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Outside grocery stores, neat yellow marks on concrete sidewalks compose masked shoppers into lines at 6-foot intervals. With most indoor gathering spaces closed, people have poured into outdoor ones like parks and beaches. Public parks, the legacies of the 19th century movement to restore health to overcrowded industrial towns, promise refuge to urban dwellers otherwise confined in their own homes. The alarming spread of the novel coronavirus has rapidly reorganized our bodies in space, temporarily shrinking our spheres of movement. We’re staying put, but we’re suddenly living in different cities.

But before all of this, infectious disease had already molded the places we live—through architecture, design, and urban planning—in enduring ways. Right now, the lockdowns on movement and social interaction are critical to keeping the coronavirus at bay. These spatial interventions have a longer lineage, however, enshrined in the buildings that emerged from 20th century modernism. In the deadly wakes of cholera, tuberculosis, and flu pandemics, early 20th century architects saw design as a panacea to the sickness of overcrowded cities. Just as those scourges scarred and then reshaped cities, so will ours.

Few lives were untouched by the spread of infectious disease in the early 20th century.

The flu pandemic killed tens of millions from 1918–20. Six cholera pandemics in the 19th century alone laid waste to hundreds of thousands of lives. Between 1810 and 1815, aggravated by overcrowding and filthy living conditions, tuberculosis was the cause of more than 25 percent of deaths in New York City. Robert Koch’s discovery of the contagious tubercle bacillus in 1882 gave rise to the sanatorium movement in Europe and the United States. Designed to house, treat, and isolate patients, these institutions emphasized strict hygiene and ample exposure to sunlight and air. Before the development of medications for tuberculosis, its treatment was environmental. These clinical environments inspired the new modern architecture. As the Swiss architect Le Corbusier declared, “A house is only habitable when it is full of light and air.”

Architectural modernism—that is, the dominant mode of design from the 1920s to the 1970s—is often reduced to a set of principles affirming purity of form, strict geometries, modern materials, and a rejection of ornamentation. These principles responded to the ravages of war and disease that defined the first half of the 20th century. Like tuberculosis sanatoriums, the clean, smooth surfaces of the architecture of this era offered an anesthetic to disease and trauma. Modernist architects from Adolf Loos to Alvar Aalto designed these curative environments as cleansed—physically and symbolically—from disease and pollution. The Looshaus, a building with windows lacking “eyebrows” or adornment, embodied Loos’ minimalist ideology and scandalized Vienna with its austerity. Le Corbusier urged people to strip their homes of needless clutter, eliminate carpets and heavy furniture, and keep the floors and walls clear. In 1925, he envisioned a spartan city where every home is whitewashed and “there are no more dirty, dark corners. Everything is shown as it is. Then comes inner cleanness.” His ultramodernist Villa Savoye embodies this aesthetic. Painted clinical white, its living quarters are suspended on columns above the germ-ridden earth below.

Modernist furniture reflected these concerns as well. As the architectural historian Paul Overy writes in Light, Air, and Openness, dust lodged in decorative features was “an enemy of hygiene to be eradicated at all costs.” Minimalist designs replaced carved wood and upholstery, where bacilli-containing dust could linger and become vectors of disease. Instead, designers used lightweight, washable materials in streamlined forms. Michael Thonet used bentwood and cane, Aalto used bent plywood, and Marcel Breuer and Mies van der Rohe used tubular steel. Easily moved for cleaning, this furniture deprived dust and insects of hiding places in the dark.

By jettisoning decoration and disavowing clutter, these designers fought against dust and grime that could nestle in dusky corners. By the dawn of the 20th century, it was known that dried tuberculosis-carrying droplets could survive and remain infectious in household dust. The popular English catchphrase “30 years in the dark but 30 seconds in the sun” reinforced public awareness of this fact as well as the medicinal potency of sunlight.

