The 2025–2026 Flu Season: What Hospital Emergency Managers Need to Be Ready For

Seasonal influenza is a predictable hazard—but its operational impact on hospitals is anything but routine.

As the 2025–2026 flu season approaches, hospital emergency managers must once again prepare for sustained strain on capacity, staffing, and critical services. Unlike short-duration disasters, influenza presents a slow-burning, high-consequence threat that tests continuity planning, command structures, and interdepartmental coordination over weeks or months.

For hospital emergency managers, this flu season is less about if you’ll activate response mechanisms—and more about how early and how effectively.

What We’re Seeing So Far

For 2025–2026, public health surveillance and modeling suggest that influenza activity is starting to increase earlier than typical in some regions, particularly due to influenza A(H3N2) viruses. The CDC recommends seasonal flu vaccination for everyone aged six months and older—reinforcing that vaccination remains the best tool for reducing severe flu outcomes. The flu vaccine for the 2025-2026 season is a trivalent vaccine targeting H1N1, H3N2 (Type A), and B/Victoria lineage.

Seasonal Influenza as a Healthcare System Stress Test

Recent flu seasons have reinforced a key reality: influenza alone can push hospitals into crisis operations, even without a concurrent disaster. High ED volumes, increased admissions, ICU boarding, and workforce absenteeism frequently converge at the same time.

For emergency managers, influenza should be treated as a predictable surge event, similar in planning for mass casualty incidents—but with extended duration and cumulative impacts.

Operational considerations include:

• Sustained ED crowding and ambulance offload delays

• Increased inpatient length of stay

• ICU and step-down bed saturation

• Supply chain stress (PPE, antivirals, respiratory equipment)

• Staff illness and burnout impacting staffing ratios

This is where early situational awareness becomes critical.

Surveillance and Triggers: Moving from Awareness to Action

Hospital emergency managers play a central role in translating surveillance data into operational decision-making. Waiting until inpatient units are overwhelmed is too late.

Key actions for 2025–2026:

• Partner with infection prevention and quality teams to monitor flu-like illness trends in the ED.

• Track daily metrics that matter operationally:

  • ED wait times

  • Admission holds

  • ICU occupancy

  • Staff sick call rates

• Establish clear activation triggers for:

  • Hospital incident command system (HICS) partial or full activation

  • Surge staffing plans

  • Deferment of elective procedures

Hospitals that define thresholds before the season gets into full swing respond faster and more cohesively.

HICS Activation and Incident Management

Influenza response often suffers from under-activation—managed “in the background” until the system is stressed. Hospital emergency managers should normalize using HICS for flu response, even at a monitoring or limited activation level.

Best practices include:

• Assigning an incident commander or operational lead during peak weeks

• Using the planning section to forecast bed demand and staffing needs

• Leveraging Logistics to track PPE burn rates and supply shortages

• Documenting actions and decisions for regulatory and after-action purposes

Flu response may not look dramatic—but it benefits greatly from formal command and coordination.

Surge Capacity and Continuity Planning

The 2025–2026 flu season should prompt a fresh review of surge and continuity plans, especially given ongoing workforce challenges.

Emergency managers should assess:

• Alternate care space readiness (converted units, PACUs, observation areas)

• Cross-training strategies for nursing and support staff

• Use of crisis standards of care decision frameworks, if applicable and necessary

• Coordination with regional healthcare coalitions for load balancing and mutual aid

• Ensure you’re registered for the PA HPP Mighty Pro system as well as your Juvare account activated and functional.

Flu surge planning is also a business continuity issue, impacting revenue, patient throughput, and staff retention.

Workforce Resilience: The Hidden Vulnerability

One of the most significant operational risks during flu season is staff absenteeism, both from illness and fatigue.

Hospital emergency managers should work with HR, nursing leadership, and occupational health, too:

• Anticipate staffing shortfalls during peak flu weeks (historically, February)

• Ensure clear policies for staff illness, return-to-work, and PPE use

• Support vaccination campaigns for staff as a resilience measure

• Integrate staff wellness considerations into response planning

A hospital cannot surge beds without a workforce to staff them.

Communications Inside the Hospital

Clear internal communication is often the difference between controlled surge and chaos.

Emergency managers should help ensure:

• Leadership receives consistent, data-driven situation updates

• Unit leaders understand current surge posture and expectations

• Messaging to frontline staff is transparent and operationally relevant

• Rumors and misinformation are addressed quickly

Influenza response succeeds when staff understand the plan and trust leadership decisions.

Planning for Overlap: Flu Is Rarely Alone

The 2025–2026 flu season will likely overlap with other respiratory threats, including RSV and COVID-19. For hospital emergency managers, this reinforces the need for all-hazards respiratory surge planning, not virus-specific silos.

Plans should account for:

• Shared isolation capacity

• Competing demands for respiratory equipment

• Diagnostic testing bottlenecks

• Compounded staffing impacts

Final Takeaway for Hospital Emergency Managers

Seasonal influenza may be familiar, but its operational impacts remain profound. The 2025–2026 flu season is an opportunity for hospital emergency managers to demonstrate the value of preparedness, coordination, and structured incident management. In many ways, flu season is the annual readiness exam for hospital emergency management programs—and preparation now will pay dividends when patient volumes peak.

Author: Charles “CJ” Sabo, MPH, CHEP, EMT-B, Manager, Emergency Management