Beyond the Room: Bed-Level Isolation as Surge-Capable Infrastructure for Pandemics and Disasters—A Conceptual Framework

Abstract The COVID-19 pandemic exposed a structural limit of hospital isolation infrastructure: airborne infection isolation and protective-environment rooms are fixed assets that cannot be multiplied at the speed of a respiratory surge, and the constraint is more severe in field hospitals after disasters. Pandemic workarounds (ward conversion, portable negative-air machines, and modular container construction) each addressed part of the problem at the cost of bed capacity, sustained containment, or deployment speed. This concept paper aims to synthesize the failure modes of room-scale isolation into a device-agnostic set of clinical and engineering criteria for deployable bed-level single-patient isolation with switchable pressure polarity, in-enclosure air-quality monitoring, and on-board between-patient decontamination. These criteria are summarized in a requirements matrix, and one illustrative implementation is outlined. The intended contribution is a framework to guide future design, testing, and evaluation, not a validated solution; no validation data are presented, and none should be inferred.