Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day two hundred
Speaker 1: and sixty five since coronavirus was declared a global pandemic.
Speaker 1: Today's main story A vaccine is likely to start shipping
Speaker 1: around the US before the end of the year, but
Speaker 1: states are getting mixed messages from the federal government about
Speaker 1: how much of it they'll get, and that makes it
Speaker 1: hard to set up programs to give people the shots.
Speaker 1: But first, here's what happened in virus news today. Nations
Speaker 1: across Europe are pushing ahead with fast track vaccine programs.
Speaker 1: The UK has approved of vaccine and is hoping to
Speaker 1: inoculate millions of Britons before year end. Spain aims to
Speaker 1: vaccinate up to twenty billion people by June, and Sweden
Speaker 1: expects to get enough doses next quarter to immunize a
Speaker 1: fifth of its population. The US posted another day of
Speaker 1: record COVID nineteen infections and deaths. That comes as overburdened
Speaker 1: hospitals around the nation brace for a surge in cases
Speaker 1: after Thanksgiving. Coronavirus hospitalizations in New York topped four thousand
Speaker 1: for the first time since late May. New York City
Speaker 1: plans to partner with private companies to create an institute
Speaker 1: devoted to predicting and responding to future pandemics, according to
Speaker 1: the city's mayor, Build A Blasio. Finally, California, the first
Speaker 1: state to tell residents to stay home to fight the
Speaker 1: coronavirus pandemic, may be about to do it again. Governor
Speaker 1: Gavin Newsom warned Thursday that the state would impose a
Speaker 1: new shelter at Home order if hospitals start running short
Speaker 1: of intensive care capac city that could happen in some
Speaker 1: areas as soon as this week. The order would be
Speaker 1: imposed in specific regions rather than statewide. If imposed, the
Speaker 1: order would last three weeks. And now for today's main story.
Speaker 1: Weeks before states expect to receive their first shipments of
Speaker 1: COVID nineteen vaccines, they're getting conflicting messages from the federal
Speaker 1: government about exactly how many doses may arrive. Some governors
Speaker 1: have made splashy announcements about how much of FISER and
Speaker 1: bio en Tex vaccines they expect to get if the
Speaker 1: US Food and Drug Administration authorizes them this month. Other
Speaker 1: states can't provide a solid answer, but all of them
Speaker 1: must submit orders and distribution plans. Friday, I spoke with
Speaker 1: reporter Angelical loveto about how the shifting expectations are creating
Speaker 1: all sorts of problems. Over the past few weeks, there's
Speaker 1: been a lot of anticipation about the rollout of COVID
Speaker 1: nineteen vaccines, with first doses available potentially very soon, but
Speaker 1: the gargantuan task of supplying vaccines to all fifty states
Speaker 1: raises a lot of questions about how this is going
Speaker 1: to be achieved. What do we know about how states
Speaker 1: are liaising with the federal government in the US about
Speaker 1: how many doses they will need or the timeline for
Speaker 1: getting those doses. So we have heard from federal officials
Speaker 1: that at the very beginning, there will be six point
Speaker 1: four million of the fiser vaccine doses available, and those
Speaker 1: doses need to be spread out across all of the states,
Speaker 1: as well as a few cities and then oratories, as
Speaker 1: well as five federal agencies. So all of those doses
Speaker 1: need to get spread out, and from what we have
Speaker 1: heard is that the federal government is giving estimates to
Speaker 1: all of those jurisdictions. However, we've heard that some of
Speaker 1: those numbers have been changing, and that's very frustrating, as
Speaker 1: you can imagine if you're trying to plan exactly what
Speaker 1: you're getting and how you will build those out. As
Speaker 1: of today, all of those jurisdictions should have received their
Speaker 1: final numbers because they need to place their initial orders
Speaker 1: today as in Friday. That way, the federal government knows
Speaker 1: exactly who wants what day one, so as soon as
Speaker 1: the FDA authorizes a vaccine, those shipments will start going out. Now,
Speaker 1: there are a lot of numbers and a lot of
Speaker 1: math involved in these calculations, obviously, and in terms of
Speaker 1: the individual states, how are they supp hosts to really
Speaker 1: calculate how many doses of the vaccine they will need.
