The COVID city: Disease shaped architecture in the 20th century. Will that happen again?

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An invisible enemy sweeps across the world, killing people left and right. Doctors and scientists call for us to reshape the way we live. Buildings and cities get remade with a new prescription: fresh air, sunlight, bringing the outdoors in.

That’s what happened a century ago as tuberculosis cut through the cities of Europe. Disease shaped modern architecture and shaped the way we still live today.

Will that happen again today? Will the coronavirus shape a new way of living?

“The fears and the issues are very similar,” architectural theorist Beatriz Colomina says. “We are in the middle of a pandemic again. And architecture has always had a close relationship with illness.”

What might be the hallmarks of post-COVID-19 architecture?

That is the argument of her engaging new book, X-Ray Architecture, published last month. In it, she explores the connections between medicine and 20th-century architecture, a theme that she has been thinking about for decades. It turns out that the links are everywhere – and, reading it, it’s hard not to imagine parallels with our current moment.

Look at the basics of the canon of modern architecture: An obsession with the colour white. Large windows. Terraces and balconies. Flat roofs. “We have been presented with all these as simply questions of style,” says Colomina, a Princeton University professor, from her home in New York. “But we have been ignoring what architects were saying very clearly: That architecture was being presented as a cure.”

In the late 19th and early 20th centuries, the perceived answer to tuberculosis was environmental. The disease was associated with dust and dirt (in fact, it is bacterial), and the cure was light and air. At sanitoriums – above all in Davos, Switzerland – affluent Europeans spent their days taking the cure, which meant spending the entire day in the sun.

Around 1900, these structures involved the most advanced building technology of the day, including reinforced concrete. “There was this enormous coincidence between avant-garde doctors, avant-garde architects and engineers,” Colomina says. And even as the science on TB advanced, “It took a very long time for the environmental understanding to go away.” And so architects and doctors together were prescribing “that we should live in white buildings, expose ourselves to the air,” she adds.

“Little by little, the prescription of architecture for tuberculosis becomes the prescription for everyone.”

Then you see it everywhere. Le Corbusier, the Swiss-French architect who is probably the most influential Modernist figure, developed his manifesto Five Points for a New Architecture in the 1920s. His Villa Savoye of 1930 – among the most famous buildings of the century – puts them into action, starting with raising the building on pillars or “pilotis” and culminating in a roof deck. These, Colomina points out, are medical: they get the building away from the diseased earth and they allow residents to spend days in the sun. (As she quips in the book, nobody seems to know anything about skin cancer.)

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Sanitoria themselves became hugely influential. The Paimio facility in Finland, by architects Alvar and Aino Aalto, was a mid-rise building lined by full-length concrete balconies; it was radical when designed in 1929, normal by 1950. Today it looks like something out of a contemporary condo-marketing brochure. And the Aaltos’ ideas about interior design – for instance, that a patient in bed should be able to see out the window – seem incredibly prescient.

Colomina makes other, more distant links that have their own logic. X-ray technology was a popular novelty for decades starting in the 1890s. When architects started imagining glass buildings, in which the interior activity shows up on the facades like an X-ray image; when Mies van der Rohe starts writing about a “skin and bones architecture,” a building and a body became inseparable.

Colomina is not the only scholar to connect health and Modern architecture. In the 40 years since she began thinking about this theme, it has become more widely understood. The Canadian Centre for Architecture mounted a fine exhibition (which included Colomina) on the topic in 2012.

But her book is valuable right now for the way it covers such a broad range of subjects and places; the idea of illness comes to define an entire century, just as it defines our current reality so completely.

So how will the way we live change in the wake of COVID-19? If tuberculosis kept people outside, and the coronavirus now traps us indoors, what new prescriptions will we adopt for the future?

It’s already happening, Colomina suggests, since so many of us are working from home. “If our cities are designed for a separation between work and living,” she says, “we may now return to a preindustrial idea of work and life in one place.” And that place isn’t just home, but for many of us in bed. The place of the greatest intimacy and retreat is now where we Zoom to the world. “Surely a different kind of city will emerge from this,” she suggests. Hopefully the cure we choose will leave our cities stronger.

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