COVID-19 made the weaknesses in our pandemic preparedness at national and global levels painfully clear. But a new study highlights that even at the first, local steps of an outbreak with pandemic-potential, we are worryingly underprepared. Health officials in New York set up a regional test of healthcare facilities to identify and respond to a patient with a mystery infection that could pose a pandemic-level threat.
But things didn’t go well. Overall, responses were slow, appropriate use of personal protective equipment was spotty, and only 60 percent of facilities passed the basics of the test—an overall failing grade. The drill centered on “professional patient actors,” who staggered into healthcare facilities feigning expected symptoms of an H5 bird flu infection—a virus type thought to have pandemic potential.
The actors wore makeup to look unwell, used eye drops and petroleum jelly to mimic having conjunctivitis (aka pink eye), and had a fake cough. They complained about feeling weak and feverish and reported taking a Motrin (fever reducer) before coming in. When questioned, they said they hadn’t traveled out of the country and, if asked about any sick contacts, would respond, “Does a sick bird count?” They would tell a sad tale of trying to save a sick duck they found in a park.
In the story, the duck doesn’t make it, and the now-ill patient didn’t wear any gloves while handling it. The chatty actor would tell this story without prompting. To pass the test, a healthcare facility needed to mask the patient and put them in an isolation room.
Ideally, the masking would occur within a minute or less of the patient walking in, and isolation would occur in 10 minutes or less. For this drill, both masking and isolation were enough to pass, regardless of timing.
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