1 00:00:00,960 --> 00:00:05,680 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred 2 00:00:05,720 --> 00:00:09,720 Speaker 1: and sixty five since coronavirus was declared a global pandemic. 3 00:00:10,720 --> 00:00:15,040 Speaker 1: Today's main story A vaccine is likely to start shipping 4 00:00:15,080 --> 00:00:18,320 Speaker 1: around the US before the end of the year, but 5 00:00:18,520 --> 00:00:21,840 Speaker 1: states are getting mixed messages from the federal government about 6 00:00:21,880 --> 00:00:25,159 Speaker 1: how much of it they'll get, and that makes it 7 00:00:25,239 --> 00:00:28,560 Speaker 1: hard to set up programs to give people the shots. 8 00:00:29,640 --> 00:00:38,640 Speaker 1: But first, here's what happened in virus news today. Nations 9 00:00:38,720 --> 00:00:42,760 Speaker 1: across Europe are pushing ahead with fast track vaccine programs. 10 00:00:43,440 --> 00:00:46,280 Speaker 1: The UK has approved of vaccine and is hoping to 11 00:00:46,320 --> 00:00:51,440 Speaker 1: inoculate millions of Britons before year end. Spain aims to 12 00:00:51,520 --> 00:00:55,640 Speaker 1: vaccinate up to twenty billion people by June, and Sweden 13 00:00:55,720 --> 00:00:59,560 Speaker 1: expects to get enough doses next quarter to immunize a 14 00:00:59,680 --> 00:01:06,120 Speaker 1: fifth of its population. The US posted another day of 15 00:01:06,240 --> 00:01:12,360 Speaker 1: record COVID nineteen infections and deaths. That comes as overburdened 16 00:01:12,400 --> 00:01:15,960 Speaker 1: hospitals around the nation brace for a surge in cases 17 00:01:16,319 --> 00:01:22,759 Speaker 1: after Thanksgiving. Coronavirus hospitalizations in New York topped four thousand 18 00:01:23,200 --> 00:01:27,840 Speaker 1: for the first time since late May. New York City 19 00:01:27,880 --> 00:01:31,640 Speaker 1: plans to partner with private companies to create an institute 20 00:01:31,640 --> 00:01:36,920 Speaker 1: devoted to predicting and responding to future pandemics, according to 21 00:01:36,959 --> 00:01:43,440 Speaker 1: the city's mayor, Build A Blasio. Finally, California, the first 22 00:01:43,440 --> 00:01:46,039 Speaker 1: state to tell residents to stay home to fight the 23 00:01:46,040 --> 00:01:51,040 Speaker 1: coronavirus pandemic, may be about to do it again. Governor 24 00:01:51,080 --> 00:01:54,520 Speaker 1: Gavin Newsom warned Thursday that the state would impose a 25 00:01:54,600 --> 00:01:58,559 Speaker 1: new shelter at Home order if hospitals start running short 26 00:01:58,640 --> 00:02:02,320 Speaker 1: of intensive care capac city that could happen in some 27 00:02:02,400 --> 00:02:06,520 Speaker 1: areas as soon as this week. The order would be 28 00:02:06,520 --> 00:02:12,040 Speaker 1: imposed in specific regions rather than statewide. If imposed, the 29 00:02:12,160 --> 00:02:21,400 Speaker 1: order would last three weeks. And now for today's main story. 30 00:02:22,639 --> 00:02:25,920 Speaker 1: Weeks before states expect to receive their first shipments of 31 00:02:25,960 --> 00:02:30,320 Speaker 1: COVID nineteen vaccines, they're getting conflicting messages from the federal 32 00:02:30,360 --> 00:02:36,000 Speaker 1: government about exactly how many doses may arrive. Some governors 33 00:02:36,000 --> 00:02:39,360 Speaker 1: have made splashy announcements about how much of FISER and 34 00:02:39,480 --> 00:02:42,520 Speaker 1: bio en Tex vaccines they expect to get if the 35 00:02:42,639 --> 00:02:47,880 Speaker 1: US Food and Drug Administration authorizes them this month. Other 36 00:02:48,000 --> 00:02:53,440 Speaker 1: states can't provide