Patient-zero drill put health facilities to the test—40% of them failed
Patient-zero drill put health facilities to the test—40% of them failed
“零号病人”演习考验医疗机构：40%未能通过
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. 新冠疫情让我们痛苦地意识到，我们在国家和全球层面的大流行防范能力存在严重缺陷。但一项新的研究指出，即使是在具有大流行潜力的疫情爆发初期，我们在地方层面的准备工作也令人担忧。
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. 纽约卫生官员对当地医疗机构进行了一项区域性测试，旨在评估其识别并应对可能构成大流行威胁的神秘感染患者的能力。但结果并不理想。总体而言，医疗机构的反应迟缓，个人防护装备的使用情况参差不齐，仅有60%的机构通过了测试的基本要求——这被视为一个不及格的整体成绩。
“These drills identified needs for health care workers and health care facility staff member training to achieve earlier identification, masking, and isolation of potentially infectious febrile patients,” the officials wrote in the study, which was published in the Morbidity and Mortality Weekly Report. “这些演习表明，医护人员和医疗机构工作人员需要接受培训，以实现对潜在传染性发热患者的早期识别、佩戴口罩和隔离，”官员们在发表于《发病率与死亡率周报》（Morbidity and Mortality Weekly Report）的研究中写道。
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. 演习的核心是“专业患者演员”，他们假装出现H5禽流感（一种被认为具有大流行潜力的病毒）的预期症状，步履蹒跚地走进医疗机构。演员们化了妆以显得病态，使用眼药水和凡士林模拟结膜炎（红眼病）症状，并伴有假咳嗽。他们抱怨感到虚弱和发烧，并称在就诊前服用过美林（退烧药）。
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. 当被问及情况时，他们表示没有出国旅行；如果被问及是否接触过病患，他们会回答：“接触过病鸟算吗？”他们会讲述一个悲伤的故事：试图救助在公园里发现的一只病鸭。在故事中，鸭子没能活下来，而这位“患者”在处理鸭子时没有戴任何手套。这些健谈的演员会在没有提示的情况下主动讲述这个故事。
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. 要通过测试，医疗机构必须为患者佩戴口罩并将其安置在隔离室中。理想情况下，患者进入后一分钟内应佩戴口罩，并在10分钟内完成隔离。对于本次演习，无论时间长短，只要完成了佩戴口罩和隔离这两项操作即视为通过。
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. 在2026年1月至6月进行的演习中，演员们走访了73家医疗机构。其中大多数位于纽约市（52家），纽约市外15家，新泽西州3家，美属维尔京群岛3家（美国将其视为同一卫生区域）。演员们主要走访了急诊科（73家中的42家），但也包括医院门诊（73家中的19家）和紧急护理中心（73家中的12家）。这些机构同意参加演习，但不知道演习的具体时间。
Failing grades
不及格的成绩
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. 总体而言，只有60%（73家中的44家）的机构同时做到了为演员佩戴口罩并进行隔离。仅约55%的急诊科同时完成了这两项操作，而门诊和紧急护理中心的通过率分别为68%和67%。18%的机构没有为自称发烧且咳嗽的患者提供口罩。
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. 在那些完成了佩戴口罩和隔离的机构中，不到一半（43%）在1分钟的目标时间内完成了佩戴口罩，不到一半（48%）在10分钟的目标时间内将患者转移到了隔离室。门诊的隔离中位时间为20分钟，至少有一家门诊耗时近一小时。总体而言，佩戴口罩的中位时间为2分钟，隔离的中位时间为11分钟。
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. 大多数医疗机构（93%）对演员进行了症状筛查。但是，尽管有“死鸭子”的故事，73家机构中只有7家的工作人员询问了有关禽流感接触史的具体问题。与演员接触的临床医生在佩戴推荐的个人防护装备（手套、口罩、防护服和护目镜）方面表现不一致。只有25%的人佩戴了所有推荐的防护装备；6%的人什么都没戴。19%的临床医生没有佩戴口罩或呼吸器。
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. 73家机构中只有40家（55%）的工作人员按照建议通知或计划通知内部感染预防与控制（IPC）人员。低通过率和漫长的响应时间预示着问题。作者强调：“如果未实施适当的IPC措施，医疗机构的候诊区可能成为呼吸道病毒传播的高风险场所。”
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. 这些不合格的结果甚至可能高估了准备情况。并非所有受邀参加演习的医疗机构都同意参加，而那些拒绝参加的机构得分可能更差。此外，尽管演习是突击进行的，但一些机构可能提前得到了消息，这可能会提高他们的表现。