The question for Canadian healthcare facilities in 2026 is no longer whether another significant pathogen will emerge.
It is whether your facility’s infection prevention systems will hold when it does. Avian influenza A(H5N1) has been spreading among animal populations across North America and has produced a growing number of human cases globally, raising the level of concern among public health authorities well above theoretical. At the same time, the lessons from COVID-19 remain unevenly applied across the healthcare sector.
This guide gives you a practical, evidence-grounded preparedness strategy for avian flu and the broader category of emerging pathogens, built on the IPAC principles that protect your patients, your staff, and your community when outbreak pressure is highest.
The 2026 Emerging Pathogen Landscape: What Canadian Facilities Need to Know
The term “emerging pathogen” refers to an infectious agent that is newly recognized, newly introduced to a population, or changing in ways that increase its public health significance.
In 2026, the emerging pathogen landscape is shaped by several converging factors. Zoonotic spillover, the transmission of pathogens from animals to humans, is occurring at a frequency that reflects ongoing ecological disruption, agricultural intensification, and increased human-animal interface. The WHO has reported that avian influenza viruses continue to circulate in bird populations globally, with H5N1 and H5N2 variants detected in poultry flocks and wild birds across North America and Europe throughout 2024 and into 2025.
Antimicrobial resistance remains a concurrent threat. Canada’s Chief Public Health Officer highlighted in the 2024 state of public health report that drug-resistant organisms continue to spread through community and healthcare settings, with healthcare-associated infections remaining a significant preventable burden.
Pandemic preparedness is not a one-pathogen strategy. Your IPAC program must be flexible enough to respond to pathogens with different transmission modes, different clinical presentations, and different impacts on specific patient populations.
The IPAC lessons from COVID-19 and preparing for the next pandemic are essential reading for any facility that wants to build genuine structural resilience rather than a response plan that exists only on paper.
Avian Influenza A(H5N1): Current Risk Level and Healthcare Implications
H5N1 is a highly pathogenic avian influenza virus that has been circulating in bird populations for decades.
What has changed in recent years is the geographic breadth of its spread and its documented ability to infect mammals, including cattle, as confirmed by the CDC in its 2024 response to the US dairy cattle outbreak. Human cases associated with exposure to infected cattle and poultry have occurred in the United States, raising concern about the potential for adaptation toward more efficient human-to-human transmission.
As of early 2026, Canada’s Public Health Agency assessed the public health risk to the general population in Canada as low, with a higher but still manageable risk for people with direct exposure to infected animals. However, the risk level for healthcare workers who might care for a human case, particularly in the absence of personal protective equipment suited to airborne plus contact precautions, is meaningfully higher.
The case fatality rate of H5N1 in humans with confirmed infection has historically been high. While the denominator of total exposed individuals is likely undercounted, healthcare facilities cannot plan based on the assumption that H5N1 would be mild in a human outbreak scenario.
Your facility must have a defined protocol for receiving, isolating, and caring for a patient with suspected avian influenza, even if the probability of that patient presenting to your specific setting today is low.
The IPAC Framework for Emerging Respiratory Pathogens
Managing a novel respiratory pathogen requires applying the precautionary principle, meaning you apply the highest indicated level of precaution while the pathogen’s transmission characteristics are still being determined.
Transmission-Based Precautions for Avian Flu
Current guidance for managing suspected or confirmed H5N1 human cases recommends a combination of contact, droplet, and airborne precautions.
This means that healthcare workers caring for these patients require a fitted N95 or higher respirator, eye protection, a fluid-resistant gown, and gloves as a minimum. Facilities that have not established a respiratory protection program with current fit test records for clinical staff cannot meet this standard at the moment it is needed.
The respiratory protection and fit testing requirements for clinical staff must be addressed as part of your emerging pathogen preparedness, not deferred until a case is suspected. Fit testing requires advance scheduling and trained personnel, neither of which can be arranged on the day of a possible case.
Isolation room availability and the criteria for placing a patient in airborne isolation must be defined in your protocol before an event occurs. Facilities that do not have negative pressure isolation rooms must have a written alternative strategy that has been reviewed with their regional public health authority.
Environmental Controls and Ventilation
For emerging respiratory pathogens with confirmed or suspected airborne transmission, ventilation becomes a critical engineering control.
Negative pressure isolation rooms that exhaust air directly to the outside, or through HEPA filtration before recirculation, are the preferred environment for care of airborne precaution patients. Facilities that lack these rooms must identify what alternatives they have available and communicate those limitations to their regional health authority as part of their preparedness planning.
The role of UV-C disinfection technology in managing airborne pathogens is an area of active adoption in healthcare settings, with portable UV-C units being used as an adjunct to ventilation in spaces that cannot be modified structurally. Understanding what this technology can and cannot do is important for facilities considering it as part of their preparedness toolkit.
