How to Build Workplaces That Protect Employee Health

AI is transforming the world. And it starts with the right compute. ARM is the AI compute platform trusted by global leaders, proudly NASDAQ listed, Built for the future. Visit arm.com discover.

Welcome to the hbr ideacast from harvard business review. I'm alison beard. When you live through a global pandemic, you become much more aware of the places you go and the people you see. Because COVID 19 spreads through the aerosols and droplets that come out of the mouths and noses of those who are affected. We're told to wear masks, stay outside and avoid crowds. Some of us have been lucky enough to work from home since the outbreak began, wherever we live. But many others, doctors and nurses, grocery store clerks, mailmen, continue to go into work physically every day. As lockdowns loosened, we saw employees in the manufacturing, retail and hospitality sector start doing the same. And now in many places, even knowledge workers are heading back into the office. But how do we make sure these workplaces are safe going forward? What changes can we make to better protect workers health and the broader environment? John Machomer is a senior lecturer at Harvard Business School and veteran of the real estate and construction industries. And he's been thinking about these issues for a long time, well before this year's pandemic. He's the co author of the book Healthy How Indoor Spaces Drive Performance and Productivity. John, welcome to the show.

Thank you. I'm delighted to be here.

So as I said in the intro, you've been researching safe and healthy workplaces for years.

Pre pandemic, what were the biggest areas.

Of concern that you found with respect to healthy buildings? It's a relatively new phenomenon. I've spent most of my life in real estate and construction, as you said, and for the last 10 or 20 years the industry has been thinking a lot about green buildings and we've been thinking about energy efficiency and natural products and things like that. It turns out that green buildings aren't necessarily healthy buildings because there's so much emphasis at saving energy, which means we're not doing as much in the way of ventilation and filtration and using other means to evaluate the air. So I heard a presentation by Joe Allen, who became my co author from the Chan School of Public Health. And he talked about a study called the COG FX study or cognitive function study. And what the team did was to do double blind experiments with volunteers who did their regular work in a special work environment in a warehouse where the researchers could change the amounts of three things in the air, carbon dioxide, particulates and VOCs. Or volatile organic compounds. And the subjects would take tests around simple things like cognition, memory strategy, some aspects like that. And no surprise, when the air was stuffier and worse, they performed worse. We all know this sort of intuitively, you know that it's difficult to focus in a stuffy conference room or to stay awake in an airplane on the tarmac that hasn't had the ventilation on. But now we had real empirical evidence of this and what the amount was, and I started to think, you know, we're missing the boat here. If we just focus on green buildings and energy efficiency and don't think about how the actual human beings are doing.

So the point is it's not just about protecting people from getting sick, which is just sort of a baseline thing that employers need to do. It's actually about getting better work work out of them.

Yeah. So you'd be surprised how little attention before six months ago was paid to not having people get sick. There are plenty of workplaces, whether they're offices or factories or meatpacking places or something like that, where there is mold and where there's poor air and where there are vermin and other aspects like that that you'd really think would be the absolute minimum. So a lot of our research at the Chan School of Public Health is about all nine foundations of a healthy building are of which air quality and ventilation are two. But moisture, noise, security, dust, some of those other things are other aspects as well. But what really gets people's attention is not if you're just going to help them save cost, but help them grow the top line. So the idea that we can really provide an environment where idea workers can be more productive and do that extra phone call or that extra piece of writing or that one extra interview for a podcast, for example, anything that grows people's revenue is really appealing. And so that's what we started to chase down and chase down the numbers on that.

When I read your research, I got a little bit overwhelmed thinking about all the systems operating behind the scenes. Air and ventilation, water, noise, light. So how should we prioritize those things?

