Updated

U.S. states have made progress in stockpiling drugs and preparing to vaccinate people in case of a flu pandemic but are far behind in plans for the ensuing months of disruption, the government said on Thursday.

The report from the U.S. Health and Human Services department showed most states responsible for maintaining food supply in an emergency were ready, but transportation plans had a long way to go. Experts said the economic crisis would only make things worse.

"It's mixed. I see the glass half full in the sense that the important issues are being addressed seriously by serious people," William Raub, who has been helping organize pandemic preparedness for HHS, told Reuters.

Most health experts agree that a pandemic of something, probably influenza, is inevitable and the U.S. government has been pushing states to develop preparedness plans.

No one can say when or what disease will strike, but the No. 1 suspect now is H5N1 avian influenza, or bird flu, which has infected 394 people and killed 248 of them since 2003.

The virus does not infect people easily now but continues to pop up in flocks of birds in Asia, Europe, the Middle East and Africa and could mutate into a form that people pass easily to one another.

"The pandemic threat is real and continuing, irrespective of how much the perception of the threat may wax or wane over time. Therefore, if we are to counter the next pandemic effectively, we must prepare now," said Raub.

TRYING TO SURVIVE

The 50 U.S. states, five territories and Washington, D.C., got good marks on getting ready to distribute antiviral drugs and vaccines. More difficulties turned up in preparing areas such as 'surge capacity" — the ability of a hospital to care for a sudden influx of sick or injured patients.

"The vast majority of hospitals are like the vast majority of other elements — they are in the private sector," said Dr. Til Jolly, deputy chief medical officer at the Department of Homeland Security.

"And economic times are tough," Jolly added.

Mike Osterholm, director of the Centers for Infectious Disease Research and Policy at the University of Minnesota, said the economic recession was already damaging preparedness efforts.

"People are just trying to survive and asking 'Is this the time to be preparing for a catastrophe?'," Osterholm said in a telephone interview.

Association of State and Territorial Health Officials executive director Dr. Paul Jarris said any progress was being jeopardized by reductions in federal funding.

"Federal funding for state and territorial pandemic preparedness ended in August 2008," Jarris said in a statement. In addition, overall federal funding for preparedness activities has been cut by 25 percent since 2005."

Raub said the report had been sent to all states and was meant as guidance.

Many states were still thinking in terms of "an incident", he said, instead of planning for months of disruption that would affect the whole country and the world.

The report said areas funded by the U.S. Centers for Disease Control and Prevention had done their best, including in disease surveillance and laboratory preparation.

But community outreach was still weak. "Most states have not begun to work with businesses, school districts, spiritual leaders or with other non-governmental organizations in planning. These are critical partners that need to be included in pandemic influenza planning," the report said.