NYC Health + Hospitals Leads Multi-Agency Training Exercise for H5N1, or Bird Flu

NYC Health + Hospitals Leads Multi-Agency Training Exercise for H5N1, or Bird Flu

The "patient" simulated symptoms of H5N1 that became more acute to test health care providers' ability to quickly screen, isolate, and transport them to NYC Health + Hospitals/Bellevue

During the drill, healthcare workers donned appropriate personal protective equipment and followed strict protocols to protect against exposure to the simulated pathogen

The risk of H5N1 coming to New York City is low

Oct 22, 2024

New York, NY - NYC Health + Hospitals led a training exercise testing the health care system's ability to screen and isolate a "patient" with simulated symptoms of H5N1 and relevant exposure history, also known as bird flu, and safely transport from NYC Health + Hospitals/Kings County to NYC Health + Hospitals/Bellevue. Health care and ambulance workers needed to wear an N95 respirator, eye protection, gown and gloves and follow strict protocols to ensure their safety while handling the patient to prevent exposure to the pathogen. H5N1 is a highly pathogenic avian influenza virus that is widespread among wild birds globally and has been responsible for outbreaks in poultry and dairy cows. While the risk to the U.S. general population remains low, the virus has a historical fatality rate of over 50%. In 2024, 27 human cases have been reported in the U.S., primarily among dairy and poultry workers, though no fatalities have been reported. The risk of H5N1 coming to New York City is low. Health care workers seeing the simulated patient were informed that this was an exercise to test the health system's various protocols for bird flu. The exercise was a coordinated effort between the health system and the NYC Health Department.

"This exercise underscores our commitment to ensuring that our health system is prepared to respond to infectious disease threats, including H5N1," said Dr. Syra Madad, Chief Biopreparedness Officer at NYC Health + Hospitals, who led the exercise. "While the current risk to the general public is low, these preparedness efforts are critical to testing protocols and maintaining a high level of readiness."

The drill involved a simulated patient who was pre-screened through a collaborative protocol between NYC Health + Hospitals' Virtual ExpressCare and the NYC Department of Health and Mental Hygiene. The patient, exhibiting mild respiratory symptoms following close contact with an H5N1-infected bird, was evaluated by a provider through Virtual ExpressCare and sent to NYC Health + Hospitals/Kings County for influenza testing. Simulated samples were then sent to the NYC Health Department's Public Health Laboratory for confirmatory testing.

The exercise tested the protocols of the NYC Health + Hospitals Transfer Center jointly staffed by Ambulnz transfer center coordinators and health system nurses.

"At Virtual ExpressCare, our role in early screening and coordination during this exercise highlights the vital connection between digital health solutions and real-time clinical action," said NYC Health + Hospitals Executive Director of ExpressCareErfan Karim, MPH. "By ensuring patients are evaluated swiftly and safely, even before they reach our physical facilities, we're reinforcing the agility and preparedness of our health system to handle potential infectious threats like H5N1. This level of integration between virtual care and in-person response protocols is key to safeguarding both patients and healthcare workers."

"As part of an ongoing effort to maintain emergency readiness, the Emergency Department at Kings County Hospital regularly conducts drills to ensure that frontline staff are up to date on the proper procedures and protocols related to highly infectious pathogens," said Donald Doukas, MD, Associate Medical Director and Director of Disaster Medicine for the Emergency Department at NYC Health + Hospitals/Kings County and clinical lead for the H5N1 exercise. "We are excited to be a part of the continued collaboration between NYC Health + Hospitals and the NYC Department of Health to ensure staff and patient safety."

Transferring the "patient" with simulated symptoms of H5N1 to a stretcher at NYC Health + Hospitals/Bellevue.

"Preparedness and practice go hand-in-hand," said Beth Maldin, Deputy Commissioner for the Health Department's Office of Emergency Preparedness and Response. "The skills we sharpen through these drills help us prepare to identify and respond to infectious disease threats and develop the strong interagency collaboration that is necessary for emergency response. We're excited to work with NYC Health + Hospitals, and other partners, on this exercise."

As part of the exercise, the simulated patient was transferred from NYC Health + Hospitals/Kings County to NYC Health + Hospitals/Bellevue for ongoing care. The transfer was a critical test of the emergency medical services (EMS) protocol for handling infectious disease patients. Throughout the process, all personnel followed heightened safety protocols, ensuring the simulated patient's transport was handled with the highest levels of care.

Health care and ambulance workers needed to wear an N95 respirator, eye protection, gown and gloves and follow strict protocols to ensure their safety while handling the patient to prevent exposure to the simulated pathogen.

"Planning for and practicing infectious disease protocols is critical to ensuring that we are prepared to protect the safety of our EMS team members and our patients at all times," said Ambulnz Vice President Sam Mezrahi. "The NYC Health + Hospitals Transfer Center is jointly staffed by Ambulnz transfer center coordinators and health system nurses and is a critical coordination point for critical and urgent transports within the system. The Transfer Center team coordinates communication between the sending and receiving facilities and the ambulance crews at all points in the process. Through Ambulnz's medical transport deployment software's integration with the Epic Transfer Center, all parties are able track the patient and EMS crews as they progress through all stages of the transport."

The event included regional and national observers from the Centers for Disease Control and Prevention, the New York State Department of Health, the Greater New York Hospital Association, and NYC Emergency Management.

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About NYC Health + Hospitals
NYC Health + Hospitals is the largest municipal health care system in the nation serving more than a million New Yorkers annually in more than 70 patient care locations across the city's five boroughs. A robust network of outpatient, neighborhood-based primary and specialty care centers anchors care coordination with the system's trauma centers, nursing homes, post-acute care centers, home care agency, and MetroPlus health plan-all supported by 11 essential hospitals. Its diverse workforce of more than 43,000 employees is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible. For more information, visit www.nychealthandhospitals.org and stay connected on Facebook, Twitter, Instagram and LinkedIn.

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