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Part 1 of 2: Understanding the Impact

Part 1 of 2: Understanding the Impact

Navigating the “Tripledemic” in the ICU

Respiratory virus season has arrived — and, with it, a slew of challenges for patients and healthcare providers alike. While seasonal viruses are nothing new, the current “tripledemic” threat of influenza, respiratory simplex virus (RSV) and Covid-19 could pose new and elevated challenges.

A Rising Concern

In a recent Becker's survey, 75% of respondents noted “some level of concern that this virus season will strain resources and capacity at their hospital or health system.”1 Early indicators support cause for concern:

  • According to the CDC, the amount of respiratory illness (fever plus cough or sore throat) causing people to seek healthcare is elevated or increasing across most areas of the country2
  • Emergency department visits for Covid-19, flu and RSV all increased in November3

What could a heavy respiratory virus season mean for your patients and staff?



Impact on Staff

ICUs often face significant, albeit predictable, levels of strain during winter months.4 While impacts vary by season and by community, common challenges include:

Higher Patient Loads

As hospital admissions and ICU transfers increase, Registered Nurses can face the critical challenge of supporting higher patient-to-nurse ratios. While Certified Nursing Assistants and other aides are essential care team members, their training doesn’t cover everything an RN can safely do.

Floating Between Units

Some health systems may be able to reallocate nursing staff from other departments during this season. While this is a good option for some hospitals, it may require training and learning curves before these team members are performing at their usual capacity in a new setting.

Absenteeism and “Presenteeism” Due to Staff Sickness

As in any workplace, employee absenteeism due to seasonal illnesses can affect staffing levels and overall productivity. Presenteeism (working while ill) can also affect productivity, along with introducing a host of other concerns.5


Impact on Patients

Patients and community members, of course, face their own challenges during this season.

Shortage of Available Beds

As hospitalizations increase, bed shortages often become issues — and this impacts transfers, as well. A 2018 study showed that inability to accept and/or transfer patients was a challenge during flu season even before Covid-19 entered the scene.4

Risk of Healthcare-Associated Infection

While influenza is primarily a community-based condition, the CDC notes that healthcare-associated influenza infections can occur in any healthcare setting — and they are most common when influenza is also circulating in the community.6

Potential Equipment & Medication Shortages

While healthcare organizations constantly monitor flu and other virus levels in the community and adjust resources accordingly, the risk of shortages remains. Shortages of resources like mechanical ventilators and medications could impact patients’ care.4


How Can Hospitals Prepare for This Virus Season?

There are many ways for healthcare providers to prepare for respiratory virus seasons — ranging from community-based initiatives to equipment planning.

Promote Influenza and Other Vaccines

The CDC states that immunization against flu, Covid-19 and RSV remains the best way to safeguard against hospitalizations, long-term health impacts and death.7 For the first time ever, immunizations are available for all three of these conditions (for groups eligible for RSV immunization).7


Stay Up-to-Date on Clinical Guidance

Keep your teams current on the latest flu, Covid-19 and RSV clinical guidance for different populations, including patients who have risk factors for severe respiratory illness. The CDC offers guidance regarding testing, treatment and vaccinations.8

Inventory Your Equipment

Now is the time to take stock of your current equipment levels. If you are preparing for a surge in ICU admissions, that may include respiratory therapy devices, along with ICU beds with specialized features supporting pulmonary health, early mobility and skin protection. (We’ll dive into key features to look for in part two of this series.)


While this year’s respiratory virus seasoning may be challenging, advance planning can make a significant difference for patients and staff alike. Stay tuned for part two of this blog, where we will offer a checklist to help you prepare your equipment fleet to meet the challenge.



  2. Accessed December 11, 2023.
  3. Accessed December 12, 2023.
  4. Lane CJ, Bhatnagar M, Lutrick K, Maves RC, Weiner D, Rios Olvera D, Uyeki TM, Cobb JP, Brown JC. ICU Resource Limitations During Peak Seasonal Influenza: Results of a 2018 National Feasibility Study. Crit Care Explor. 2022 Jan 5;4(1):e0606. doi: 10.1097/CCE.0000000000000606. PMID: 35018345; PMCID: PMC8735785.
  5. Blanchet Zumofen MH, Frimpter J, Hansen SA. Impact of Influenza and Influenza-Like Illness on Work Productivity Outcomes: A Systematic Literature Review. Pharmacoeconomics. 2023 Mar;41(3):253-273. doi: 10.1007/s40273-022-01224-9. Epub 2022 Dec 14. PMID: 36515814; PMCID: PMC9748403.