WASHINGTON -- Many state and local governments are not adequately prepared to deal with a surge of patients in a flu pandemic or quickly distribute vaccine and antiviral drugs, according to two reports by federal investigators being released today.

An analysis of preparations by five states and 10 municipalities across the country found that many had failed to take steps considered crucial during a pandemic, such as recruiting health-care workers to volunteer, creating systems to track hospital beds and medical equipment, and determining how to manage a patient load that exceeds what emergency rooms are able to handle.

"Our review found that although the selected states and localities are making progress within the five components of medical surge that we reviewed, more needs to be done to improve states' and localities' ability to respond to a pandemic," investigators from the Department of Health and Human Services Office of Inspector General concluded.

For the first report, investigators collected information last summer about pandemic planning in Portland and Lewiston, Maine; St. Louis and Rolla, Mo.; Sioux Falls and Mitchell, S.D.; Virginia Beach and Blacksburg, Va.; and Seattle and Longview, Wash.

In a 30-page report, investigators found:

• Fewer than half of the communities had started to recruit volunteer medical workers to help with a surge of patients, and none of the states had implemented an electronic system to manage such volunteers.

• All 10 communities had acquired additional medical equipment to respond to a pandemic, but "many experienced difficulties with managing this equipment," and only three states had electronic systems to track beds and equipment.

• Although nine of the 10 communities had either identified or were working to identify alternative sites for treatment of patients that hospitals could not accommodate, few had signed formal agreements for the use of those facilities.

• Nine of the 10 communities had not identified guidelines for adjusting triage, admissions and care to handle a rush of patients in a crisis; many cited liability concerns.

Although the investigation was conducted before H1N1 appeared and many communities began planning for the second wave, some experts said they thought that little had been done to improve the care administered when patient loads hit crisis levels.

Von Roebuck, a spokesman for the federal Centers for Disease Control and Prevention, said that "CDC agrees that while states, overall, are doing well with antiviral drug distribution and development of vaccination plans, local pandemic preparedness can and should be improved."