Avian Influenza Hospital Drills Expose Gaps in Masking and Isolation Protocols
Unannounced drills using professional actors posing as patients revealed that fewer than half of healthcare facilities achieved target times for masking and isolating individuals with symptoms of avian influenza A(H5). Conducted between January and June across New York City, New York state, New Jersey, and the U.S. Virgin Islands, the simulation exercise tested 73 drills at 69 healthcare facilities, according to findings published in the Morbidity and Mortality Weekly Report by Nang Thu Thu Kyaw, PhD, of the New York City Department of Health and Mental Hygiene, and colleagues. While 60.3% of the simulated encounters resulted in successful masking and isolation, only 43.1% hit the 1-minute target for masking, and just 48.1% met the 10-minute target for isolation.
Varying Performance Across Emergency Departments and Urgent Care Clinics
The drills exposed performance differences depending on the clinical setting. The New York University Standardized Patient Program managed the actor deployments across hospital emergency departments, outpatient clinics, and urgent care centers. Speed also varied widely by location. The median time to masking stretched to 5 minutes in urgent care centers, while the median time to isolation reached 20 minutes in outpatient clinics, as noted in the Centers for Disease Control and Prevention report. Overall, clinicians correctly identified the actors as being at risk of avian flu in 63.4% of the drills, but infection prevention and control staff were notified only 54.8% of the time.
Clinicians Fail to Screen for Avian Influenza Exposure
Although nearly every facility conducted symptom screening (93.2%) and gathered patient travel histories (79.5%), specific questioning regarding avian influenza exposure lagged severely behind. Clinicians asked about exposure history unique to avian flu in just 9.6% of the exercises. Researchers attributed this shortfall to screening protocols remaining optimized for travel-related illnesses rather than zoonotic pathogens encountered through animal contact. Inconsistent use of personal protective equipment undermined safety standards. MedPage Today reported that 18% of facilities failed to provide a mask to a visibly coughing patient reporting a fever, while 19% of clinicians did not wear a mask or respirator during clinical evaluations.
Involving Frontline Non-Clinical Staff in Rapid Response
The findings highlight that receptionists, registrars, greeters, and security personnel frequently act as the first point of contact for arriving patients. Researchers emphasized that expanding competency-based infection prevention and control training beyond clinical providers to include all public-facing staff members remains essential for cutting down delays in patient isolation during potential respiratory outbreaks.
Frequently Asked Questions About the Avian Influenza Drills
Which organizations and jurisdictions participated in the simulation exercises?
The drills were conducted by the New York University Standardized Patient Program across 69 healthcare facilities in New York City, New York state, New Jersey, and the U.S. Virgin Islands between January and June. Participating sites included hospital emergency departments, outpatient clinics, and urgent care centers within HHS Region 2.
What specific scenario did the professional actors present to healthcare workers?
Actors aged 20 to 28 presented symptoms and histories resembling avian influenza A(H5), including pink eye, fever, muscle aches, coughing, and general illness, while explicitly reporting no recent travel. When asked about sick contacts, they described attempting to rescue a sick duck, handling it without gloves, and having direct contact before the animal died.
What were the overall median times recorded for patient masking and isolation?
The overall median interval from patient entry to masking was 2 minutes, while the median time to complete isolation was 11 minutes. These figures fell short of the study targets of 1 minute for masking and 10 minutes for isolation.
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