Tuesday, September 30, 2025

by Matt Baker, Staff Writer, Physicians Office Resource

Each fall and winter, respiratory viruses place significant demands on outpatient medicine. Primary care physicians, pediatricians, and urgent care providers are often the first point of contact for patients experiencing cough, fever, congestion, and other respiratory symptoms. In 2025, the convergence of influenza, COVID-19, RSV, and other viral pathogens is expected to once again increase patient load, stretch staff capacity, and test the preparedness of outpatient clinics.

By acting now, practices can position themselves to manage surges efficiently while maintaining high-quality care and protecting staff well-being. This article outlines evidence-based and practical steps to prepare your team, office, and workflows for the upcoming respiratory illness season.

1. Anticipating Patient Volume and Resource Needs

One of the most predictable aspects of respiratory illness season is unpredictability—some years see moderate case counts while others overwhelm clinics. A proactive staffing and supply plan reduces bottlenecks when demand spikes.

Staffing

• Cross-training: Medical assistants may need to help with swabbing, nurses may rotate into triage roles, and front desk staff may support patient education or vaccine scheduling. Investing in cross-training now ensures flexibility later.
• Contingency planning: Develop a system for temporary coverage in the event of staff illness. Consider part-time, per diem, or retired clinicians who can step in during peak demand.
• Flex scheduling: Evening or weekend hours can help decompress high-volume weekdays and improve patient satisfaction, particularly in urgent care.

Supplies

• Diagnostic tests: Stock rapid antigen kits for quick triage and molecular assays for confirmatory diagnosis. Multiplex panels (COVID/Flu/RSV) may be especially useful for pediatric populations.
• PPE: Even if mandates fluctuate, respiratory protection remains important. Keep a reserve of N95 or KN95 masks, gloves, gowns, and eye protection.
• Vaccines: Ensure your cold storage units have adequate capacity. Verify calibration and temperature monitoring systems to prevent spoilage.

Tip: Track usage patterns from prior years to better estimate order volumes. For example, if your pediatric office doubled flu vaccine doses last year, consider increasing orders early this season.

2. Optimizing Testing and Diagnosis

Rapid, accurate diagnosis benefits both patient care and clinic efficiency.

• Point-of-care testing (POCT) reduces delays in treatment decisions and minimizes unnecessary antibiotics. A child with confirmed influenza can start oseltamivir promptly, while a patient with negative results may avoid needless antibiotic exposure.
• Multiplex testing is increasingly important as symptoms overlap. In one swab, clinicians can distinguish among COVID-19, influenza A/B, and RSV, guiding isolation, treatment, and patient counseling.
• Triage algorithms help staff decide when POCT is sufficient versus when PCR confirmation or referral is warranted. Create clear flowcharts visible to both clinicians and support staff.

Case example: A 3-year-old with cough and fever presents at your office. A rapid multiplex test confirms RSV. Instead of prescribing antibiotics or escalating unnecessarily, your team provides supportive care instructions and educates the family about red-flag symptoms. This reduces downstream costs and builds trust with parents.

3. Vaccination Strategies

Vaccines remain the strongest preventive measure against severe respiratory disease.

Influenza

• CDC recommends vaccination for everyone over six months of age, ideally before the end of October. Encourage patients not to delay, even if flu activity appears low.
• High-dose and adjuvanted formulations should be prioritized for older adults.

COVID-19

• Updated boosters targeting current variants continue to be essential. Primary care physicians are key in addressing lingering vaccine fatigue and misinformation.
• Reassure patients about safety profiles and emphasize protection against hospitalization and long COVID.

RSV

• Pediatrics: Nirsevimab, a monoclonal antibody, is now available to protect infants under eight months, and certain high-risk toddlers.
• Adults: Recently approved vaccines for older adults should be incorporated into fall immunization planning, especially for those with COPD, heart disease, or diabetes.

Implementation Tips

• Use standing orders so nurses can administer vaccines without requiring physician approval for each patient.
• Offer co-administration (flu and COVID boosters at the same visit).
• Track uptake rates by age group to identify under-vaccinated populations in your practice.