Surge Capacity Planning and Workforce Protection
A significant outbreak of an emerging pathogen creates simultaneous pressure on your patient care capacity and your workforce.
Staff who become ill cannot be replaced instantaneously, and the psychological and physical burden on those who remain creates its own risk of performance degradation and error. Surge capacity planning must address both dimensions.
Your workforce protection plan should include a defined protocol for staff exposure management, including the steps to follow if a staff member has an unprotected exposure to a suspected emerging pathogen case, how post-exposure monitoring and furlough decisions are made, and what access to antiviral prophylaxis looks like if indicated.
The pandemic preparedness IPAC strategies framework provides a multi-tiered approach to surge planning that facilities can adapt to their specific size, setting, and patient population.
Staff mental health and communication during a surge also require attention. Transparent, timely internal communication that helps workers understand the risk level, the precautions in place, and the rationale for management decisions is a direct contributor to workforce stability during a crisis.
Laboratory and Diagnostic Safety During Outbreak Investigation
When a suspected emerging pathogen case presents to your facility, the diagnostic process itself introduces infection risk that must be managed through specific biosafety protocols.
Specimen collection from patients with suspected H5N1, for example, must be performed by staff wearing appropriate PPE, with the collection occurring in an airborne precaution environment. Specimens must be clearly labeled with the suspected pathogen and transported in accordance with your facility’s laboratory transport protocols and provincial requirements for dangerous goods.
Public Health Ontario’s laboratory publishes guidance on specimen requirements for novel pathogens, and your laboratory staff and point-of-care testing personnel must be familiar with the additional handling requirements that apply when a novel or high-consequence pathogen is under investigation.
Your protocol must also address who within the facility is notified when a novel pathogen is suspected, including the chain from the treating clinician to the IPAC lead to the medical officer of health.
Veterinary and Agricultural Settings: Cross-Species Transmission Risks
The H5N1 outbreak in dairy cattle in the United States demonstrated clearly that the animal health and human health sectors cannot treat emerging zoonotic pathogens as separate problems.
Veterinary clinics and agricultural-adjacent healthcare facilities in Canada face a specific risk profile that standard IPAC programs may not fully address. Workers who have contact with poultry, wild birds, or cattle from affected regions and then present for healthcare represent a potential exposure vector that your facility’s triage process must be designed to identify.
The IPAC consulting services available for veterinary hospitals and clinics in Canada are particularly relevant in the current emerging pathogen environment, as the interface between animal and human health is where many of the most significant outbreak risks originate.
Veterinary facilities should have specific protocols for handling animals suspected of carrying avian influenza or other zoonotic pathogens, including staff PPE requirements, carcass disposal procedures, and reporting obligations to provincial animal health authorities.
Long-Term Care and High-Risk Population Preparedness
Long-term care residents represent the population most likely to experience severe outcomes from influenza and other respiratory pathogens, including novel ones.
An outbreak of an emerging respiratory pathogen in a long-term care home carries a different severity profile than the same outbreak in a community setting, simply because of the age, frailty, and immune status of the resident population.
The latest IPAC innovations for long-term care in 2025 reflect the sector’s response to the lessons of COVID-19, including enhanced visitor screening protocols, improved outbreak detection algorithms, and stronger integration between facility IPAC programs and regional public health authorities.
Long-term care homes should have a specific emerging pathogen annex to their outbreak management plan that addresses the steps to take if a novel pathogen with unknown transmission characteristics is suspected in a resident. This annex should be reviewed and updated at least annually, and it should be tested through tabletop exercises that include local public health representation.
The outbreak prevention guidance for high-risk long-term care homes provides a practical framework for building this level of operational preparedness.
Dental and Community Clinic Readiness for Emerging Pathogens
Dental clinics and community health settings are often not the first places that come to mind in emerging pathogen preparedness conversations, but they are frequently the first places where symptomatic patients present.
A patient with early-stage avian influenza or another novel respiratory illness may present to a dental appointment complaining of respiratory symptoms. Your triage process, which begins before the patient enters the operatory, must include a standardized screening protocol for acute respiratory illness and a defined response pathway if a patient screens positive.
The IPAC preparedness requirements for dental clinics include specific guidance on triage screening, the management of respiratory precautions in open-bay dental settings, and the steps to take if a patient or staff member is identified as a potential novel pathogen case.
Community health centres must similarly review their triage and isolation protocols, not only for their physical ability to isolate a patient but for their ability to communicate rapidly with regional public health and to document the exposure event in a format that supports contact tracing.
Learning from COVID-19: Structural IPAC Lessons That Still Apply
The COVID-19 pandemic was the most comprehensive test of Canadian healthcare IPAC infrastructure in a generation, and the structural vulnerabilities it revealed have not all been addressed.
