CDC Study Reveals Bird Flu Drills Involving Actors

Unannounced drills using professional actors posing as patients were conducted at 73 healthcare facilities across New Jersey, New York, and the U.S. Virgin Islands. The CDC published the findings Thursday, detailing exercises conducted between January and June 2026.

Healthcare Facilities Achieve Sixty Percent Masking and Isolation Success

Conducted between January and June by the New York University Standardized Patient Program, the evaluation tested 73 unannounced drills across emergency departments, hospital outpatient clinics, and urgent care centers. Nang Thu Thu Kyaw, PhD, of the New York City Department of Health and Mental Hygiene, and colleagues reported that patient actors were successfully masked and isolated in 60.3% of the simulations. However, adherence to strict operational timelines fell short. Only 43.1% of drills achieved the target time of 1 minute for masking, while 48.1% hit the 10-minute target for patient isolation, according to medpagetoday.com. Overall, the median time to masking was 2 minutes, and the median time to isolation reached 11 minutes. Masking occurred in 82.2% of drills, with a median time of 2 minutes. Patient actors were isolated in 71.2% of drills, with a median time from entry to isolation of 11 minutes.

Clinicians Rarely Asked About Avian Influenza Exposure During Drills

While almost every facility conducted symptom screening at 93.2% and clinicians gathered travel histories in 79.5% of drills, specific questions regarding avian influenza exposure occurred in just 9.6% of exercises, cdc.gov reported. This discrepancy suggests that screening protocols built for travel-related illnesses may not be fully adapted to zoonotic pathogens. Non-clinical personnel frequently drove the initial intake process. Security or reception staff members performed symptom screening in 52.9% of drills and provided masks in 64.4% of exercises, demonstrating that receptionists and registrars serve as vital front-line barriers during infectious disease outbreaks.

Regional Drill Distribution in the Virgin Islands

Because the U.S. Virgin Islands data was combined with results from New York and New Jersey, federal reports did not disclose individual facility performance or name the local sites involved. Participating facilities received post-drill reports and debriefings following each simulation, providing local coordinators with direct feedback on their operational readiness.

Inconsistent Personal Protective Equipment Usage

The evaluation identified notable gaps in the practical application of infection prevention and control measures. Nearly one in five facilities, or 18%, failed to provide a mask to a patient actor who arrived visibly coughing and reported having a fever, cdc.gov noted. Additionally, 19% of clinicians neglected to wear a mask or a respirator while performing clinical evaluations. Compliance varied significantly by setting, as emergency departments maintained a 95.2% availability of waiting area masks compared to just 57.9% at outpatient sites. Urgent care centers recorded the longest median time to masking at 5 minutes, while outpatient clinics registered the longest median time to isolation at 20 minutes.

Questions About Avian Influenza Simulation Drills

How were the simulation drills conducted without alerting staff?

The New York University Standardized Patient Program deployed professional actors aged 20 to 28 years old into participating facilities without prior warning, allowing researchers to evaluate real-world responses during ordinary day-to-day operations, medpagetoday.com reported. Patient actors self-reported avian flu-like symptoms and described direct contact with a sick duck without wearing gloves, shifting the focus away from traditional travel-based screenings. If asked about sick contacts, actors would ask, “Does a sick bird count?” and explain they handled a sick duck without gloves before it died. If staff did not ask about sick contacts, actors were told to disclose the bird exposure to the clinician anyway.

What specific limitations affected the study results?

Researchers noted that a relatively small number of hospital outpatient and urgent care center drills limited the broader generalizability of the findings, cdc.gov reported. Patient actors could not physically exhibit all signs of avian influenza, such as conjunctivitis or actual fever, which may have influenced how clinicians formed their initial differential diagnoses.

Did Puerto Rico participate in the regional evaluation?

Participating facilities had previously volunteered for the program, and facility coordinators received a one-page educational handout on avian influenza after scheduling the drill.

Trained Actors Reveal Real Time Responses During Surprise Visits

Kyaw told MedPage Today that sending trained actors into facilities without warning “captures how frontline teams — including non-clinical staff — respond in real time to identify practical strengths and gaps.”