a solid answer, but all of them 37 00:02:53,639 --> 00:02:58,360 Speaker 1: must submit orders and distribution plans. Friday, I spoke with 38 00:02:58,440 --> 00:03:03,480 Speaker 1: reporter Angelical loveto about how the shifting expectations are creating 39 00:03:03,639 --> 00:03:10,959 Speaker 1: all sorts of problems. Over the past few weeks, there's 40 00:03:11,160 --> 00:03:14,280 Speaker 1: been a lot of anticipation about the rollout of COVID 41 00:03:14,360 --> 00:03:19,799 Speaker 1: nineteen vaccines, with first doses available potentially very soon, but 42 00:03:20,160 --> 00:03:24,400 Speaker 1: the gargantuan task of supplying vaccines to all fifty states 43 00:03:24,560 --> 00:03:27,600 Speaker 1: raises a lot of questions about how this is going 44 00:03:27,639 --> 00:03:32,040 Speaker 1: to be achieved. What do we know about how states 45 00:03:32,080 --> 00:03:35,280 Speaker 1: are liaising with the federal government in the US about 46 00:03:35,480 --> 00:03:39,440 Speaker 1: how many doses they will need or the timeline for 47 00:03:39,480 --> 00:03:44,360 Speaker 1: getting those doses. So we have heard from federal officials 48 00:03:44,840 --> 00:03:47,360 Speaker 1: that at the very beginning, there will be six point 49 00:03:47,400 --> 00:03:53,200 Speaker 1: four million of the fiser vaccine doses available, and those 50 00:03:53,400 --> 00:03:56,640 Speaker 1: doses need to be spread out across all of the states, 51 00:03:56,880 --> 00:04:00,800 Speaker 1: as well as a few cities and then oratories, as 52 00:04:00,840 --> 00:04:04,840 Speaker 1: well as five federal agencies. So all of those doses 53 00:04:04,960 --> 00:04:07,360 Speaker 1: need to get spread out, and from what we have 54 00:04:07,440 --> 00:04:11,280 Speaker 1: heard is that the federal government is giving estimates to 55 00:04:11,640 --> 00:04:15,200 Speaker 1: all of those jurisdictions. However, we've heard that some of 56 00:04:15,200 --> 00:04:19,120 Speaker 1: those numbers have been changing, and that's very frustrating, as 57 00:04:19,160 --> 00:04:22,600 Speaker 1: you can imagine if you're trying to plan exactly what 58 00:04:22,640 --> 00:04:25,560 Speaker 1: you're getting and how you will build those out. As 59 00:04:25,600 --> 00:04:29,800 Speaker 1: of today, all of those jurisdictions should have received their 60 00:04:29,839 --> 00:04:33,320 Speaker 1: final numbers because they need to place their initial orders 61 00:04:33,600 --> 00:04:37,719 Speaker 1: today as in Friday. That way, the federal government knows 62 00:04:37,760 --> 00:04:42,159 Speaker 1: exactly who wants what day one, so as soon as 63 00:04:42,200 --> 00:04:48,800 Speaker 1: the FDA authorizes a vaccine, those shipments will start going out. Now, 64 00:04:48,839 --> 00:04:51,480 Speaker 1: there are a lot of numbers and a lot of 65 00:04:51,600 --> 00:04:55,800 Speaker 1: math involved in these calculations, obviously, and in terms of 66 00:04:55,839 --> 00:05:01,280 Speaker 1: the individual states, how are they supp hosts to really 67 00:05:01,320 --> 00:05:04,640 Speaker 1: calculate how many doses of the vaccine they will need. 68 00:05:06,040 --> 00:05:09,200 Speaker 1: So that's a very good question, and unfortunately we have 69 00:05:09,279 --> 00:05:12,119 Speaker 1: had a hard time figuring that out. We have asked 70 00:05:12,160 --> 00:05:17,039 Speaker 1: Operation warp Speed exactly how those doses will be allocated, 71 00:05:17,360 --> 00:05:19,640 Speaker 1: and it should be a simple math problem. There's six 72 00:05:19,680 --> 00:05:24,480 Speaker 1: point four million doses available initially, and