9 tips physicians can adopt to beat the tripledemic threat this winter

As winter approaches, the healthcare community faces a significant challenge with the emergence of a potential "tripledemic," a term that encapsulates the concurrent spread of flu, RSV, and COVID-19. For those unsure about the meaning of tripledemic, it's a scenario where these three respiratory illnesses surge simultaneously, potentially straining healthcare resources. Historically, the flu has been a major contributor to seasonal illness, with the 2021-2022 season seeing 9 million cases. RSV also follows a seasonal trend, often peaking during the winter months. Meanwhile, a potential resurgence of COVID-19, propelled by new variants and a decrease in vaccination rates and mitigation measures, adds to the complexity of this winter's health landscape.

Despite the yearly PSA that encourages the public to get vaccinated as soon as possible, people still get sick in large numbers. This leads to many patients flocking to their local family or primary care physician when they feel unwell. 

If physicians have not prepared themselves or their staff for a presumably busier season, their practice can easily become overwhelmed with sick patients.  

To ensure they’re well-equipped for the tripledemic, primary care physicians at independent practices can take preventive measures to protect their patients and staff.

Physicians don’t want to wait until the last minute to prepare for the tripledemic. Use the following tips to prepare your practice for the flu, RSV, and COVID-19. 

The role of a physician during a pandemic or possible tripledemic is to facilitate vaccine education and publicize the effectiveness and safety of vaccines. It’s critical to advocate for flu, RSV, and COVID-19 vaccines each year as well as the RSV prophylaxis in all infants younger than 8 months who are born during the respiratory syncytial virus (RSV) season or are entering their first RSV season.

You can recommend 3 flu vaccines for your patients this season: Fluzone High-Dose Quadrivalent, Flublok Quadrivalent recombinant, and Fluad Quadrivalent adjuvanted vaccine. 

Since some patients may not like needles, offering the nasal spray instead of a flu shot may encourage adherence to this yearly vaccine.

In July 2023, the U.S. Food and Drug Administration (FDA) approved the medicine Beyfortus (nirsevimab-alip) to prevent RSV in neonates and infants in their first RSV season and children up to 24 months who are still susceptible to severe RSV during their second RSV season. This is recommended in all infants younger than 8 months who are born during the respiratory syncytial virus (RSV) season or are entering their first RSV season unless the birthing parent received an RSV vaccination at least 14 days prior.

Older adults are also susceptible to RSV, which is why the FDA approved the first-ever RSV vaccine shots for people ages 60 and up this past summer. 

The Centers for Disease Control and Prevention (CDC) now recommends that patients 6 months and older get the updated COVID-19 vaccine to lower their risk of acute severe COVID-19. The updated COVID-19 booster vaccines from manufacturers Pfizer, Moderna, and Novavax that specifically target the XBB.1.5. variant are now available for patients.

If your practice allows for it, consider keeping a good supply of all vaccines for these 3 viruses. This creates a one-stop shop for your patients to get all of their shots in one place. It may also help with their adherence to return to your practice for follow-up booster shots.

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Since the beginning of the SARS-CoV-2 pandemic, ample evidence has accumulated that the prominent transmission of respiratory infections is airborne. As such, improving air cleanliness should be at the top of your practice checklist.

You can ensure that the HVAC systems are updated with MERV-13 filters or better and that the fans on these systems are run 24/7. You can also open windows as appropriate to allow for the mixing of air and ensure sufficient air exchanges by investing in HEPA air purifiers.

A carbon dioxide (CO2) monitor is another key piece of equipment that can aid you in preventing or limiting sickness in your practice. 

Poor air quality in your practice allows for viruses — especially COVID-19 — to spread more quickly. Investing in a tool such as a carbon dioxide (CO2) monitor can help ensure you have good ventilation to lower the spread of viruses in your practice. These monitors can help identify high levels of CO2 and notify you of poor ventilation.

It is important to note while a CO2 monitor can be a helpful tool, you shouldn’t fully rely upon it for tripledemic preparation. CO2 monitoring may provide a false sense of security if your practice doesn’t have proper air exchange and your occupancy rates are low enough. Research reveals that COVID-19 strain SARS-CoV-2 is airborne and can stay in the air for several hours if your indoor space is not properly ventilated or filtered.

It’s essential to reinforce the importance of wearing masks to your patients during a tripledemic. This is especially true for COVID-19, as it is still a health risk that can lead to mild sickness and serious, long-term complications, such as long COVID.

The World Health Organization (WHO) reported that in a 28-day period from July 31 to August 27, 2023, there were over 1.4 million new COVID-19 cases, with more than 1,800 reported deaths.

While most public spaces, including medical facilities, have become lax on masking guidelines, the resurgence of COVID-19 cases and hospitalizations indicates the need for stricter masking guidelines. Physicians can avert illness in their practices by requiring patients and visitors to wear high-quality, tight-fitting masks in their facilities.

If patients come in without a mask, be sure to have some on hand, and have your front desk staff encourage them to wear one to protect themselves and others in your practice. 

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Running a practice may limit time with your patients, but it is crucial to ensure they’re well-informed about the tripledemic.

Since respiratory viruses like COVID-19, RSV, and the flu can share similar symptoms and COVID and the flu can occur simultaneously, patients may need clarification about what virus they have, leading to many questions and concerns about their health.

Take time to educate your patients by discussing the differences between the viruses, such as signs and symptoms, and what preventive measures they can take to limit their chances of getting sick.

As you know, respiratory viruses can spread through contact with surfaces. The flu virus can live up to 24 to 48 hours on hard surfaces, with COVID living for a few hours up to several days. Also, RSV can reside on hard surfaces for several hours.

Ensure your staff routinely cleans your practice, including the waiting room, check-in desk, and patient rooms— with disinfectants throughout the day. You can also hire a daily or weekly cleaning company that uses medical-grade disinfectants to clean your practice thoroughly.

It’s not uncommon for waiting rooms to fill up quickly during the colder months, allowing germs to spread. Be sure to space out seating in your practice’s waiting room, create a system where patients wait in their vehicles until it’s time for them to be seen, and ensure that you and your staff don’t leave patients in waiting rooms for extended periods.

Learn how to get patients to keep coming back. Learn what influences patient choices and behaviors in the 2023 Patient Perspectives report.

For patients who may feel uncomfortable visiting your practice to receive a COVID-19 test, share resources that can help them order free tests online. Since September, the government has allowed households to order up to 4 free test kits through COVIDtests.gov. 

These tests can benefit your practice as they limit the number of sick patients or those recently exposed to the virus in your waiting room and allow your patients to receive antiviral prescriptions without needing to set foot in the office.

You can also recommend at-home test kits for RSV and the flu to your patients, but make sure they know these tests are typically not free. 

To prevent the spread of the tripledemic COVID-19, flu, and RSV viruses in your practice, offer healthcare services virtually. Telehealth is a safer option for immunocompromised patients who are more susceptible to getting these respiratory illnesses and having severe complications.

The Centers for Disease Control and Prevention (CDC) offers free weekly reports on influenza and data tracking on RSV and COVID-19. 

As a healthcare provider, staying current on trends that could impact your region is essential. You can also contribute to data collection in your area by reporting patient cases of the flu, RSV, and COVID-19 to your local health department.

Learn how to create a seamless patient experience that increases loyalty and reduces churn, while providing personalized care that drives practice growth in Tebra’s free guide to optimizing your practice.