This week health officials here and in states across the country expect word on how much vaccine they'll receive in the coming days to help people ward off the H1N1 swine flu virus.

The inoculations should bolster Hawai'i's resistance to a potentially severe outbreak.

Nonetheless, preparations for a worst-case scenario — the massive delivery of care for a pandemic — must not slacken.

There's some reason for concern about whether we're prepared.

Last week, the inspector general for the federal Department of Health and Human Services issued a report based on a sampling of U.S. communities. The outlook varied but in general the IG found that preparedness lagged in several key areas, including the enlistment of all the volunteer aides who will be needed to help with emergency clinics and the final arrangements for alternative emergency clinic sites.

Already some areas on the Mainland have experienced a second wave of H1N1 virus outbreaks. In some places this has forced emergency room personnel to pitch tents to accommodate the overflow from swamped ER operations.

There's been a lot of preparedness work in Hawai'i, which comes as a relief. But thorough preparations for a pandemic are absolutely essential to an island state, which can't lean on anyone for backup. There is work to be done and no time to waste.

First and foremost, although the state Health Department has a pandemic influenza plan and strategy on medical services, there is not yet a state plan addressing how essential government services and other critical operations could continue if, for example, the chain of command is disrupted by illness. The counties are working on their components of this and a consultant has been hired to draw the parts into a comprehensive whole but it won't be finished until 2010. This means only a basic framework of a plan will be available in time for H1N1.

There are still details to be worked out, too, in the arrangements for alternative clinic sites should hospitals and conventional facilities be overwhelmed.

And although progress has been made toward assembling a statewide Medical Reserve Corps to help with logistics of treatment at the clinics, more volunteers will be needed. So far about 800 volunteers statewide are enlisted and undergoing training. Right now the state is focused on completing training for those already signed up, but authorities do need to rev up recruitment soon.

Hawai'i has taken some of the steps needed to help communities cope with the potential ravages of a pandemic, but the work is not done. The anticipated brush with H1N1 flu has intensified the drive toward that goal somewhat: It's no longer seen as a vague objective that can be left for the future.

Let's make sure it remains on the front burner, where it belongs.