those are supposed 73 00:05:24,520 --> 00:05:29,840 Speaker 1: to be allocated by the adult population in each jurisdiction, 74 00:05:30,279 --> 00:05:32,760 Speaker 1: so the number of people you have over the age 75 00:05:32,760 --> 00:05:37,200 Speaker 1: of eighteen. However, we've asked for the master list of 76 00:05:37,520 --> 00:05:41,040 Speaker 1: the allocations across the states and the five federal agencies, 77 00:05:41,360 --> 00:05:43,559 Speaker 1: and we were not able to get such a list. 78 00:05:44,040 --> 00:05:47,520 Speaker 1: So it's a little difficult to figure out exactly how 79 00:05:48,080 --> 00:05:53,320 Speaker 1: those how those doses are being distributed. We've gotten numbers 80 00:05:53,360 --> 00:05:56,159 Speaker 1: from different states saying that these are the numbers we've 81 00:05:56,160 --> 00:05:59,040 Speaker 1: received from the federal government. However, we have not been 82 00:05:59,080 --> 00:06:02,719 Speaker 1: able to get of a comprehensive list, and so it 83 00:06:02,800 --> 00:06:06,840 Speaker 1: sounds like there there isn't a unilateral confirmation that if 84 00:06:06,839 --> 00:06:10,640 Speaker 1: a state says it needs so many doses, that may 85 00:06:10,720 --> 00:06:15,080 Speaker 1: not be the amount of doses they get right. And so, 86 00:06:15,200 --> 00:06:17,840 Speaker 1: for example, we reached out to a bunch of different 87 00:06:17,880 --> 00:06:20,680 Speaker 1: states in Michigan said that they couldn't give us a 88 00:06:20,680 --> 00:06:24,040 Speaker 1: concrete number because in the past several days alone they 89 00:06:24,080 --> 00:06:26,920 Speaker 1: had heard everything from a couple hundred thousand doses to 90 00:06:27,080 --> 00:06:30,320 Speaker 1: under ninety thousand, and so, as you can imagine, that's 91 00:06:30,360 --> 00:06:34,480 Speaker 1: pretty frustrating if you're a state. However, it's almost certain 92 00:06:34,520 --> 00:06:38,120 Speaker 1: that no state will receive enough vaccine doses right at 93 00:06:38,120 --> 00:06:41,600 Speaker 1: the beginning to vaccinate even the priority group that they 94 00:06:41,600 --> 00:06:44,680 Speaker 1: are supposed to start with, which is healthcare workers and 95 00:06:44,880 --> 00:06:48,040 Speaker 1: long term care residents. And we've already seen an example 96 00:06:48,160 --> 00:06:51,720 Speaker 1: of at least one state lobbying for more than it's 97 00:06:51,720 --> 00:06:55,480 Speaker 1: supposed to get. So we have Wisconsin yesterday, the Democratic 98 00:06:55,520 --> 00:06:59,800 Speaker 1: governor Tony Evers saying that you know, Republican lawmakers have 99 00:07:00,040 --> 00:07:03,520 Speaker 1: under the response and created a disaster. Therefore, he wants 100 00:07:03,640 --> 00:07:06,760 Speaker 1: enough doses to vaccinate all four hundred and fifty thousand 101 00:07:07,279 --> 00:07:10,760 Speaker 1: of the state's healthcare workers. Right now, he's only supposed 102 00:07:10,800 --> 00:07:14,440 Speaker 1: to get about sixty doses, so you can see sort 103 00:07:14,480 --> 00:07:17,560 Speaker 1: of the imbalance between what people are expecting and what 104 00:07:17,600 --> 00:07:20,480 Speaker 1: they'll need to cover everyone. However, I should also be 105 00:07:20,520 --> 00:07:24,080 Speaker 1: clear that Operation warp Speed keeps saying that that is 106 00:07:24,120 --> 00:07:28,680 Speaker 1: the initial allocation and that they will start increasing supply 107 00:07:29,000 --> 00:07:33,400 Speaker 1: every week and distributing more supplies every week so that um, 108 00:07:33,400 --> 00:07:37,560 Speaker 1: those quickly become