A study published in the CDC's Morbidity and Mortality Weekly Report used unannounced drills with trained actors to assess how healthcare facilities handle a potential avian influenza case. Over six months, researchers conducted 73 drills at 69 emergency departments, outpatient clinics, and urgent care centers in New York, New Jersey, and the U.S. Virgin Islands. The actors reported flu-like symptoms and recent contact with sick or dead birds.
The results show that while many facilities had basic infection-control measures in place, performance fell short of targets. Patient actors were successfully masked and isolated in 60.3% of drills, but only 43.1% of facilities masked them within one minute and only 48.1% isolated them within ten minutes. Notably, 18% of facilities did not give a mask to an actor who was visibly coughing and reported a fever, and 19% of clinicians did not wear a mask or respirator during evaluations. Clinicians asked about avian flu-specific exposure in just 9.6% of drills.
The authors, led by Nang Thu Thu Kyaw of the New York City Department of Health and Mental Hygiene, say the drills identify practical gaps that written protocols may miss. They recommend training front-line staff such as receptionists, registrars, and security personnel to screen and mask patients early. The study also found that urgent care centers isolated actors in all drills, while emergency departments did so only 57.1% of the time, suggesting that all acute-care settings need robust screening and isolation protocols.