Speaker 1: So that's a very good question, and unfortunately we have
Speaker 1: had a hard time figuring that out. We have asked
Speaker 1: Operation warp Speed exactly how those doses will be allocated,
Speaker 1: and it should be a simple math problem. There's six
Speaker 1: point four million doses available initially, and those are supposed
Speaker 1: to be allocated by the adult population in each jurisdiction,
Speaker 1: so the number of people you have over the age
Speaker 1: of eighteen. However, we've asked for the master list of
Speaker 1: the allocations across the states and the five federal agencies,
Speaker 1: and we were not able to get such a list.
Speaker 1: So it's a little difficult to figure out exactly how
Speaker 1: those how those doses are being distributed. We've gotten numbers
Speaker 1: from different states saying that these are the numbers we've
Speaker 1: received from the federal government. However, we have not been
Speaker 1: able to get of a comprehensive list, and so it
Speaker 1: sounds like there there isn't a unilateral confirmation that if
Speaker 1: a state says it needs so many doses, that may
Speaker 1: not be the amount of doses they get right. And so,
Speaker 1: for example, we reached out to a bunch of different
Speaker 1: states in Michigan said that they couldn't give us a
Speaker 1: concrete number because in the past several days alone they
Speaker 1: had heard everything from a couple hundred thousand doses to
Speaker 1: under ninety thousand, and so, as you can imagine, that's
Speaker 1: pretty frustrating if you're a state. However, it's almost certain
Speaker 1: that no state will receive enough vaccine doses right at
Speaker 1: the beginning to vaccinate even the priority group that they
Speaker 1: are supposed to start with, which is healthcare workers and
Speaker 1: long term care residents. And we've already seen an example
Speaker 1: of at least one state lobbying for more than it's
Speaker 1: supposed to get. So we have Wisconsin yesterday, the Democratic
Speaker 1: governor Tony Evers saying that you know, Republican lawmakers have
Speaker 1: under the response and created a disaster. Therefore, he wants
Speaker 1: enough doses to vaccinate all four hundred and fifty thousand
Speaker 1: of the state's healthcare workers. Right now, he's only supposed
Speaker 1: to get about sixty doses, so you can see sort
Speaker 1: of the imbalance between what people are expecting and what
Speaker 1: they'll need to cover everyone. However, I should also be
Speaker 1: clear that Operation warp Speed keeps saying that that is
Speaker 1: the initial allocation and that they will start increasing supply
Speaker 1: every week and distributing more supplies every week so that um,
Speaker 1: those quickly become available. You've mentioned, of course, that there
Speaker 1: are some different distribution plans, and these vary from state
Speaker 1: to state. That although there is a focus on getting
Speaker 1: the vaccine first to those specific communities like frontline workers,
Speaker 1: what are some of the other different distribution plans we've
Speaker 1: seen among the various states in terms of who will
Speaker 1: receive this vaccine first. Right, So, earlier this week, the
Speaker 1: CDCs Vaccine Advisory Committee met and finalized its inner recommendations
Speaker 1: so they will meet again whenever a vaccine is authorized,
Speaker 1: that healthcare workers and long term care residents should be
Speaker 1: the first to get vaccinated. However, that sounds easy, it's not,
Speaker 1: because if you're only getting enough vaccine doses to cover
Speaker 1: a fraction to those people, you have to make some
Speaker 1: hard choices about who you'll start with and where you'll
Speaker 1: send those doses. So we have heard that some states
Speaker 1: are viewing this differently, because some of them say, let's
Speaker 1: start with the healthcare workers, because they're the ones who
Speaker 1: are at the greatest risk of being exposed and possibly
Speaker 1: catching the virus. But other states are saying, let's start
Speaker 1: with the long term care residents because they're the ones
Speaker 1: who are getting infected the most, and if we can
Speaker 1: um tame those infections, then we can help the healthcare workers.
Speaker 1: So hopefully we'll get to a place where there are
Speaker 1: enough doses to vacate everybody simultaneously among those groups. But
Speaker 1: there could be some states where they're starting with one
Speaker 1: group or starting with the other um as we start
Speaker 1: this process. Now, these are just some of the logistical
Speaker 1: hurdles that each state is facing right now, But of
Speaker 1: course there are other maybe even broader questions about the
Speaker 1: materials needed for this vaccine as well as storing and
Speaker 1: transporting the vaccine. And I was wondering if you might
Speaker 1: go into some of those other logistical hoops that the
Speaker 1: states are facing now to to receive this vaccine and
Speaker 1: distribute it. So it's all but certain that Fiser's vaccine
Speaker 1: candidate will be the first one to receive FDA authorization,
Speaker 1: assuming of course, that the FDA does authorize it. And
Speaker 1: that vaccine is very difficult to distribute and to handle
Speaker 1: because you need to keep that vaccine candidate at negative
Speaker 1: NIE need four degrees fahrenheit. What that means is that
Speaker 1: you need these special freezers to store them. The large
Speaker 1: health systems typically have those, which is why at the
Speaker 1: beginning you will almost certainly see large health systems receiving doses.
