CDC Notifies States, Large Cities To Prepare For Vaccine Distribution As Soon As Late October

[aggiedog]

Not negative at all, but I don't see the antibody cocktail as significantly moving the needle on morbidity and mortality due to Covid. It's just not a game changer, but any treatment is better than none for those that can access it.

I work in a rural area with significant numbers of uninsured. The nearest dose of remdisivir is almost 100 miles away. My viewpoint on the healthcare system is definitely seen thru that lens.

 

[RamblingMad]

Not negative at all, but I don't see the antibody cocktail as significantly moving the needle on morbidity and mortality due to Covid. It's just not a game changer, but any treatment is better than none for those that can access it.

I work in a rural area with significant numbers of uninsured. The nearest dose of remdisivir is almost 100 miles away. My viewpoint on the healthcare system is definitely seen thru that lens.

The news paints in my opinion as fantasy land of healthcare that isn't the reality for a lot of people.

 

[Mackenzie Click-Mickelson]

i do not disagree that this is challenging. But Pfizer has answered most of these questions already with the boxes they’ve created.
As an example, a box of doses could be flown to, say Kansas City met several hours later by a UPS truck and driven straight to a rural nursing home and thawed and given immediately.

The issues with 'cold-chain' vaccines lies mostly in countries that suffer from many other things related to poor infrastructure. When I was reading up on it articles were discussing India and Bangladesh, etc regarding previous vaccines. It will be a lot easier and more manageable to distribute, even with shortcomings, in the U.S. than it will be in countries who do not have what we have.

It doesn't mean that having rural parts of America aren't an issue but we have the means by rail, plane, and tractor trailers to get things to the far reaches of our country (and depending on the lifespan of the vaccine at the temperature it must be stored at that will be enough to get it to places) and that will reduce the issues, of which they do exist. I wouldn't be confident in saying they would eliminate them though. I feel for these other countries much more in terms of the vaccine. My perspective on it probably remains more glass half full for the U.S. because of that.

You are right about KC part though I know you were just using that as an example.

 

[Mackenzie Click-Mickelson]

Not negative at all, but I don't see the antibody cocktail as significantly moving the needle on morbidity and mortality due to Covid. It's just not a game changer, but any treatment is better than none for those that can access it.

I work in a rural area with significant numbers of uninsured. The nearest dose of remdisivir is almost 100 miles away. My viewpoint on the healthcare system is definitely seen thru that lens.

Ideally that's when someone would come in and act like a courier. Easier said than done as means in terms of $ often would come into play, but not impossible as in it doesn't exist a way to do it. If money were no object...

Completely and utterly not related to COVID or vaccine talk but related to courier service my main library system in my county does interlibrary loans (free of charge). They use couriers for items (could be books, dvds, they even call out baking pans!, tools as well) at times who drive from "Kansas, Missouri, Texas and Colorado to deliver materials, as well as the U.S. Postal service." (for reference I'm in KS). They get items from all over the world (I've had books from England, Canada, Australia, New Zealand, Ireland, etc) but I had no idea until recently that they utilized a courier service as one way to get items from certain parts of the U.S.

 

[aggiedog]

Ideally that's when someone would come in and act like a courier. Easier said than done as means in terms of $ often would come into play, but not impossible as in it doesn't exist a way to do it. If money were no object...

A courier for the remdisivir you mean? If so, then no. It is not given in hospitals that don't have ICU's (we are a small, rural hospital that relies on transferring pt's that need more intensive care), at least not last I heard, due to the fact that it was in short supply. Our nursing director did say if we had someone we thought might need it she could maybe backdoor a dose via some big city nursing contacts, but officially, no, we don't get it. And during the last surge patients that needed ICU's were being transported 3-5+ hours away because all the nearby (1-2hrs) ICU's were full.

 

[Mackenzie Click-Mickelson]

A courier for the remdisivir you mean? If so, then no. It is not given in hospitals that don't have ICU's (we are a small, rural hospital that relies on transferring pt's that need more intensive care), at least not last I heard, due to the fact that it was in short supply. Our nursing director did say if we had someone we thought might need it she could maybe backdoor a dose via some big city nursing contacts, but officially, no, we don't get it. And during the last surge patients that needed ICU's were being transported 3-5+ hours away because all the nearby (1-2hrs) ICU's were full.

