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I really don't know why anyone is surprised by these revelations #COVID19 vaccine manufacturing & distribution snafus.
A THREAD: https://www.wsj.com/articles/pfizer-slashed-its-covid-19-vaccine-rollout-target-after-facing-supply-chain-obstacles-11607027787?reflink=desktopwebshare_twitter
A THREAD: https://www.wsj.com/articles/pfizer-slashed-its-covid-19-vaccine-rollout-target-after-facing-supply-chain-obstacles-11607027787?reflink=desktopwebshare_twitter
For 9 months, our government has failed to create working supply chains for both testing 
and PPE 
.
We still lack:
* raw materials
* manufacturing capability
* data on need
* logistics
* price supports
* equitable distribution
Why would we expect vaccines to be different?
and PPE .We still lack:
* raw materials
* manufacturing capability
* data on need
* logistics
* price supports
* equitable distribution
Why would we expect vaccines to be different?
Back in MARCH, a bunch of us called out that the system was broken. I wrote this with @ashishkjha and @DrValGriffeth. NOTHING that we talked about has been fixed. https://www.nejm.org/doi/full/10.1056/NEJMp2006141
Instead, the feds developed this mess of a system - a "fumbling" effort by "inexperienced" people with no background in supply chain logistics, manufacturing, disaster preparedness, or healthcare https://www.nytimes.com/2020/05/05/us/jared-kushner-fema-coronavirus.html
We learned very early in this pandemic that our national strategy was one of bluster & photo ops -- not one of doing the hard work to get supplies in the hands of those who need them.
For PPE, we set up workarounds - groups like @getusppe developed data networks & equitable distribution strategies. https://getusppe.org/data
For testing, the country relied on public-private partnerships, like RI's work with CVS. https://www.cnbc.com/2020/04/06/cvs-launches-drive-thru-rapid-testing-in-rhode-island-and-georgia.html
For testing, the country relied on public-private partnerships, like RI's work with CVS. https://www.cnbc.com/2020/04/06/cvs-launches-drive-thru-rapid-testing-in-rhode-island-and-georgia.html
But let's be clear: these efforts are simply SUBSTITUTES for a federal strategy. And there is no way that they are equivalent to a good, organized, all-50-state, publicly-funded effort.
Which brings me to vaccines.
Alarm bells have been ringing about the lack of strategy for vaccine manufacturing, distribution, & messaging, for months.
Alarm bells have been ringing about the lack of strategy for vaccine manufacturing, distribution, & messaging, for months.
In September, @healthyamerica1 & @DavidLakey_MD wrote a piece in @statnews imploring "Operation Warp Speed" to come up with a plan https://www.statnews.com/2020/09/14/key-to-efficient-vaccine-distribution-start-preparing-early/
Simultaneously, potential breakdowns in the cold-storage distribution chain were highlighted, by @pharmalot and others: https://www.statnews.com/pharmalot/2020/09/08/covid19-vaccine-supply-chain-cold-chain/
In OCTOBER, @ASTHO sounded the alarm that they *still* had no funds & no federal guidance on strategy. https://www.astho.org/Press-Room/Public-Health-Leaders-Request-COVID-19-Vaccine-Infrastructure-and-Administration-Funding/10-15-20/
(pdf from 11/20: https://www.astho.org/COVID-19/Vaccine-Distribution-and-Implementation-in-States-and-Territories-Brief/)
(pdf from 11/20: https://www.astho.org/COVID-19/Vaccine-Distribution-and-Implementation-in-States-and-Territories-Brief/)
As of NOVEMBER - despite knowing that multiple Phase 3 trials were nearing the end, & despite earlier promises to release vaccines pre-election - there was still no central repository for distribution plans, according to @KHNews https://www.kff.org/coronavirus-covid-19/issue-brief/states-are-getting-ready-to-distribute-covid-19-vaccines-what-do-their-plans-tell-us-so-far/
Not to mention that months on, NO ONE is talking about how to handle longstanding, well-founded mistrust from Black & brown communities, as outlined so beautifully by @DrBrittaniJ.
Without trust, even the best supply chain is useless.
https://twitter.com/DrBrittaniJ/status/1334594110888554499?s=20
Without trust, even the best supply chain is useless.
https://twitter.com/DrBrittaniJ/status/1334594110888554499?s=20
With consumer confidence in the federal government at an all-time low -- and #misinformation campaigns at an all time high -- even healthcare workers have expressed hesitancy about the vaccine.
[For more, check out @CaulfieldTim's timeline] https://www.cnbc.com/2020/10/31/2020-election-coronavirus-vaccine-disinformation-will-continue.html
[For more, check out @CaulfieldTim's timeline] https://www.cnbc.com/2020/10/31/2020-election-coronavirus-vaccine-disinformation-will-continue.html
Meanwhile, the guy who is directing Operation Warp Speed can't explain why DJT is making certain executive orders.... or why we passed on buying an extra 100 million doses of the vaccine. https://twitter.com/GMA/status/1336286297338605569?s=20
Let's be clear:
Almost 300K Americans have died.
Another 300K will likely die before inauguration.
And a vaccine is *the best chance we have* at getting things back to normal, quickly.
But what good is a vaccine, if it stays on the shelves?
Almost 300K Americans have died.
Another 300K will likely die before inauguration.
And a vaccine is *the best chance we have* at getting things back to normal, quickly.
But what good is a vaccine, if it stays on the shelves?
So to those who expect that a miracle will be wrought, and #COVID19 will simply disappear?
Sorry. Not gonna happen.
Sorry. Not gonna happen.
To those who expect that herd immunity will naturally come to pass?
Not gonna happen. (Look at Sweden or NYC.)
Not gonna happen. (Look at Sweden or NYC.)
To those who think that the states will magically figure it out, without funding or clear national guidance?
Nope.
Nope.
For the next 43 days, we'll just continue to bumble along, through the good will of philanthropy, forethought of a few great states' depts of health, & hard work of HCWs, pharmacists, & techs who have already sacrificed so much...
and continue to watch preventable deaths, grow.
and continue to watch preventable deaths, grow.
TL/DR?
1. We need investments in manufacturing and supply chain
2. We need investments in data architecture & equitable distribution
3. We need clear #publichealth messaging, stat
4. Magical thinking doesn't work to stop pandemics
1. We need investments in manufacturing and supply chain
2. We need investments in data architecture & equitable distribution
3. We need clear #publichealth messaging, stat
4. Magical thinking doesn't work to stop pandemics
At the end of the day, despite having sunk billions of dollars into the creation of a vaccine - our feds have failed to close the last-mile gap.
Just as they failed with testing, and with PPE.
Just as they failed with testing, and with PPE.
** PS: to those who have asked: I will soon also have a thread on why I trust the mRNA vaccines, and why I am enthusiastic about getting one.