Supply chain fragility for PPE, particularly for N95 respirators and gowns, remains a concern in many facilities that returned to pre-pandemic inventory levels once immediate pressure subsided. A genuinely prepared facility maintains a rolling reserve of critical PPE and has documented supplier agreements that provide priority access during a supply constraint event.
The communication failures during COVID-19, both internal and between facilities and public health authorities, contributed to inconsistent implementation of precautions across the sector. Building a communication protocol that defines who receives what information, through what channel, and within what timeframe is a structural improvement that will serve your facility regardless of which pathogen triggers the next response.
Training degradation is also a recognized post-pandemic risk. Staff who were extensively trained in outbreak response during the pandemic may have had limited ongoing practice of those skills in subsequent years. The IPAC training framework for Canadian healthcare addresses how to maintain staff competency in outbreak response between active events through simulation and scenario-based practice.
Building Your 2026 Preparedness Plan: A Step-by-Step Framework
A preparedness plan that does not have a clear owner, a defined activation trigger, and tested response procedures is not a preparedness plan. It is a document.
Begin with a gap assessment that evaluates your current program against the elements described in this guide. Identify which of the following are missing or incomplete: a respiratory protection program with current fit test records, an emerging pathogen triage protocol, a written surge capacity plan, an outbreak management plan with a novel pathogen annex, a PPE reserve inventory, and a communication protocol linking your facility to public health.
Assign ownership of each gap to a specific person or role, with a completion date. Gaps that are assigned to “management” or “the team” without individual accountability rarely close.
Test your plan. A tabletop exercise that walks your leadership team and IPAC lead through a scenario involving a suspected novel pathogen case will reveal operational gaps that no amount of document review can surface. The readiness assessment resources available through InfectionShield can help you structure this exercise and evaluate your results against current standards.
Review and update your plan at least annually, and any time there is a significant change in the pathogen landscape, your workforce, or your physical facility.
Conclusion
Avian flu and the broader category of emerging pathogens represent a real and present planning challenge for Canadian healthcare facilities in 2026.
The facilities that respond most effectively to the next significant outbreak will not be those that scramble to build systems under pressure. They will be the ones that built those systems methodically, tested them honestly, and maintained them consistently when the immediate urgency of the last crisis had faded.
Your patients and your staff cannot wait for the next outbreak to demonstrate that your preparation was insufficient. Start building the gaps closed today, and make 2026 the year your facility’s preparedness program becomes genuinely operational rather than aspirationally documented.
FAQ
How serious is the current risk of avian influenza H5N1 for Canadian healthcare workers?
Canada’s Public Health Agency has assessed the general population risk as low as of early 2026, but acknowledges higher risk for individuals with direct animal exposure. For healthcare workers who might care for a confirmed or suspected human H5N1 case without adequate PPE, the risk is meaningfully higher given the virus’s historical severity in human infection. Every clinical facility should have a defined protocol for managing suspected cases, regardless of how low the current probability appears.
What PPE is recommended for healthcare workers caring for suspected avian flu patients?
Current guidance recommends a combination of airborne, droplet, and contact precautions for suspected H5N1 human cases. This means a fit-tested N95 or higher respirator, protective eyewear or a face shield, a fluid-resistant gown, and gloves as a minimum. Your facility’s fit testing records must be current for all staff who may be assigned to care for such patients, as fit testing cannot be completed adequately on short notice once a case has been identified.
Should dental clinics develop an emerging pathogen protocol even if they are not a primary care setting?
Yes. Dental clinics are often the first point of contact for patients who are symptomatic with a novel illness but have not yet identified their symptoms as a reason to seek medical care. A standardized triage screening protocol, a defined response pathway for symptomatic patients, and staff familiarity with respiratory precaution procedures are baseline requirements for any clinical setting in the current pathogen landscape. Dental settings that perform aerosol-generating procedures carry particularly elevated respiratory risk in this context.
How should a long-term care home respond if a resident is suspected of having a novel respiratory pathogen?
The resident should be placed on airborne, droplet, and contact precautions immediately pending investigation. Staff entering the resident’s room must wear appropriate PPE. The facility’s IPAC lead, director of care, and medical director must be notified immediately, and the local medical officer of health must be contacted without delay. Visitor access should be restricted to the resident’s immediate care circle. Your outbreak management plan should have a specific protocol for novel pathogen scenarios that guides these decisions in real time.
What is the role of a healthcare facility’s IPAC consultant during an emerging pathogen event?
An IPAC consultant provides expert guidance on protocol adaptation when standard procedures may not be sufficient for a novel pathogen, supports staff training and communication during a rapidly evolving situation, assists with documentation and reporting requirements for regulatory authorities, and provides objective assessment of whether the facility’s precautions are proportionate to the identified risk. Establishing a relationship with an IPAC consultant before an emerging pathogen event means that support is available immediately when the situation demands it.