Best practices during RSV, flu and COVID-19 season

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Due to early and increasing activity of respiratory syncytial virus (RSV) and influenza in California and the U.S., as well as an uptick in COVID-19 cases, there is concern over the State’s hospital resources for both adults and children. In response, the California Department of Public Health (CDPH) has issued an Early Respiratory Syncytial Virus and Seasonal Influenza Activity Health Advisory in addition to an All Facilities Letter on Guidance for Response to Surge in Respiratory Viruses among Pediatric Patients.

Public health officials are requesting that health care providers take the following actions to reduce the number of emergency room and hospital visits.

Consideration should be given to the following measures:

  • Expand capacity to provide pediatric care services via in-person and/or high-quality telehealth services, particularly during mid-morning and mid-evening time periods when emergency department utilization traditionally increases.
  • Utilize high-quality remote care options (e.g., phone advice lines, video visits) supported by emergency department referral decision support for after-hours advice and consultation.
  • Offer and encourage timely COVID-19 and flu vaccinations for all eligible patients.
  • Identify appropriate high-risk infants/young children and contact to administer prophylactic palivizumab per guidance from the American Academy of Pediatrics as soon as possible.
  • Identify appropriate patients for early antiviral administration for influenza and/or COVID-19 to reduce risk of progression to severe disease, in accordance with CDC recommendations.
  • Encourage patients to receive seasonal influenza and COVID-19 vaccines and updated boosters, as appropriate.
  • Counsel patients to take everyday actions that can stop the spread of viruses, including masking; handwashing; covering coughs and sneezes; avoiding contact with the eyes, nose, and mouth; staying away from people who are sick; and staying home when sick.
  • Share and disseminate messages to parents and caregivers to increase education about viral respiratory illnesses, including: getting up to date on vaccination for influenza and COVID-19; supportive care at home; signs and symptoms concerning for severe illness; and when to seek health care.
  • Prepare for increased call volume and appropriate phone triage from patients, caregivers and potential referrals for respiratory infections and care.
  • Maximize efficiency by providing letters as needed for school or work to prevent emergency services from handling these requests.
  • Avoid referrals to the emergency department for testing unless the results are necessary to guide clinical care and decision making.
  • Work to increase access capacity to address potential rise in outpatient demand for care associated with increased seasonal viral infections.