State-to-state readiness varies widely

Trailers packed with cots and medical supplies are parked in secret locations around Colorado, ready for doctors to open makeshift hospitals in school gyms if a flu pandemic strikes.

Parts of southeastern Washington state are considering drive-thru flu shots during a pandemic — although a practice run this fall showed they had better hire traffic cops.

If Alabama closes schools amid a super-flu, students may take classes via public television. In Dallas, city librarians may replace sick 911 operators.

States and communities are getting creative as they struggle to answer the Bush administration's call to prepare for the next influenza pandemic, whether the culprit is the much-feared Asian bird flu or some other super-strain.

The Associated Press took a closer look at those preparations and found wide differences in how far along states are — and little consensus on the best policies, even among neighboring states, on such basic issues as who decides whether to close schools.

Almost half the states have not spent any of their own money yet to gird against a super-flu, relying instead on grants from the federal government.

Ethical queries abound about how to ration scarce drugs and vaccine. As Oklahoma epidemiologist Dr. Brett Cauthen puts it, that is "the toughest question out there."

Some states are debating whether to purchase the recommended anti-flu medications to store for their citizens or gamble that they will receive enough from a federal stockpile.

Some states proudly list other pandemic supplies they have amassed in guarded warehouses — 4.5 million protective face masks, for example, boasts New York. But others, such as West Virginia, still are putting final drafts of their plans to paper.

"How are states doing and how do we know how states are doing?" asked Dr. Pascale Wortley of the Centers for Disease Control and Prevention. "There's a lot of important things that are very hard to measure. It's a real challenge."

Indeed, when the government's first official assessment of state readiness begins in a few weeks, officials expect few states will have tackled some of the toughest issues:

• How will you keep grocery stores stocked?

• Will you reserve enough anti-flu drugs for utility workers so the water and electricity stay on?