available. You've mentioned, of course, that there 109 00:07:37,560 --> 00:07:42,120 Speaker 1: are some different distribution plans, and these vary from state 110 00:07:42,200 --> 00:07:45,119 Speaker 1: to state. That although there is a focus on getting 111 00:07:45,160 --> 00:07:49,080 Speaker 1: the vaccine first to those specific communities like frontline workers, 112 00:07:49,480 --> 00:07:52,760 Speaker 1: what are some of the other different distribution plans we've 113 00:07:52,880 --> 00:07:55,360 Speaker 1: seen among the various states in terms of who will 114 00:07:55,400 --> 00:08:00,440 Speaker 1: receive this vaccine first. Right, So, earlier this week, the 115 00:08:00,640 --> 00:08:06,840 Speaker 1: CDCs Vaccine Advisory Committee met and finalized its inner recommendations 116 00:08:06,880 --> 00:08:10,680 Speaker 1: so they will meet again whenever a vaccine is authorized, 117 00:08:10,760 --> 00:08:14,160 Speaker 1: that healthcare workers and long term care residents should be 118 00:08:14,200 --> 00:08:18,520 Speaker 1: the first to get vaccinated. However, that sounds easy, it's not, 119 00:08:19,000 --> 00:08:22,640 Speaker 1: because if you're only getting enough vaccine doses to cover 120 00:08:22,720 --> 00:08:25,120 Speaker 1: a fraction to those people, you have to make some 121 00:08:25,200 --> 00:08:28,240 Speaker 1: hard choices about who you'll start with and where you'll 122 00:08:28,280 --> 00:08:31,560 Speaker 1: send those doses. So we have heard that some states 123 00:08:31,640 --> 00:08:35,800 Speaker 1: are viewing this differently, because some of them say, let's 124 00:08:35,800 --> 00:08:38,720 Speaker 1: start with the healthcare workers, because they're the ones who 125 00:08:38,800 --> 00:08:42,120 Speaker 1: are at the greatest risk of being exposed and possibly 126 00:08:42,160 --> 00:08:45,800 Speaker 1: catching the virus. But other states are saying, let's start 127 00:08:45,800 --> 00:08:48,760 Speaker 1: with the long term care residents because they're the ones 128 00:08:48,800 --> 00:08:51,199 Speaker 1: who are getting infected the most, and if we can 129 00:08:51,880 --> 00:08:55,480 Speaker 1: um tame those infections, then we can help the healthcare workers. 130 00:08:55,960 --> 00:08:58,679 Speaker 1: So hopefully we'll get to a place where there are 131 00:08:58,800 --> 00:09:03,400 Speaker 1: enough doses to vacate everybody simultaneously among those groups. But 132 00:09:03,480 --> 00:09:07,640 Speaker 1: there could be some states where they're starting with one 133 00:09:07,679 --> 00:09:10,840 Speaker 1: group or starting with the other um as we start 134 00:09:10,920 --> 00:09:14,560 Speaker 1: this process. Now, these are just some of the logistical 135 00:09:14,640 --> 00:09:17,440 Speaker 1: hurdles that each state is facing right now, But of 136 00:09:17,480 --> 00:09:22,719 Speaker 1: course there are other maybe even broader questions about the 137 00:09:22,800 --> 00:09:27,559 Speaker 1: materials needed for this vaccine as well as storing and 138 00:09:27,640 --> 00:09:30,640 Speaker 1: transporting the vaccine. And I was wondering if you might 139 00:09:30,679 --> 00:09:34,520 Speaker 1: go into some of those other logistical hoops that the 140 00:09:34,600 --> 00:09:37,960 Speaker 1: states are facing now to to receive this vaccine and 141 00:09:38,000 --> 00:09:42,319 Speaker 1: distribute it. So it's all but certain that Fiser's vaccine 142 00:09:42,400 --> 00:09:46,280 Speaker 1: candidate will be the first one to receive FDA authorization, 143 00:09:46,440 --> 00:09:50,000 Speaker 1: assuming of course, that the FDA