In the drill, which ran between January and June 2026, actors visited 73 healthcare facilities. Most were in New York City (52), with 15 in New York outside the city, three in New Jersey, and three in the US Virgin Islands (which the US considers part of the same health region).

Actors mostly 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 be part of the drills but didn’t know when they would occur.

Failing grades

Overall, only 60 percent (44 of 73) of the facilities both masked and isolated the actors. Only about 55 percent of emergency departments did both, while 68 percent of clinics and 67 percent of urgent cares passed. Eighteen percent of facilities didn’t offer a mask to the coughing patient who said they had 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 mask was 2 minutes, and the median time to isolation was 11 minutes.

Most of the healthcare facilities (93 percent) screened the actor for symptoms. But—despite the dead duck tale—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 the recommended PPE; 6 percent wore none. Nineteen percent of clinicians didn’t wear a mask or respirator. 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 the lengthy times spell trouble. “Health care facility waiting areas can be high-risk settings for transmission of respiratory viruses if appropriate IPC measures are not implemented,” the authors highlight.

These substandard results may also overestimate preparedness. Not all the healthcare facilities invited to participate in the drills agreed to do them—and those facilities that declined may have scored even worse. Also, although the drills were unannounced, some facilities may have had a heads-up, which could have boosted their results.