So a lot of what we look at is where are the proper benefit cost trade offs for actually anybody, for homeowners or for office tenants or for office landlords, or for schools or hospitals or military, because you can get a little carried away with some extremes. Like one extreme, in my view, is a total lockdown of everything. It's super effective to have everybody stay at home, but it's really expensive. There's sort of a hierarchy of the ways to balance the cost and benefit, and the way we talked about it is as a hierarchy of controls. And if you think of a. A pyramid that's fatter on the bottom and narrower on the top, the bottom segment is the most effective, which is the social distancing that really works, but it's also the most expensive. That's why we put it on the bottom.

And not possible for lots of essential workers.

That's right. If you move up a little higher, the next level on this pyramid or hierarchy is around selective participation or essential workers coming into work, which might include doctors. It also includes bus drivers, grocery store workers, people like that. That's not as effective in preventing the spread of the virus, but it's also less expensive because the economy has to function. The next level up is around mechanical controls, engineering controls. These are things like ultraviolet, like ionization, also like ventilation, filtration, things like that, a lot of which aren't that expensive. Like if you set your. If the building manager says we're going to have five turns of fresh air each hour instead of two, that doesn't really cost much more in equipment, it costs more in electricity. The next level up, which is narrower but less expensive, is administrative controls. And these are things like having some people come in, some people not staying six feet away, having distance at the salad bar, not even having a salad bar, or doing surveys or screening people. And they're very top level, which is not really that effective, but it's super as much less expensive as the personal protective equipment. So the art for a homeowner, a worker, somebody who's going to work in an office or a meatpacking plant, or for a landlord or for a lender or for a school, is balancing all those things in a beneficial benefit, cost manner.

So post pandemic across all different types of workplaces, hospitals, stores, restaurants, factories, offices, are there some baseline standards of operation that can be applied with regard to air quality, water quality to ensure that workers stay safe?

Well, safe is relative. There's nothing that's absolutely safe, but there's certainly aspects of relative safety and comfort. One of the things that we write about in the book and still talk about now is the difference between what are the minimums that might be set by building codes or by standards like the ashrae, American Society of Heating and Refrigeration Engineers, minimum standards for ventilation, for particulates, for water quality, and what is in a sense a sort of a best practice that's not crazy expensive. Like we don't have to all drink, distilled water, but we also don't want to be drinking out of the puddle. So there are lots of pieces like that where lots of individual entities will be responsible for this. What's really changed in the last five years is the ability of individuals to measure these things. So if you thought about indoor air quality five or 10 years ago, you need to get an industrial hygienist to come in with a big machine. They go off to the lab, they measure stuff, they come back a week later, and the information just goes to the facility manager or the big boss. Well, today you can go on Amazon or some other site and get 10 different very good personal air quality monitors that measure on a real time, continuous basis, humidity, temperature, particulates, carbon dioxide, volatile organic compounds, and some other characteristics that leads to tremendous consumer knowledge and democratization of information that didn't exist before.

Yeah, the power dynamics are a little.

Bit tricky here, though, because lots of companies rent their space, especially when you're a small tenant. How do you persuade your landlord to invest in these things? As an employee, how do you make the case to your employers there will be demand, surely, but how do we make sure that that translates into action?

I think the power dynamics are really tricky. It's a great question because you can imagine the democratization of the whole system where individuals measure the air quality. Maybe they tie their Fitbit or their Apple Watch or their other health indicator to the air quality. Then you can imagine a group of, say, the people in, for example, in New York, the workers who still are employed, going to negotiate with their landlord. And you're already reading about 10 or 20% rent cuts. You can imagine a deeper one. Or that the commercial tenants or the residential tenants who still can pay their mortgage, having a lot more negotiating leverage. So you can imagine the individuals doing that. You could also imagine a very large landlord, like one of the big real estate investment trusts that owns, that manages 20 or 30 million square feet, saying, we are going to be the demonstrably cleanest landlord anywhere. And if you come to our shopping malls or our apartments, here's the the dashboard we're giving you in real time every day to show what is the situation with the air quality, the water quality, some of the safety and things like that in our building, and it's our selling point. Or you can imagine a very large tenant, like the General Services Administration, the largest tenant in the US saying, we're going to measure this.

