play in terms of the health of their people and the health of their company.”

Experts also recommend other wellness-first design elements, such as active clean overhead lighting that emits antimicrobial wavelengths for constant cleaning; touchless door and cabinet pulls; large conference rooms to promote social distancing and semi-enclosed collaboration areas. To help combat noise, designers referenced acoustical mitigation measures, including softer surfaces, such as carpet, plush furniture and window treatments; as well as sound-proofing and the introduction of designated quiet zones. 

“If you look at all of the major crises we’re facing–the COVID crisis, the equity crisis, the climate crisis, the chemicals crisis–so much of that points back to our buildings as the problem, which means healthy buildings are part of the solution set to all of these problems,” Allen continues. “We’re an indoor species. We spend all of our time in places we work, travel, live, play, pray and heal [indoors] and it has such a massive impact on our health.”