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Still out in the cold

"It will be hard for our people to believe that we will be able to get even just the first vaccine injected by February."

 

What is our situation almost a year into the COVID-19 lockdown? The announced discovery and production of five vaccines from US, European and Asian manufacturers just before the end of 2020 should have been greeted with hope and relief worldwide.

It did for a while – until the “battle” over the acquisition and distribution of the vaccines got in the way. Already, the questions of medical ethics, of health and equity are rearing their ugly heads. A lot of countries are howling over the actions of certain developed ones cornering most of the vaccines. And within each country, a number of sectors are saying some are more equal than others. But these are subjects of other stories.

What matters now is the need to manufacture as many of these vaccines in the soonest time possible and their deployment to as many of the global population as can be reached in the shortest possible time. That would be the surest way to spare us from another year of the harrowing experience of deaths and job losses, among others, born out of this pandemic. Sadly, if we go by the latest reports, such may not be happening anytime soon in many countries. Unfortunately, if we don’t get our act together anytime soon, that may also be the case in the country. We remain out in the cold as far as the COVID- 19 vaccination program is concerned.

First, we have yet to have a firm handle on the vaccines’ availability. We got that Pfizer commitment for the delivery of ten million doses as early as September only for us to drop the ball, as DFA Secretary Teddyboy Locsin tweeted, and lost the allocation. It went to Singapore. Then, we have this long drawn out process of signing up with the other manufacturers despite assurances from the usual quarters that we are on track to get our fair share. Finally, we have this seemingly rushed purchase of the Chinese Sinovac jab which some sectors have denounced as highly over priced and probably less effective compared with the others in the market.

So, despite all the talk and assurances of getting our first doses as early as the first week of February everything remains iffy leaving us hoping against hope that indeed we will soon have our first one hundred injections even as our neighbors in the region are already in their millionth. For now, we just have to cross our fingers and demand that those in charge of this program be more transparent and forthright in their pronouncements instead of giving us the kind of B.S. they have been spewing in the past week or so.

In any event, we note that the early and proper procurement of the vaccine is just the start, albeit a major part, of the challenges we have to reckon with for this vaccination program to succeed. We have yet to be apprised of the logistics part of the entire program which is as critical, maybe even more so, considering the state of our system. A paper prepared and published by the SEKO Logistics Knowledge Hub last January 3, noted that”...the deployment of COVID-19 vaccines will prove a challenge due to the volumes required, but also involving the intricacies of transportation and storage; testing the robustness of global supply chains to the nth degree...”

Brian Bourke, the hub’s Chief Growth Officer, explained that the heavy migration of shoppers to e-commerce platforms worldwide due to the lockdowns has stretched the global supply chain to the max. We are seeing, Burke advised, a “perfect storm in logistical terms.”

Bourke says: “A lot of companies are re-stocking inventory because of the surge in ecommerce, and at the same time you have the release of new products such as the iPhone, the new Galaxy phone, the new PlayStation, and the new Xbox – putting a lot of pressure on the capacity of the global supply chain. That’s going to happen on a magnitude the likes of which we’ve not seen in a very long time, if ever, and it’s going to be a sustained effort...” adding that it’s not just a lack of air freight capacity. In the US alone, he noted, there was a lack of drivers, not enough cars, vans, delivery vehicles and the like as everything is happening all at once. And he is talking here of just the ordinary course of things. The vaccine distribution adds new complexities to the entire system considering the scale required to move these vaccines globally down to the farthest ends of the earth. It will be the biggest logistical challenge the world has ever seen, Bourke said.

The latest reports from America and some European countries, all of whom have started their vaccination rollout, validate Bourke’s statement. “We have barely hurdled the initial challenges to implementation,” incoming President Biden’s team said as they started the push for a more robust implementation and, yes, a huge increase in the country’s COVID-19 stimulus package.

And we are just talking here of the first 20 million doses being rolled out in the US. By April, Bourke advised, once that scale gets up to 100 million or less per month, we may encounter bigger problems as any increase in scale also increases the opportunity for disruption. To avoid that disruption spiralling out of control, Bourke suggested three main issues which must be addressed, namely: a) cold chain capacity; b) storage requirements and c) last mile delivery.

In the US, companies are scrambling to get their systems enhanced and ready to rock and roll. Of the three issues mentioned it is enhancing cold chain capacity that tops the list as the vaccines have different storage and handling requirements. The Pfizer vaccine, for example, needs to be stored at below -70 degrees Celsius, which their supply chain is not currently set up for as most supply chain carriers operate between two and eight degrees Celsius.

It is good that the other US vaccine, Moderna’s, can be stored fro 30 days between two and eight degrees. The other vaccines -- UK’s Oxford/ Astra/Zeneca, SinoVac and Sinopharm from China, NovoVax from India and Sputnik from Russia – can reportedly be stabilized and stored at between two and eight degrees like Moderna’s. The question is: do we have even that Modern or Sinovac friendly system in place?

Apparently, we have. Anthony Dizon who heads the Cold Chain Association of the Philippines (CCAP) said their group has the capacity to handle our requirements if asked. Per his computation, 50 million doses of vaccines can be easily stored in a total of 1100 pallets or containers. Their 37 member group have a total combined capacity of 500,000 pallets nationwide and, equally important, has a member that can commit to handle the Pfizer vaccine as well. The problem is the government has yet to discuss this matter with them and firm up any requirements as needed. What is keeping our officials from sitting down with the group to get things in place before any of these vaccines get loaded by the manufacturers? Your guess is as good as mine.

Quite apart from the cold chain capacity is the storage requirement in each and

every region, in each and every municipality down to the littlest barangay. Has the government figured this out since not all areas, as we have always known, are not created equal. Even just the matter of power outages can already be a huge problem in most areas since any such outage can cause refrigeration to fail and render the vaccines useless

Finally, the matter of last-mile delivery. Do we have the trucks, the drivers and related staff to take care of the last mile? Okay we may have the capacity to store the vaccines when they do arrive in the designated distribution hubs, say, Manila, Clark, Cebu, Tacloban, Cagayan de Oro and Davao. But once the vaccines arrive in these hubs, do we have the means to bring them to the municipalities and barangays with the specialized staff trained to handle and undertake the vaccination. Then there is the added issue of different interval periods for the second dose and, of course, the prioritizing of recipients and subsequently tracking them.

Given these concerns and challenges, it will be very hard indeed for our people to believe that we will be able to get even just the first vaccine injected by February as our officials are openly and, might I add, shamelessly suggesting. Grabe.

Topics: Jonathan Dela Cruz , COVID-19 , COVID- 19 vaccination , DFA Secretary Teddyboy Locsin
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