As daily reports show widespread frustration and anger over the COVID-19 vaccine distribution, supply chain experts are marveling at the mind-bending complexity of meeting national and global needs.
Why is this rollout so hard?
Because it’s not at all like distributing the next iPhone, said Dr. Ravi Srinivasan, associate professor of operations management at Loyola University Maryland and a supply chain expert.
Srinivasan described the vaccine rollout as “not the typical supply chain situation.”
In fact, he added, when your demand is the entire adult population of the U.S. and the rollout “cannot be within a few years but probably six months to a year, it’s an unprecedented supply chain challenge.”
For the healthcare community, not to mention all the people who want to get back to their lives, six months seems like an eternity. From the perspective of a supply chain expert, it’s absurdly fast.
Given the as-yet-unknown capacity to produce vaccines, the two-dose requirement that includes a rigid timeframe and the cold storage requirements (the Pfizer vaccine must be stored at minus 94 degrees Fahrenheit), this would be a difficult distribution even before factoring in volatile human behavior at the receiving end.
Precious Supply, Huge Demand
“Some hospitals really had that cold storage capacity, while others had to obtain it,” said Bob Atlas, Maryland Hospital Association president and CEO, “and that capacity is not something that community practices or doctor’s offices are going to necessarily have so I think there’s going to be a long-range reliance on hospitals for vaccine distribution.”
Atlas added, “From large complex medical centers in urban areas to small or medium-sized hospitals in small towns, the cultures are different, the racial and ethnic makeup of the workforce is different. So sometimes in-house you need to do different kinds of education and communication efforts.”
Another factor is data management. Tracking who had what dose and when, who has turned down the vaccine altogether, who has gotten the vaccine at a health department, hospital, CVS or Walgreens or a private practice.
“You might also need a call center to take calls for appointments from people,” said Atlas.
Finally, customers must do their part and show up at the right place at the right time – provided they are willing to receive the vaccine in the first place.
Local healthcare experts are trying to reassure people that the vaccine is safe.
During a community discussion hosted by the Horizon Foundation, Dr. Ruth Karron, professor and director of the Johns Hopkins Vaccine Initiative at the Johns Hopkins Bloomberg School of Public Health, said the vaccines were a “triumph of science.”
She commended “thousands and thousands of volunteers who quite literally rolled up their sleeves to participate in the trials.”
Scheduling vaccine for frontline healthcare workers is more difficult than scheduling volunteers, said Atlas, because “you don’t want to have everybody from the same care unit go at the same time.”
And if eligibility is announced before vaccines are actually available, people tend to get angry.
“If we get to a point where we say everybody over age 65 is now eligible to go, well, we have a million people over 65 in the state of Maryland – about one out of every six people,” pointed out Atlas. “We’re going to have more people eligible to be vaccinated than we will have supplies.”
Healthcare providers are also concerned about ensuring the vaccine is rolled out in a way that’s fair, taking into account the already-existing racial disparities for COVID-19.
“We know there are a number of ethical questions about how to prioritize,” said Dr. Mohammed Shafeeq Ahmed, interim president of Howard County General Hospital.
“We don’t have sufficient vaccine right now to vaccinate everyone who wants it and everyone who we believe should get it,” said Dr. Maura Rossman, Howard County health officer.
As of mid-January, vaccines were being administered in Howard County by the health department, Howard County General Hospital and, for staff and residents of nursing homes, by CVS and Walgreens.
Rossman said she hopes doctor’s offices will be added as vaccine distributors because the more places that give vaccines, the faster distribution will be. “If we left it to one group, we wouldn’t be as fast,” she said.
Ahmed agreed, “It is a ‘divide and conquer’ strategy.”
Dig Deep – And Roll Up Your Sleeve
For now, the “supply chain” might get some long deserved attention.
“As much as the United States has invested in bringing these two vaccines to market, it’s unfortunate we haven’t spent the same time and treasure on how to get it into people’s arms,” Rossman lamented.
As people roll up their sleeves, human beings are bringing wide a range of emotions and behaviors to the table.
“We see this as the beginning of the end to get us back to our normalcy,” Rossman said. “Until that time, we have to continue to wear our masks. We need to continue social distancing and washing our hands.”
It may take months to return to what we used to do before COVID-19, she added. “We have to dig deep. We need to care about each other and support each other.”
By Susan Kim | Staff Writer | The Business Monthly | February 2021 Issue