The UK faces from this week the crucial challenge of moving from propaganda to reality. The rest of the world will carefully observe the successes, but above all the errors, of the Government of Boris Johnson, in its bid to be the first to launch a massive vaccination campaign against covid-19. The British army began to carry out a trial of distribution of the treatment, dubbed “Operation Panacea”, as soon as it learned that the national regulatory authority of medicines (MHRA, in its acronym in English) had given the green light to the vaccine from Pfizer and BioNTech. The pilot exercise was carried out at the Ashton Gate Stadium in Bristol. It is one of the large spaces designated for a logistical challenge that includes the transport of the drug from the European continent to the island, its storage in facilities with an undisclosed location to the public, and its subsequent distribution to stadiums and convention centers, 50 hospitals and hundreds of medical clinics. “I am sure that all the experts who collaborate closely in the effort will be able to identify the easiest route for the vaccine to be accessible to all those who need it,” Professor Ugur Sahin, co-founder of BioNTech, assured the ITV chain.
The British media chased after all the trucks leaving the Pfizer manufacturing plant in Puurs, Belgium. None of them showed any sign of identity on their bodywork or on the containers. Downing Street has taken extreme security measures to prevent theft or acts of vandalism. Interpol has sent an alert to 194 police agencies around the world to be prepared for the possible activity of criminal organizations willing to do business with the vaccine. “They have begun to plan how to infiltrate or break the distribution chain, in addition to looking for potential victims through false web pages that may pose a risk to people’s lives,” warned the general secretary of the international agency, Juergen Stock .
Most of the trucks concluded their journey in the central England town of Folkestone after crossing the Channel via the Channel Tunnel. From there, according to sources cited by various means, they were distributed to three laboratories of Public Health England (PHE, in its acronym in English, the managing body of the English public health).
As in any operation of this size, problems have started to emerge from the first minute, and it has been necessary to change plans and improvise solutions. The announced decision that the first to receive the vaccine would be the nursing homes has been altered by a simple problem of arithmetic and temperature. The containers where the initial transport takes place can store up to 5,000 doses, but the regulatory authorities, so far, have only allowed their division into packages of up to 975 units. They are the ones that can be stored in the Pfizer-designed dry ice-fed thermal sensor container. The vaccine needs to be kept at a temperature of -70ºC. Most of the thousands of nursing homes across the UK house only a few dozen people, so without detailed planning you run the risk of wasting many doses of a product that does not last for more than six hours transport in a conventional refrigerator. The first to recognize the problem was the Home Rule Government of Wales, which in a public statement acknowledged that “in practical terms, at this time, we are not able to distribute this vaccine to residences.” Pfizer has also admitted the problem, but its managers say that the drug, once stabilized at its final destination, is capable of maintaining its effectiveness for up to five days at a temperature between -2º and -8º. It is foreseeable that the MHRA will give its approval in the coming days to the partitioning of the lots and an appropriate distribution design.
The general director of Primary Care of the NHS in England, Nikita Kanani, has sent a letter this Monday to hundreds of local medical centers in which he warns them to be ready from December 14. “Each one of you must be ready to distribute 975 doses to priority patients as of that date —those over 80 years of age who can attend by themselves or those with previous pathologies that increase risk—. You should use the vaccine quickly in the days after it is delivered. We can only guarantee three and a half days of vaccination from arrival at the center, as long as it is properly stored at a temperature of -2º -8º ”, Kanani warns in the document.
Several members of the English health personnel with whom EL PAÍS spoke at the end of this week pointed out that the decisions are still in a highly centralized phase, and that they had hardly had conversations with their superiors in which they had been warned that they should start prepare to provide support. Kanani explains in his letter that the NHS leadership “works closely with the Clinical Engagement Groups (CCGs) to identify which centers will be ready to start vaccinating in the designated week.” The CCGs are the administrative nuclei of the NHS that organize the necessary health care at the local level. The priority selection criterion will be the concentration in the respective areas of citizens over 80 years of age, although the CCGs have also been asked to “consider situations of inequality or poverty” when selecting centers.
“We are trying to find the best way to get the vaccine to people, but for now it will have to be the people who come to get vaccinated,” admitted on the BBC Frank Atherton, the chief medical adviser to the Government of Wales. “We must temper priorities and adjust them to operational reality, to be able to distribute the vaccine in an efficient and safe way.”
The British Government now recognizes that the operation will have to begin in its easier phases, and that the first doses will have to be distributed in the large centers controlled by the army (up to 100,000 weekly doses in each, as calculated by the NHS) and in the 50 selected hospitals throughout the country. Jonathan Van-Tam, the chief medical adviser to the NHS in England, and the man to whom the Johnson Government has relegated all communication in its fight against the coronavirus, has admitted that nursing homes, again, will have to wait, and that they will probably be the main beneficiaries of the vaccine developed by the University of Oxford and Astrazeneca, much easier to transport and store than that of Pfizer. “As soon as it is legally and technically possible to bring the vaccine to residences, we will,” he said. “But it is a complex and fragile product. This is not a yogurt that can be put in and out of the fridge several times ”.
The response of the residences, tragic victims of the government’s mistakes during the first wave of the pandemic, has been blunt. Vic Rayner, the CEO of National Care Forum (the organization that concentrates the majority of non-profit centers for the elderly), has demanded that an answer be found to the problem: “Being the first Western country to authorize the vaccine against covid-19 is a remarkable fact. But now we must put all our energy and ingenuity into ensuring that the most vulnerable are the first to receive it, ”he said.
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