So how much of this requires government regulation and intervention versus the people who own the properties, Whether it's Real estate companies or employers themselves deciding to invest in improvements and redesign buildings on their own.

So a lot of what I teach at HBS is around financing of infrastructure and things that we sort of wish all governments would do, that the governments would tax us properly and build out roads and producing water and power. And that's done on the basis of consensus for the good of all of us. However, if government fails to do that, then who is going to? And the question of whether there'll be another Yelp or Kayak or somebody like that, or Trip advisor who figures this out or whether there'll be a big landlord who figures this out is open. I think it's unlikely that there would be any kind of political or science consensus in the United States about a federal standard with enforcement for indoor air quality. However, you can certainly imagine a group of colleges, a group of hospitals, a group of office landlords, a group of apartment landlords all together saying we're going to do this for one standard. And you see this in other industries anyway. Underwriters Laboratory is a good example of electrical industry getting together to say we're going to solve self regulate ourselves to make sure that this stuff works. So I personally think it's more likely to happen through some kind of voluntary rating program that's analogous to LEED or green buildings or some of these other things that are used where entities opt in and say our trade association is giving us the imprimatur. And there are various rating systems for healthy buildings. One is called well, another is called Fit well, the US Green Building Council has one also.

So let's assume that landlords and employers.

Want to do this.

How much of it can be done through improving existing structures versus designing and building better spaces from the ground up?

Of course, that is the question of the hour or of the decade, because buildings last a very long time. It's not like how long will it take to move out all the the Windows 7 machines in the world? Or how long will it take to get catalytic converters on cars? Which takes 10 or 20 years. The age of the fleet of buildings can be hundreds of years. So people will say anecdotally now that 70% of the buildings that will exist in New York and 2100 exist today. So buildings last a very long time. The retrofit question becomes a big deal. It happens that most of the buildings built before about 30 or 40 years ago are pretty drafty anyway. So a lot of the modern buildings are tougher. Where people have said we're going to keep all this air inside. And we're going to fight the sun and fight everything else with mechanized systems. For the most part, buildings can do quite a bit more ventilation just by running the fans more and changing the filters more. There also are options like ultraviolet treatments. And there are lots of discussions about whether you treat the ductwork or maybe in a conference room, you treat the high air because the eyes don't want to see ultraviolet. Plus it's expensive or ionization, plus it's do that in certain points. You might imagine a sports arena or someplace like that doing that. It also leads to kind of a have and have not. So if you think about, say, in the commercial real estate world, the big owners who have hundreds of buildings or thousands of buildings tend to also be pretty well capitalized, not have a lot of debt. And they have very good internal groups of multiple people who can do research on these issues and they can go out and invest in those buildings and then attract the tenant. And, and we wrote a case study about 425 Park Avenue in New York, the first office building in Park Avenue in 60 years. It's claimed to be the healthiest building in New York. And the claim the landlord made is in the up market we'll get a rent premium. In the down market, we'll get the tenant, and that will remain to be seen. So then the question becomes, what happens to the B and C buildings? Like, it's one thing have a building on Park Avenue that could get $200 a square foot for rent. It's another if you're a mom and pop landlord out in the suburbs somewhere and you have a $20 a square foot building with two dentists and two law firms and dentists haven't paid their rent in two months, it could be really difficult to keep those buildings alive. And so there's likely to be sort of a shakeout in the office building space the way there obviously is in retail and in hospitality.

Yeah.

It seems with, you know, so many businesses closing during the economic downturn, so many companies cutting their office space requirements, as people have realized remote work is long term possibility, there will be a huge contraction in the commercial real estate industry At a time when we're saying, oh, but you need to improve these buildings so that they're safer. So how is that going to work?

