Evidence Of Respiratory Infection Transmission Within Physician Offices Could Inform Outpatient Infection Control

Health Aff (Millwood). 2021 Aug;40(8):1321-1327. doi: 10.1377/hlthaff.2020.01594.


Early in the COVID-19 pandemic, outpatient clinics throughout the US shifted toward virtual care to limit viral transmission in the office. However, as health care facilities have reopened, evidence about the risk of acquiring respiratory viral infections in medical office settings remains limited. To inform policy for reopening outpatient care settings, we analyzed rates of potential airborne disease transmission in medical office settings, focusing on influenza-like illness. We quantified whether exposed patients (that is, those seen in a medical office after a patient with influenza-like illness) were more likely to return with a similar illness in the next two weeks compared with nonexposed patients seen earlier in the day. Patients exposed to influenza-like illness in the medical office setting were more likely than nonexposed patients to revisit with a similar illness within two weeks (adjusted absolute difference: 0.7 per 1,000 patients). Similar patterns were not observed for exposure to urinary tract infection and back pain as noncontagious control conditions. These results highlight the potential threat of reopening outpatient clinics during the pandemic and the value of virtual visits for patients with suspected respiratory infections.

MeSH terms

  • COVID-19*
  • Humans
  • Infection Control
  • Outpatients
  • Pandemics
  • Physicians' Offices
  • Respiratory Tract Infections* / epidemiology
  • Respiratory Tract Infections* / prevention & control
  • SARS-CoV-2