Hospital leaders say the health system won’t be ready if the avian flu that’s infected American dairy cattle becomes widespread among humans.

In discussing a hypothetical scenario, the hospitals have struck a different tone than the Biden administration. It says the risk is currently low to most people and that agencies are closely monitoring for any sign of danger to Americans.

Still, hospital officials told POLITICO they’re dismayed that they don’t feel better prepared, just four years after Covid-19 caught them unawares. They’re not confident that the health care system — including the government agencies that have wound down Covid responses — can avoid the missteps around tests, bed space and communication that plagued the last public health emergency, should this strain of flu, H5N1, become more of a threat.