Well, nobody knows if I knew that investing in that. There's also an argument that the firms who take space will want more space because they want people to be separated. And it could change the housing or apartment industry. Both in cities where People say, oh, I guess I need to have a Zoom studio forever. Our sense in the United States is the cities that are the winner, cities like New York and Los Angeles and Miami and Washington will continue to attract people. The lesser buildings will struggle, which is part of the natural business cycle anyway. What's interesting is that some of the tier 2 and tier 3 cities may be way more attractive. So a Cincinnati or a Denver or a Charlotte looks a lot more attractive to people if they're thinking about, I don't really need to be in the total business center. I'd like to see people occasionally. I'd like to live outside in the suburbs. So it changes that equation.

Yeah, you talked about the haves and the have nots, and certainly all tenants might be in a better position to advocate for changes. But I do imagine a world where the Apple and Facebook and Google campuses already incorporate all of this stuff and they have the most healthy workplaces in the world, whereas people who are working in fast food chains or emerging market factories won't have any of that. So how do we make sure this spreads beyond the wealthy companies who can.

Afford the best buildings?

Sure, the propagation of these ideas matters a lot. And you mentioned some of the big tech companies. They also are already aware of the impacts on cognition that I talked about at the very beginning. So the new Apple headquarters designed by Norman Foster, who also designed the 425 Park Avenue, was extremely aware of those healthy building aspects as well as daylight seeing nature outside and things like that. When you have that kind of workforce you're trying to attract, when the workforce has a lot of choices and when you want them to be at least in a physical position where they can be as productive as they can be based on their own motivation and their own skills, then it's really appealing to those big employers and they tend to be really thoughtful about that to begin with, as do the big law firms, investment banks, so forth. Propagating out to others is a second issue. So you can imagine big manufacturing companies like a Nike might want to look back into the supply chain, look not just at the life safety, but also the health of some of these workers. Beyond that, you're getting in the realm where it's pretty to think so, but hard to imagine that companies are going to care that much deeply back into their supply chain about how people are treated. So that would then mean that some sort of either industry or government regulation would make sense. And for many of these governments, they get other things on their mind around the immediate starvation or immediate issues in climate change or immediate issues in recession before they're thinking about healthy buildings.

Do you find that this case that.

You were trying to make pre pandemic about the importance of these investments and how they can increase productivity and all of that, is it just such an easier sell now with the employers and real estate companies that you talk to?

Yes, it's sort of a two level question. People want to make the change in the shorter term. And certainly everywhere you looked in the last three or four months, everybody's saying my building is healthier, my airline is healthier, my hotel is healthier. We get all these emails from people about how healthy we are, but that was a response to the initial condition. Then the second thing they're asking us about now is, okay, what's the enduring thing? We've responded. We what if we say at this level of community spread for a long time, what if it goes away? What do we do? So there's a chance to think about what are the longer term implications. A lot of the short term reactions have been around the administrative controls, around only half the people can come in each day, or we're going to stay six feet apart, one person in the elevator, or we're going to do a lot of cleaning and sterilization. And in the longer run they'll say that's pretty expensive. What can we do about thinking about fans, ultraviolet ionization, things like that?

What are the key metrics that people want to be tracking as they go back into offices and workplaces of a different sort?

There's a series of things to be tracked and they're health performance indicators and they're similar to key performance indicators. What gets measured gets done, of course. And the health performance indicators that can be measured are partly in the building and partly in the people. The objective is not really to have healthy buildings. The objective is to have healthy humans. But there's a range of ways in which these are measured. There are really six things. They're alliterative. I wish I had a better six level way to talk about it. But they're around settings and screening and sensors and standards and surveys and statistics. So one is around settings and that would be in the building, like, okay, what's the temperature set for? The second is around screening. And you can imagine screening, say if you walk into lots of retail stores right today, they'll take your temperature. It's not necessarily a great screen, but it's a way to screen. Or in a lot of universities they will make you do a swab test or a spit Test or something like that to screen you for Covid. There are multiple flavors of sensors. Whether it's sensors on humans, like taking your temperature or measuring your blood oxygenation or something like that, or in the building measuring the particulates, measuring the CO2, or all those kind of things can be reported on in real time if somebody wants to see the dashboard. There are standards, and that's part of what we talked about earlier. There aren't really standards for what a building should look like. Beyond meeting the building code and the minimum heating and ventilating code, we think that there will be standards arising from a number of self governing industry groups in the United States. There are surveys and surveys range from me having to fill out Crimson Clear before I go into a Harvard building. Do you have symptoms? No. Have you been with somebody who has symptoms? No. Have you had Covid tests?

