An investigation by the Department of Health and Human Services' Office of Inspector General gave states and localities poor grades in preparing for a pandemic such as the H1N1 flu expected this fall.The report, State and Local Pandemic Influenza Preparedness: Medical Surge, cited deficiencies in several areas, including recruiting volunteers and developing electronic systems to manage them. None of the five surveyed states had fully implemented an electronic system for managing medical volunteers, even though required by ASPR to have such systems in place by last month. All 10 localities had acquired limited caches of medical equipment; however, many experienced difficulties with managing this equipment. In addition, only three of the five states had implemented electronic systems to track available hospital beds and medical equipment during an emergency.

Other deficiencies were noted in securing alternate care sites, in preparing guidelines for altering triage, admission and patient care, and documenting lessons learned from surge activities.