So the issue then is that you're a hospital that doesn't have an ICU? Or is it that you're 100miles away from the nearest dosage? If it's the ICU part that's different than the distance part. Can't really change a hospital easily over to an ICU, but transportation/distance is more easily overcome (in perspective).

 

[Jonfw2]

I have a quick question for you. I hop in and out of this thread and you seem to have a lot of info about covid. Are you a Dr. or do you work for a pharmaceutical company?

I work in finance and keep up on this for my job. I’m also in one of the vaccine studies.

 

[Jonfw2]

It’s no negative, it’s being more realistic. The news also doesn’t call for 100% Pollyanna optimism either. People have to admit that there are going to be challenges to getting this vaccine out there. While your earlier example of flying it out and getting it to the NH is excellent and most likely will be how this vaccine will initially be deployed around the country. I think others are starting to wonder how it will get to the point where they would be able to get it. This isn‘t going to be the type of vaccine that doctors offices or pharmacies have in stock that you can just head over and get. Most likely it’s going to be hospitals that get those cases of vaccines and it will be very difficult, logistically, for people to get vaccinated once it opens up to everyone can get it. There just won’t be enough places around the country that can store it properly.

What would be an example of something here you consider “Pollyannaish optimism”?

 

[aggiedog]

The issue is that we don't have an ICU, so if a patient needed it but isn't sick enough to warrant an ICU, they'd have to be transferred just to be able to get it. And when cases surge, transferring becomes very difficult to impossible. And I'll correct myself, as I forgot about a smallish hospital that does have 6 ICU beds 50 miles from here, so technically you could get a dose there, if there was a bed open. We rarely transfer TO that hospital though, as it is a bare strep up from us.

So having treatments "available" isn't the same as being able to get the treatment, at least not for a large chunk of the country who doesn't live near more metropolitan health care.

 

[NotUrsula]

UPS and FedEx have both already said they have been building freezer facilities nationwide to prepare for this.

I suspect that they are being just slightly disingenuous about that with regard to products that require -80C. There are freezers and there are freezers, and this kind are just not manufactured in large numbers. There are only a handful of mfrs, and some are reporting backorders. Unless a "freezer farm" is really only one freezer unit, I don't see where they are getting large numbers of them. Also, these freezers typically are not big walk-in units; the usual version is about the size of a 7 Cubic foot chest freezer (but the capacity is quite a bit smaller, due to the larger volume of insulation needed to maintain the temperature.)

The Pfizer shipping carrier is about the size of a carryon bag, but remember that a large part of that volume is taken up by the insulation and the space for the dry ice. There is no way that this system will accommodate walk-ups in any but the largest communities, because if you don't use it you lose it, REALLY quickly. Facilities will have no choice but to set appointments for dispensing exactly the number of doses that will be available in a scheduled shipment. Otherwise they will be overwhelmed with angry folks who waited for hours but were not able to get the dose.

 

[RamblingMad]

I suspect that they are being just slightly disingenuous about that with regard to products that require -80C. There are freezers and there are freezers, and this kind are just not manufactured in large numbers. There are only a handful of mfrs, and some are reporting backorders. Unless a "freezer farm" is really only one freezer unit, I don't see where they are getting large numbers of them. Also, these freezers typically are not big walk-in units; the usual version is about the size of a 7 Cubic foot chest freezer.

The Pfizer shipping carrier is about the size of a carryon bag, but remember that a large part of that volume is taken up by the insulation and the space for the dry ice. There is no way that this system will accommodate walk-ups in any but the largest communities, because if you don't use it you lose it, REALLY quickly. Facilities will have no choice but to set appointments for dispensing exactly the number of doses that will be available in a scheduled shipment. Otherwise they will be overwhelmed with angry folks who waited for hours but were not able to get the dose.

It's going to be a mess.

Why would a company increase their production of these freezers for a one off event? Economically, that doesn't make sense.

 

[Jonfw2]

It's going to be a mess.

Why would a company increase their production of these freezers for a one off event? Economically, that doesn't make sense.

Give me a for instance. A hypothetical. Something that will happen in the next couple months that would constitute “a mess”.

 

[RamblingMad]

Give me a for instance. A hypothetical. Something that will happen in the next couple months that would constitute “a mess”.

Distributing the vaccine is going to be a mess. When was the last time you messed with dry ice?