does authorize it. And 144 00:09:50,360 --> 00:09:54,760 Speaker 1: that vaccine is very difficult to distribute and to handle 145 00:09:55,160 --> 00:09:59,679 Speaker 1: because you need to keep that vaccine candidate at negative 146 00:09:59,800 --> 00:10:02,960 Speaker 1: NIE need four degrees fahrenheit. What that means is that 147 00:10:03,000 --> 00:10:06,480 Speaker 1: you need these special freezers to store them. The large 148 00:10:06,600 --> 00:10:09,360 Speaker 1: health systems typically have those, which is why at the 149 00:10:09,400 --> 00:10:15,199 Speaker 1: beginning you will almost certainly see large health systems receiving doses. 150 00:10:15,400 --> 00:10:17,840 Speaker 1: If you don't have those freezers, you need to keep 151 00:10:17,880 --> 00:10:21,679 Speaker 1: them in this special container that Feiser has created and 152 00:10:21,720 --> 00:10:25,960 Speaker 1: will ship out the doses in. And these containers are 153 00:10:26,160 --> 00:10:29,439 Speaker 1: kept cold with dry ice. And if anybody out there 154 00:10:29,480 --> 00:10:33,120 Speaker 1: is familiar dry ice, you know that it's difficult to manage. 155 00:10:33,200 --> 00:10:37,000 Speaker 1: There are specifics. You can only open the container a 156 00:10:37,040 --> 00:10:39,560 Speaker 1: few times a day. Or else you run the risk 157 00:10:39,760 --> 00:10:43,320 Speaker 1: of the dry ice vaporizing. So they require a lot 158 00:10:43,400 --> 00:10:47,600 Speaker 1: of different handling instructions and it's not just as easy 159 00:10:47,640 --> 00:10:49,720 Speaker 1: as getting it there and leaving it on the shelf. 160 00:10:51,280 --> 00:10:54,400 Speaker 1: Have there been any, say, trial runs in just seeing 161 00:10:54,559 --> 00:10:58,800 Speaker 1: how these supply lines or distribution chains work when it 162 00:10:58,880 --> 00:11:03,240 Speaker 1: does come to getting the vaccine out to the various states. Yes, 163 00:11:03,520 --> 00:11:07,840 Speaker 1: so there have been test runs to practice shipping the 164 00:11:07,960 --> 00:11:11,800 Speaker 1: vaccines as well as the ancillary supply kits. So these 165 00:11:11,880 --> 00:11:16,240 Speaker 1: kits will include things like syringes, masks, things that you'll 166 00:11:16,240 --> 00:11:19,920 Speaker 1: need to actually give the vaccines. So over the past 167 00:11:19,960 --> 00:11:22,960 Speaker 1: few weeks, there have been test shipments and they haven't 168 00:11:23,000 --> 00:11:26,640 Speaker 1: included any real vaccines or any real supplies, but rather 169 00:11:26,840 --> 00:11:30,800 Speaker 1: empty containers. And we've heard from at least two states 170 00:11:30,840 --> 00:11:34,439 Speaker 1: who said that they got their test shipments of the vaccines, 171 00:11:34,520 --> 00:11:37,680 Speaker 1: but not of the ancillary supply kits. So North Dakota 172 00:11:38,080 --> 00:11:41,600 Speaker 1: and Colorado both reporting that they didn't receive those shipments. 173 00:11:42,000 --> 00:11:45,200 Speaker 1: Um Colorado even said that their kit went to another 174 00:11:45,360 --> 00:11:48,840 Speaker 1: state because of a label printing error. We reached out 175 00:11:48,880 --> 00:11:52,880 Speaker 1: to McKesson, which is the company responsible for creating and 176 00:11:52,960 --> 00:11:55,640 Speaker 1: sending the kits, and they said that this was part 177 00:11:55,679 --> 00:11:58,120 Speaker 1: of the normal process and that this is why you 178 00:11:58,160 --> 00:12:01,560 Speaker 1: test things. They've addressed the issues and they confirmed that 179 00:12:01,600 --> 00:12:05,319 Speaker 1: they fixed them. And so of course we are just 180 00:12:05,600 --> 00:12:11,040 Speaker 1: discussing the very early rollout of this vaccine, but this 181 00:12:11,120 --> 00:12:15,520 Speaker 1: eventually will be ramped up to vaccinating the general population. 