4. Workflow and Infection Control

Maintaining safe and efficient office flow is essential when contagious illnesses peak.

• Cohorting patients: Designate specific exam rooms or time blocks for sick visits to limit cross-contamination.
• Telehealth: Retain telemedicine as a tool for mild symptom checks, prescription renewals, or post-illness clearance notes. It helps reduce waiting room congestion.
• Infection prevention: Retrain staff on proper donning and doffing of PPE, surface disinfection, and handling of contaminated waste.
• Air quality: Portable HEPA filters or upgraded HVAC systems can lower airborne viral load, particularly in pediatric offices where masking compliance may be variable.

5. Patient Education and Communication

Clear, proactive messaging empowers patients and reduces strain on staff.

Topics to Emphasize

• Prevention: Hand hygiene, proper cough etiquette, and masking in crowded settings remain effective.
• When to seek care: Provide criteria for home care versus urgent evaluation (e.g., shortness of breath, dehydration, persistent high fever).
• Return-to-school/work guidance: Parents especially appreciate written instructions on when children are safe to return.

Communication Channels

• Digital: Use EHR messaging, text alerts, and practice websites to update patients on vaccine availability or testing policies.
• Printed handouts: Distribute educational sheets at check-in or discharge.
• Community engagement: Partner with schools, daycares, and senior centers to share timely information.

Example: A pediatric practice can post weekly updates on flu vaccine availability on its Facebook page, reducing phone call volume to the front desk.

6. Clinical Management and Therapeutics

Beyond prevention, clinicians must be ready with evidence-based management strategies.

Antivirals

• Influenza: Oseltamivir remains first-line for high-risk patients; baloxavir offers single-dose convenience. Initiate therapy within 48 hours of symptom onset for greatest benefit.
• COVID-19: Nirmatrelvir/ritonavir (Paxlovid) is highly effective but requires screening for drug-drug interactions. Remdesivir remains an option for certain high-risk outpatients.
• RSV: Supportive care remains the standard, though hospitalization thresholds differ for infants and older adults.

Protocol Development

• Create standardized treatment pathways for common clinical scenarios. For instance:
• High-risk older adult with flu-like symptoms → rapid flu test → if positive, initiate antiviral immediately.
• COVID-positive patient with mild symptoms but CKD → consult protocol for Paxlovid contraindications and consider alternatives.

Antibiotic Stewardship

• Reinforce guidelines for avoiding unnecessary antibiotic prescriptions. Overprescribing increases resistance and offers little benefit for viral illness.

7. Data and Reporting Requirements

Accurate data tracking supports public health surveillance and helps clinics anticipate surges.

• Ensure your EHR is configured for automated reporting of COVID-19, flu, and RSV testing where required.
• Assign a staff lead to monitor state and local health department updates for outbreak alerts.
• Consider participating in syndromic surveillance networks, which can offer early warnings of community spread.

8. Supporting Staff and Sustaining Resilience

High patient volumes and long seasons can wear down even the most dedicated teams. Sustaining morale and resilience is critical.

• Regular check-ins: Short daily huddles keep communication open and allow staff to voice concerns.
• Mental health resources: Encourage use of employee assistance programs, peer support, or wellness apps.
• Recognition: Small gestures—lunch for the team, public acknowledgment of extra effort—help maintain morale.
• Break coverage: Ensure staff can take true breaks to recharge, especially during double shifts.

Conclusion

The respiratory illness season is inevitable, but its impact on your practice can be managed with preparation. By strengthening staffing plans, securing supplies, implementing efficient testing, promoting vaccinations, and communicating effectively with patients, outpatient practices can stay ahead of the surge. 

Primary care physicians, pediatricians, and urgent care providers are the backbone of community respiratory illness response. With thoughtful preparation, your practice can continue to deliver safe, timely, and effective care—even when waiting rooms fill and phone lines buzz. Ultimately, preparation is not just about logistics—it’s about protecting your patients, your staff, and the trust your community places in you.