Hospital-preparedness earned most of Utah's points. Utah has enough lab scientists to test for anthrax or plague in a suspected outbreak, and hospitals were deemed prepared to care for a surge of extra patients, including having needed extra medical equipment available, being able to immediately consult with infection-control experts and having a system to prioritize distribution of vaccines or antiviral medicines to hospital workers.

Since the survey was based in effect on self-reporting, there were no surprises, Craynor said, but the report looks bleaker than reality in other areas.

For instance, Utah was docked a point for not having an epidemiologic surveillance system that is Web-based and able to communicate with the CDC. Utah does have the system running in a testing phase and is in the process of training people.

In the report, Utah lacks bioterrorism response laboratories. Also true, said Craynor, but it's a matter of physical space, not capability of technicians to run the tests. Utah has identified other facilities in the state that "could lend us space in an emergency" to meet those needs.

Also lacking is chemical terrorism response capability. Utah has a Level 2 lab, unlike the Level 1 lab that would be needed. There are about 10 of those in the country.

"To have that, we'd need significant increased federal funding. It's about equipment, not skills. We can now test for pretty much any industrial chemicals or pesticides," Craynor said.

The only hospital-related area for which Utah didn't receive a point was "plans, incentives or provisions to encourage health-care workers to continue to come to work during a major infectious disease outbreak." Two states received points for that.

The goal of the report is to focus attention on areas that leave America vulnerable.

"We need to stop shrugging our shoulders and start rolling up our sleeves," warned Lowell Weicker Jr., TFAH Board president and former three-term U.S. senator and governor of Connecticut, in a statement released with the report. "The response to Hurricane Katrina was a sharp indictment of America's emergency re- sponse capabilities. This report provides further evidence of the major gap between response plans and realities. We need to get real in our planning for health emergencies."

Nationally, the report gave the Strategic National Stockpile a C-plus, and federal readiness plans a C-minus. Federal coordination for an emergency received a D, while the smallpox vaccination initiative earned a D-minus.

The full report is available online at www.healthyamericans.org.

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E-mail: lois@desnews.com