Speaker 1: If you don't have those freezers, you need to keep
Speaker 1: them in this special container that Feiser has created and
Speaker 1: will ship out the doses in. And these containers are
Speaker 1: kept cold with dry ice. And if anybody out there
Speaker 1: is familiar dry ice, you know that it's difficult to manage.
Speaker 1: There are specifics. You can only open the container a
Speaker 1: few times a day. Or else you run the risk
Speaker 1: of the dry ice vaporizing. So they require a lot
Speaker 1: of different handling instructions and it's not just as easy
Speaker 1: as getting it there and leaving it on the shelf.
Speaker 1: Have there been any, say, trial runs in just seeing
Speaker 1: how these supply lines or distribution chains work when it
Speaker 1: does come to getting the vaccine out to the various states. Yes,
Speaker 1: so there have been test runs to practice shipping the
Speaker 1: vaccines as well as the ancillary supply kits. So these
Speaker 1: kits will include things like syringes, masks, things that you'll
Speaker 1: need to actually give the vaccines. So over the past
Speaker 1: few weeks, there have been test shipments and they haven't
Speaker 1: included any real vaccines or any real supplies, but rather
Speaker 1: empty containers. And we've heard from at least two states
Speaker 1: who said that they got their test shipments of the vaccines,
Speaker 1: but not of the ancillary supply kits. So North Dakota
Speaker 1: and Colorado both reporting that they didn't receive those shipments.
Speaker 1: Um Colorado even said that their kit went to another
Speaker 1: state because of a label printing error. We reached out
Speaker 1: to McKesson, which is the company responsible for creating and
Speaker 1: sending the kits, and they said that this was part
Speaker 1: of the normal process and that this is why you
Speaker 1: test things. They've addressed the issues and they confirmed that
Speaker 1: they fixed them. And so of course we are just
Speaker 1: discussing the very early rollout of this vaccine, but this
Speaker 1: eventually will be ramped up to vaccinating the general population.
Speaker 1: Millions more people to receive these doses. What are some
Speaker 1: of the other possible logistical challenges we might see once that,
Speaker 1: once that distribution plan scales up, right, So the irony
Speaker 1: here is that we're spending so much time talking about
Speaker 1: whether people are ready for day one that it's easy
Speaker 1: to lose sight of the fact that day one could
Speaker 1: actually be the easiest day because at the beginning, you know,
Speaker 1: we're only talking about six point four million doses getting shipped,
Speaker 1: and in the grand scheme of things, that's really not
Speaker 1: that many. We could quickly come to the point where,
Speaker 1: you know, many more doses are being shipped, as well
Speaker 1: as vaccine doses from multiple companies, So this could quickly
Speaker 1: quickly increase in scale, and of course with scale comes complexity.
Speaker 1: Are you making sure that they're going to the right places,
Speaker 1: Are you making sure that the people giving them are
Speaker 1: tracking everything correctly. Are you making sure that people who
Speaker 1: got the first shot are coming back in for their
Speaker 1: booster shot. These are all things that will quickly increase
Speaker 1: in complexity and are really vital to making sure that
Speaker 1: actually go smoothly, because, like you mentioned earlier, this is
Speaker 1: a huge, huge effort and there are so many moving
Speaker 1: parts that will need to be accounted for throughout this
Speaker 1: whole process. That was Angelica Levido, and that's it for
Speaker 1: our show today. For coverage of the outbreak from one
Speaker 1: bureaus around the world, visit Bloomberg dot com slash Coronavirus
Speaker 1: and if you like the show, please leave us a
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Speaker 1: The Prognosis Daily edition is produced by Top for foreheads
Speaker 1: Jordan Gaspure, Magnus Hendrickson, and Meat Laura Carlson. Today's main
Speaker 1: story was reported by Angelica Levito. Original music by Leo Sidrin.
Speaker 1: Our editors are Rick Shine and Francesca Levi. Francesco Levi
Speaker 1: is Bloomberg's head of Podcasts. Thanks for listening.