Terraces, balconies, and flat roofs are common elements in modernist architecture, even in climates less suited to luxuriating outdoors. Beyond their aesthetic appeal, these features embodied modernist preoccupations with the healing effects of light, air, and nature. Influential California modernist Richard Neutra, whose father died of the influenza in 1920, was obsessed with making sunlight and natural ventilation available in every habitable space. In his Corona school in Los Angeles, built in 1935, Neutra used telescoping glass walls to fluidly connect each classroom with the gardens outside.

The influence of these principles on architectural modernism crystallized in Alvar Aalto’s Paimio Sanatorium in Finland, built in 1933. The clinical aesthetic of the sanatorium achieved full expression in this monument to health, a landmark of international modernism. He conceived of the entire building as a medical instrument. Aalto bridged inside and outside with sunning balconies on each floor and a rooftop sun deck where healthier patients could bask. Windowed rooms offered sweeping views of the forest outside, while walking trails led patients through the landscape.

These architectural features—terraces, flat roofs, and precisely designed interiors and furniture—served the pursuit of a therapeutic lifestyle, even as they expressed the design theories of functionality and rationality that are identified with modernism.

Epidemics have long transformed our built environments—and social worlds.

More than a remedy for a germ-addled world, its minimalist aesthetic manifested a deeper desire for transcendence. According to Dutch architect Jan Duiker, “This spiritual economy leads to the most appropriate construction, depending on the material used and evolves steadily towards dematerialization, spiritualization. … It is undoubtedly the intrinsic economy of the material that enables us to achieve more and to satisfy higher spiritual demands more truly than our forefathers were able to do.” At the same time, these designs embodied a philosophy that united moral, physical, and social well-being. Writing in City of Tomorrow, Le Corbusier said: “Hygiene and moral health depend on the lay-out of cities. Without hygiene and moral health, the social cell becomes atrophied.”

In our current health crisis, the truth of this statement has become painfully clear. Without early mitigation measures, some densely populated cities have proved to be particularly fertile breeding grounds for the novel coronavirus. For the moment, experts prescribe social distancing as a temporary, if prolonged, stopgap to a problem awaiting a medical solution. Yet epidemics have long transformed our built environments—and social worlds. In the 1800s, Baron Haussmann’s vast renovation of Paris’ and London’s rebuilt infrastructure followed devastating cholera outbreaks.

Although the situation is still unfolding, already the COVID-19 pandemic is begetting new design theories. According to Architectural Digest, many designers and architects anticipate the broad implementation of automated touchless technologies—such as voice-activated elevators, hands-free light switches, and cellphone-controlled hotel room entry—in public spaces to mitigate against contagion. As the sanatorium inspired modernist buildings, so too might construction elements from 21st century health care be appropriated for public space, such as ventilation systems to remove contaminated air. Like the modernists who rejected ornament in service of hygiene, contemporary designers are likely to utilize anti-bacterial materials in forms that can be easily sanitized.

Speculating on the impact of social distancing on urban design, some suggest that architects may design smaller venues and more open spaces to alleviate density. By increasing the number of security lanes and automating check-in procedures, redesigned airports could reduce congestion and ease passenger flow. Depending on how productive remote work proves to be in this pandemic, virtual space may also hasten the decline of open offices. Already, co-working disrupter WeWork appears to be pivoting from shared desks to “buffer seating”—that is, the cubicle. Rather than a provisional fix, social distancing could become a design paradigm.

As our time in isolation creeps on, the denial of physical interaction has underscored the crucial social infrastructure that supports our well-being. Without child care, working parents are barely keeping their heads above water, while some people living solo find a pall of loneliness hanging over their days, Zoom meetings be damned. Even as urban density can aggravate the spread of disease, it delivers some of our most cherished human encounters—at the park, the café, the sporting arena, and the concert hall. And while wealthier city dwellers have retreated to less-populated areas to escape the virus, renouncing density in favor of suburban sprawl, as some advocate, is not the answer. Sustainable urban design might instead combat vectors of contagion—litter, pollution, overcrowding—by encouraging people to think of public spaces more like home so they are invested in their care. Rather than denying our fundamental social connections, design might cultivate a deeper sense of global belonging.