40% of Health Facilities Failed Bird Flu Preparedness Drill

A drill running between January and June 2026 sent actors to 73 healthcare facilities to test bird flu preparedness. Most were in New York City (52), with 15 elsewhere in New York state, three in New Jersey, and three in the US Virgin Islands, which the US groups into the same health region as the others.

Actors primarily visited emergency departments (42 of 73), but also hospital outpatient clinics (19 of 73) and urgent care centers (12 of 73). The facilities had agreed to participate in the drills but were not told when the visits would occur.

Failing Grades

Overall, only 60 percent (44 of 73) of the facilities both masked and isolated the actors. Roughly 55 percent of emergency departments did both, while 68 percent of clinics and 67 percent of urgent care centers passed. Eighteen percent of facilities did not offer a mask to the coughing patient who reported having a fever.

Of those that masked and isolated, fewer than half (43 percent) did so within the one-minute goal, and less than half (48 percent) moved the patient to an isolation room within the 10-minute goal. Outpatient clinics had a median time to isolation of 20 minutes, with at least one clinic taking nearly an hour. Overall, the median time to masking was 2 minutes, and the median time to isolation was 11 minutes.

Most facilities (93 percent) screened the actor for symptoms. However, staff at only seven of the 73 facilities asked questions specific to bird flu exposure.

Clinicians interacting with the actors inconsistently wore recommended personal protective equipment — gloves, mask, gown, and eye protection. Only 25 percent wore all recommended PPE, while 6 percent wore none. Nineteen percent of clinicians did not wear a mask or respirator at all. Staff at only 40 of the 73 facilities (55 percent) notified or planned to notify internal Infection Prevention and Control (IPC) staff, as recommended.

The poor pass rate and lengthy response times point to a significant vulnerability. “Health care facility waiting areas can be high-risk settings for transmission of respiratory viruses if appropriate IPC measures are not implemented,” the authors noted.

These results may also overestimate actual preparedness. Not all facilities invited to participate agreed to do so, and those that declined may have scored even worse. Additionally, while the drills were unannounced, some facilities may have received an informal heads-up, which could have artificially improved their results.