Abstract
Unannounced drills using professional patient actors (mystery patients) have been used to evaluate health care facility management of patients with infectious diseases of public health concern. Ongoing outbreaks and the expanding role of urgent care centers highlight the need to evaluate the ability of health care facilities to rapidly identify, isolate, and safely manage patients with transmissible diseases. During January-June 2026, 73 drills were conducted in three jurisdictions within U.S. Department of Health and Human Services Region 2 (New Jersey, New York, and the U.S. Virgin Islands) using a simulated avian influenza A(H5) scenario. During these drills, facilities conducted symptom screening in 68 (93%) drills and obtained travel history upon patient arrival in 58 (80%) drills. Among 60 (82%) drills during which the patient was appropriately masked, the median interval from arrival at the facility to masking was 2 minutes (IQR = 1.0-6.0 minutes) (target = 1 minute), and among 52 (71%) drills during which the patient was isolated, the median interval from arrival to isolation was 11 minutes (IQR = 8.0-19.2 minutes) (target = 10 minutes). Both masking and isolation occurred in 44 (60%) drills. The clinical team planned to notify infection prevention and control teams in 40 (54%) drills. The clinician wore all recommended personal protective equipment in 17 (25%) drills. These drills provided an opportunity for facilities to examine implementation of the principles of identification, isolation, and informing. Findings from these drills will help guide future public health interventions to improve readiness among regional health care facilities for emerging and reemerging infectious disease threats.