No.

But surveys also include, were your colleagues socially distancing? Was somebody sneezing on you? Are they staying six feet away? Do you feel comfortable in the work? Do you think that the place feels clean? And if I had electrosurgery a while ago and part of the survey was, did you think that the facility was up to your measure of cleanliness? And finally, there are statistics, all those aspects of settings, screening, sensors, standards, surveys and statistics are how the health performance indicators can get measured. And they're the ways in which an individual or a group of individuals or workers, or a tenant company or a landlord company, or a school, or the military or hospital or the government could all elect to evaluate the building and the people in it as they were trying to find the best cost benefit way to go through the hierarchy I described before.

So I know that a lot of us are just hoping for a return to normal, but it seems like what you're suggesting is that there won't be that in the workplace. So I'd love to just have you predict what you think various places of work will look like in the future. For example, what might a nursing home look like in terms of protecting the residents who are paying for it to operate and then the workers who are coming in and out every day.

The two biggest differences would be around one, around the normal rules that will apply, like masking and hand washing, and the other is around the pay for the healthcare workers because many of these people are paid so little that they have two or three jobs and they wind up having to go back and forth to different facilities and they can't afford to miss a day's work and not get paid. So whether that Happens in publicly run things like Veterans Administration ones or not. Certainly the elite ones. Like there are plenty of elite retirement communities in Massachusetts and they've all thought about this and they weren't among the ones who were hit so far. So once again you get this further divide between haves and have nots that combines with your financial status and how much you have to be exposed to working coronavirus.

All right, now let me give you another scenario. What about a hotel that has restaurant and retail? How does that look different going forward than it did in the past?

I think that's a market question more than a Covid question. So it has to do with the comfort of the people. Would you be comfortable going with your family and sitting in a going to the buffet in a hotel right now? Probably not, no. Yet the hotel people will tell you that we totally fumigated your room and nobody's been there for three days and it's safe and we'll give you a pre made meal. Please come. But assuming that those entities do what they say they're going to do, it becomes a question of the demand. And as a tourist, are you comfortable? And then the second question is around business travel. So with a global recession, there's less need for business travel, there's less business, and in particular with the quite big success of some online conferences in various online platforms, you can imagine a significant decline in business travel. So I think it's more a question of market and business travel and are people comfortable doing discretionary travel and less a question of can a restaurant or a hotel be made safe? Yes, it can be made safe.

Okay. And final question. What does the office of the future look like? The law firm, the publishing house, the accountancy, the design firm.

I don't see in the long run that looking that different than it has historically. There may be bigger cubicles, there may be ventilation over your cubicle, but largely people will be washing hands and wearing masks in the bathroom will look different and the food condition will look different. But a lot of those are things that people kind of should have done anyway. So I think that's a question of demand also because for all the entities you just mentioned that you don't need a big law library anymore. You don't necessarily need to meet face to face with people. You don't have to spend all day getting to New York for two hour meeting and coming back. People's comfort with remote work and a decline in general economic activity I think will drive the answer to those questions more than the health concern. Because health concern can be managed.

Terrific. Well, thanks so much for talking with us today.

Thank you. I really enjoyed it.

That's John Machamer, senior lecturer at Harvard Business School and the co author of the book Healthy How Indoor Spaces Drive Performance and Productivity. This episode was produced by Mary Duke. We get technical help from Rob Eckart. Adam Buchholz is our audio product manager. Thanks for listening to the hbr ideacast. I'm alison beard.