Many state and local governments are not adequately prepared to deal with a surge of patients in a flu pandemic or quickly distribute vaccine and antiviral drugs, according to two reports by federal investigators. An analysis of preparations by five states and 10 municipalities found that many had failed to take steps crucial during a pandemic, such as recruiting healthcare workers to volunteer, creating systems to track hospital beds and medical equipment, and determining how to manage a patient load that exceeds what emergency rooms are able to handle.