19 Mar 2020

Prepare to Spread the COVID-19 vaccine

The COVID-19 virus is showing all indications of disrupting every individual’s life habits. While social isolation is largely voluntary so far, the fear of the disease is also coercing some to ostracise others who may show related symptoms. The helplessness factor has also initiated a blame-game of sorts, with a few even allocating this corona virus a nationality. Some people are seen to discover religion anew, and many others have displayed acts of kindness, reported from around the world.

This raging pandemic has left everyone focusing on one hope, to ‘dampen the curve’ of the infected. The idea is, to buy time, so that local healthcare networks can ably cope with the numbers expected. Sadly, that means that a lot of pain also abounds, and it is most unfortunate doctors are had to resort to triage – selective treatment of the ill – due to high load on the medical system in a few regions.

We appear to have no other recourse against this invisible enemy, but to consciously isolate from unnecessary proximity... until a vaccine is developed.

The COVID-19 vaccine will be delivered; either this year sometime, if testing is fast-tracked, or the following year. Depending on how extreme the disease spreads in the coming months, a conscious risk, to waive some standard trials and safety procedures, might be taken. It will be a tough risk assessment call.

However, there is one risk that cannot be taken. There is no scope to bypass the logistics (cold-chain) care that will ensure that the vaccine can reach every infected region of the world on priority, and then to other pockets that might have escaped. Unless the virus mutates into a benign form, or dies out on its own, which at this stage seems far, a vaccine, when developed, will be the only safeguard for the global population. At this point we will need to adopt the opposite tack, and ensure the vaccine is spread like wildfire!

Social Distancing & Self-Isolation is the first tool in our armory, to delay the spread of COVID-19. A Vaccine is the next move... are we prepared to make use of it properly!

We must ready ourselves for the vaccine and plan ahead for an extensive and assured delivery mechanism. The worrisome part is, even today, for the well-mapped range of viruses, the existing vaccination system does not necessarily reach every person in need. This state of affairs of the vaccine delivery network needs to be reassessed. Given the prevailing pandemic, countries need to focus now, much in advance, on a vaccine delivery plan. While today we worry about hospital equipment & beds and hence work to dampen the curve, very shortly we will have to ensure the vaccine is made available, at every remote hamlet and village, globally.

Though we hope to slow the spread of the virus, we will have to consciously hasten the spread of the vaccine, when we get it. Time to plan is now!

Is the existing cold-chain system ready to handle the load to take the vaccine to billions... and to do so quickly, within months.
Hopefully, the vaccine will be once in a lifetime shot, and not a seasonal requirement. No matter what, it will need to reach every corner of the world and the cold-chain must live up to this task. We cannot afford to ignore that the next trouble spot will be executing a globally networked delivery mechanism for the COVID-19 vaccine. It may be the only way to stop this virus in its track, and get society and economy back on its feet.

Vaccines need to be handled, after production to end-use, within specified temperature ranges. In all probability, the protocols to follow will be like those for the Influenza vaccine, which requires to be kept between 2°C and 8°C, while in transport and storage. The problem to consider is whether we will require to inoculate all 8 billion of humankind? Will the current cold-chain network be capable of handling extraordinarily large quantities of the vaccine? Clearly, the current system is designed to cope with the existing scale of vaccination, in each country.

Looking ahead, the scale of the COVID-19 vaccine outreach would be in multiples of the present status, and countries must plan accordingly. It is not a matter of adding capacity of vaccine refrigerators at existing vaccination centres, but possibly require a different structure. Giving the severity of the pandemic, each pharmaceutical outlet could be enabled to store and inject the vaccine. Maybe even outlets in shopping malls, offices or theatres. Doing so, will immediately multiply the delivery points of the vaccine, instead of crowding up the existing hospitals and clinics. A few million individuals can be quickly trained to inoculate. Each inoculation will have to be recorded and an extensive database has to be collated. The unique identity of each citizen will come handy here, to be mapped against the vaccination. This will require a mobilisation, at par or even exceeding the type India executes for its elections. Not a single person can be bypassed.

Existing cold-chain enterprises, may need to allocate specific resources in their network. It will require minor redesign to designate storage space and transport load for this purpose. Luckily, the food cold-chain has synergistic use for this purpose, and should assist in this global war. The food cold-chain has the maximum reach, with an extensive last mile connectivity. Most importantly, such private operators will have to be prepare to safely process the vaccine loads as they connect them with points of delivery. Vaccines are fragile cargo, requiring strict adherence to the handling protocols, especially in temperature maintenance. Non-standardised care will be disastrous and some training will be needed here as well.
The vaccine, when developed, will need to reach every living soul, irrespective...
Observe the global reaction to COVID-19, and realise that its vaccination program (soon one hopes) will fall in the lap of governments. Each government will have to take the responsibility to ensure that each of its citizens is inoculated. This cannot be left entirely to private enterprise. No individual should be denied the vaccine for want of private funds. Public funds have to be allocated and this public service will have to be well planned. Government offices that deal in cold-chain and healthcare services will need to converge and partner more than they ever have before. Some minimal forethought will be needed to execute this well, in a timely and speedy manner. It is going to require forging of dependable public-private partnerships, at a scale never seen before.

Majority of cold-chains do not handle medical supplies. Such cold-chain operators must familiarise themselves with vaccine handling, identify a few in their team and be ready to roll into action. If they need additional equipment or monitoring tools, they should prepare a list in advance and inform the local health services. The health services authorities must develop an appropriate platform to keep track of vaccine delivery into each locality. In various population centres, volunteers or suitable individuals can be identified to undergo a short training to give vaccine shots and on keeping records. A first aid trainee could do this.
Cold-chain operators, gear up to serve to counter a real threat.. humankind's biggest!
I am not sure how bad this Corona Virus is for humankind, but given the fact that countries are willingly locking down, is ample indication that even a fool could not miss. Let us not be satisfied merely with slowing its murderous spread. Before we can build enough hospitals to handle the projected numbers, we will have a vaccine. That is the next tool in our arsenal – and we must prepare to use it properly and effectively.

We can wish for the rapid development of the COVID-19 Vaccine, and hope that it will be the type that will immunise people against this virus for life. But most importantly, we need to start planning an efficient delivery mechanism to ensure that the vaccine will be provided to everyone on planet earth.

Originally Posted on Linkedin Pulse
Update (29-March-2020)
Extracts of this post were subsequently on-

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