about it and they are sitting in a hallway for three days. Hopefully not. That investigation of that exposure is not one that I think we do as routinely as you would say a pertussis, or a TB, or a varicella, it doesn’ t ring a bell. It should. You could argue what interventions, what symptoms to follow up on, maybe they’ re high-risk patients and you would have broader prophylaxis.”

Passetti noted,“ We do prophylaxis with Tamiflu when we have a number of hospital-onset flu cases. We have some facilities that offer single patient rooms and some that have multi-patient rooms. It’ s a bit of a case-by-case decision because it has to be more than just infection prevention to do Tamiflu prophylaxis. The bedside physician needs to address it and it’ s more dependent on the situation in most of our area with more likelihood in higher-risk areas to do Tamiflu prophylaxis.”

Talbot next asked panelists about patient placement when they come into ERs and other waiting rooms with acute respiratory infection syndrome, what panelists did in a“ high-snot environment.”

“ We’ re fortunate to have single-patient rooms which is a patient safety issue as well as a family enjoyment issue,” Nyquist said.“ We do have information about how we cohort patients and when we have a huge flu or RSV surge, we cohort like symptoms unless we have information that someone has pertussis. We work with the families; two patients in a room, two kids with RSV, how do we ensure that the families aren’ t interacting with the other child? And so we do cohorting based on symptoms and there are other nuances if we know what the virus is.”

Talbot then asked,“ Do you track if you have a secondary viral infection because we put two syndromes together, is that a metric that IPC looks at?”

Nyquiest responded,“ We don’ t have shared rooms, so it’ s very rare. But in the past when we had a smaller hospital we actually did track that when we were cohorting and we didn’ t have an issue, fortunately.”

Talbot added,“ One thing that I think peds is better at is having separate waiting areas. When you come into a pediatric practice you have the‘ snot’ waiting area and the other waiting area.”

Nyquist agreed, noting,“ You try to do the best you can, but if someone’ s waiting in the emergency department for four hours, they’ re roaming around, and so it’ s really about trying to do sourse control as best as you can with kids who won’ t wear a mask. And also encourage the family members to wear masks. It’ s tough, but we get kids into exam rooms as quickly as possible so you don’ t have them in the waiting room.“

Talbot then switched gears.“ On the adult side, I think we don’ t do as good of a job [ at controling respiratory secretions ] because we are at capacity and the biggest thing is to mask the patient who comes in with symptoms, having at least some barrier of source control.”

The panel then turned to the topic of policies around healthcare workers returning to work after being ill, especially when data and regulations are variable.

“ I was on the HICPAC healthcare worker personnel guideline,” said Talbot.“ They developed some draft guidance, more of what we would call a‘ virus-agnostic’ approach that was well thought out and swas till on the CDC website as a draft recommendation and they published their evidence review about a year ago. At Vanderbilt, we recently moved to a policy of providing personnel with a certain

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28 • www. healthcarehygienemagazine. com • march-april 2026