Here's one of those sensationalized US media reports on it:

https://www.msn.com/en-us/foodanddr...own-covid-19-vaccine-distribution/vi-BB1aUbNe

 

[mom2rtk]

Economically, that doesn't make sense.

Compared to the price of what this is doing to our economy, I bet it would be worth it.

 

[Jonfw2]

Distributing the vaccine is going to be a mess. When was the last time you messed with dry ice?

Here's one of those sensationalized US media reports on it:

https://www.msn.com/en-us/foodanddr...own-covid-19-vaccine-distribution/vi-BB1aUbNe

So what does that mean- 10,000 doses lost? Just give me a ballpark.

 

[RamblingMad]

Compared to the price of what this is doing to our economy, I bet it would be worth it.

True. But how do you convince the companies making the freezers to spend capital to build out production for a one off event? Why would their board or shareholders agree to this expense? And what do they do with the excess capacity once this is over?

The greater good isn't economical. Maybe we raise peoples taxes and use that money to pay for the freezers.

 

[dvcgirl67]

Distributing the vaccine is going to be a mess. When was the last time you messed with dry ice?

Here's one of those sensationalized US media reports on it:

https://www.msn.com/en-us/foodanddr...own-covid-19-vaccine-distribution/vi-BB1aUbNe

Here's an article that talks about Pfizer's vaccine. They're coordinating their own shipments and not using the government contractor to handle it (smart move). They've developed these small "thermal shipper" suitcases and if unopened, it will maintain the vaccine at the proper temp for up to 10 days. I'm guessing once they crack the suitcase open, that it's "go time".....they'd need to either transfer to deep freezer, or administer those vaccines in a timely matter. It seems like Pfizer didn't trust letting a third party handle this. I don't blame them.

Here's the pertinent part: I'll link full article below.

“The responsibility for determining how many deep-freeze machines exist at healthcare facilities has fallen on states because there is no central inventory,” FreightWaves’ Eric Kulisch writes. He notes that uncertainty about the cold-chain capabilities of transportation providers and vaccine administration facilities resulted in Pfizer developing a special cooler, or “thermal shipper,” with real-time GPS and thermal monitoring that can maintain deep-freeze vaccine storage for 10 days if left unopened. Kulisch reports that the shipping container is “about the size of a small suitcase” and uses dry ice to maintain recommended storage temperatures.

https://www.pharmaceuticalcommerce....ate-its-own-coronavirus-vaccine-distribution/

 

[TLSnell1981]

Compared to the price of what this is doing to our economy, I bet it would be worth it.

Funds are wasted in many areas that have little benefit to the masses. I think this would be money well spent.

 

[RamblingMad]

Here's an article that talks about Pfizer's vaccine. They're coordinating their own shipments and not using the government contractor to handle it (smart move). They've developed these small "thermal shipper" suitcases and if unopened, it will maintain the vaccine at the proper temp for up to 10 days. I'm guessing once they crack the suitcase open, that it's "go time".....they'd need to either transfer to deep freezer, or administer those vaccines in a timely matter. It seems like Pfizer didn't trust letting a third party handle this. I don't blame them.

Here's the pertinent part: I'll link full article below.

“The responsibility for determining how many deep-freeze machines exist at healthcare facilities has fallen on states because there is no central inventory,” FreightWaves’ Eric Kulisch writes. He notes that uncertainty about the cold-chain capabilities of transportation providers and vaccine administration facilities resulted in Pfizer developing a special cooler, or “thermal shipper,” with real-time GPS and thermal monitoring that can maintain deep-freeze vaccine storage for 10 days if left unopened. Kulisch reports that the shipping container is “about the size of a small suitcase” and uses dry ice to maintain recommended storage temperatures.

https://www.pharmaceuticalcommerce....ate-its-own-coronavirus-vaccine-distribution/

So are they using UPS, FedEx, or USPS? I get they are making their containers that depend upon dry ice. But how is it getting from them to the store/doctor that will administer it?

 

[mom2rtk]

True. But how do you convince the companies making the freezers to spend capital to build out production for a one off event? Why would their board or shareholders agree to this expense? And what do they do with the excess capacity once this is over?

The greater good isn't economical. Maybe we raise peoples taxes and use that money to pay for the freezers.

Uh, yes? Or print more money like they've been doing for all sorts of other garbage. Whatever. Just do what you must to open the economy back up.

I think a lot of people really aren't grasping how ugly this is all going to get really soon. This is the time to pull out all the stops.