A county survey released in March showed that 67% of hospitals in L.A. County that responded to a survey in 2005 did not have plans for coping with a flu pandemic, and only three of five facilities reported having extra supplies of gloves, masks, gowns and Tamiflu, an anti-flu medication.
Some critics said the state has been moving dangerously slowly.
"Without a detailed blueprint for action, we fear chaos when the pandemic actually hits," the California Medical Assn. said in a February letter to the state Department of Health Services.
The letter questioned how key resources, even those as basic as face masks, would be distributed, as well as how hospitals might prepare for a surge in patients. Since then, the association has begun working with the state to improve preparations.
One serious shortcoming is the lack of ventilators. Across the nation, there are only about 105,000, experts say. A pandemic flu could require more than six times that many, said Osterholm, an expert on pandemic flu preparedness.
Backer said the state was still trying to count the number of ventilators in California. The machines are not easy to come by, at a cost of more than $30,000 each.
Indeed, California now is counting all of the necessary supplies and resources it has, and it needs those results before deciding what purchases to make, Backer said.
For its part, the county is creating a reserve volunteer medical registry of doctors, nurses and respiratory therapists who could be called out in an emergency, Fruhwirth said. The county already has a reserve corps of about 600 retired doctors and nurses whose licenses are not active.
The county also is identifying additional "surge capacity" in schools, gymnasiums and community centers that could house and feed ill patients, Fielding said.
After the anthrax attacks of 2001 on the East Coast, the county health department received more than $40 million in federal bioterrorism grants to prepare for a disaster. Some of that money has gone to the creation of 11 disaster resource centers based at hospitals, each of which has one self-inflating tent to house up to 20 patients. Each center also has 16 extra mechanical ventilators and 70 disposable ventilators.
Federal officials have essentially warned local health authorities around the nation that they would be largely on their own in a pandemic, perhaps for an extended period.
Experts say an influenza pandemic lasting up to 18 months would have at least two peak waves, each lasting several weeks.
"Any community that fails to prepare, with the expectation that the federal government or ... the state government would step in and rescue them, will be tragically wrong," said Leavitt, the Health and Human Services secretary, at the summit.
Jeffrey Levi, executive director of Trust for America's Health, said local officials should be planning ways of keeping people from infecting one another. Such "social distancing measures" would put areas where people congregate in large numbers off-limits.
"Will we close the schools? Will we shut down theaters? Will we shut down Disneyland? And what will that mean for the Orange County tax base?" Levi said. "Those kinds of things need to be talked through ahead of time."
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Times wire services contributed to this report.