182 00:12:16,000 --> 00:12:19,360 Speaker 1: Millions more people to receive these doses. What are some 183 00:12:19,440 --> 00:12:24,280 Speaker 1: of the other possible logistical challenges we might see once that, 184 00:12:24,840 --> 00:12:29,280 Speaker 1: once that distribution plan scales up, right, So the irony 185 00:12:29,360 --> 00:12:32,600 Speaker 1: here is that we're spending so much time talking about 186 00:12:32,960 --> 00:12:36,520 Speaker 1: whether people are ready for day one that it's easy 187 00:12:36,600 --> 00:12:38,720 Speaker 1: to lose sight of the fact that day one could 188 00:12:38,720 --> 00:12:42,560 Speaker 1: actually be the easiest day because at the beginning, you know, 189 00:12:42,600 --> 00:12:46,520 Speaker 1: we're only talking about six point four million doses getting shipped, 190 00:12:46,559 --> 00:12:49,400 Speaker 1: and in the grand scheme of things, that's really not 191 00:12:49,480 --> 00:12:52,440 Speaker 1: that many. We could quickly come to the point where, 192 00:12:52,480 --> 00:12:56,120 Speaker 1: you know, many more doses are being shipped, as well 193 00:12:56,160 --> 00:13:01,160 Speaker 1: as vaccine doses from multiple companies, So this could quickly 194 00:13:01,240 --> 00:13:05,880 Speaker 1: quickly increase in scale, and of course with scale comes complexity. 195 00:13:06,000 --> 00:13:08,720 Speaker 1: Are you making sure that they're going to the right places, 196 00:13:08,800 --> 00:13:11,200 Speaker 1: Are you making sure that the people giving them are 197 00:13:11,320 --> 00:13:14,480 Speaker 1: tracking everything correctly. Are you making sure that people who 198 00:13:14,520 --> 00:13:16,800 Speaker 1: got the first shot are coming back in for their 199 00:13:16,800 --> 00:13:21,680 Speaker 1: booster shot. These are all things that will quickly increase 200 00:13:21,760 --> 00:13:25,240 Speaker 1: in complexity and are really vital to making sure that 201 00:13:25,640 --> 00:13:29,840 Speaker 1: actually go smoothly, because, like you mentioned earlier, this is 202 00:13:29,960 --> 00:13:33,480 Speaker 1: a huge, huge effort and there are so many moving 203 00:13:33,520 --> 00:13:37,080 Speaker 1: parts that will need to be accounted for throughout this 204 00:13:37,120 --> 00:13:44,560 Speaker 1: whole process. That was Angelica Levido, and that's it for 205 00:13:44,600 --> 00:13:47,200 Speaker 1: our show today. For coverage of the outbreak from one 206 00:13:47,960 --> 00:13:52,400 Speaker 1: bureaus around the world, visit Bloomberg dot com slash Coronavirus 207 00:13:53,200 --> 00:13:55,320 Speaker 1: and if you like the show, please leave us a 208 00:13:55,360 --> 00:13:59,160 Speaker 1: review and a rating on Apple Podcasts or Spotify. It's 209 00:13:59,200 --> 00:14:02,640 Speaker 1: the best way to help more listeners find our global reporting. 210 00:14:03,600 --> 00:14:06,920 Speaker 1: The Prognosis Daily edition is produced by Top for foreheads 211 00:14:07,040 --> 00:14:12,320 Speaker 1: Jordan Gaspure, Magnus Hendrickson, and Meat Laura Carlson. Today's main 212 00:14:12,360 --> 00:14:17,320 Speaker 1: story was reported by Angelica Levito. Original music by Leo Sidrin. 213 00:14:17,840 --> 00:14:21,880 Speaker 1: Our editors are Rick Shine and Francesca Levi. Francesco Levi 214 00:14:22,240 --> 00:14:25,400 Speaker 1: is Bloomberg's head of Podcasts. Thanks for listening.