Rapid roll-out of vaccine? Yes, but not in France....!

[NormanH]

I'd like to invite you both to explain exactly how you would envisage the logistics of vaccinating people in the thinly populated rural areas of France, given that the vaccine

"Pfizer's vaccine must be kept at nearly minus 100 degrees Fahrenheit

to remain effective. That's about 20 degrees colder than extreme winter

temperatures at the South Pole. Early on, experts warned that the U.S.

lacked the necessary ultra-cold storage trucks and cargo planes needed

to ship hundreds of millions of doses at sub-sub-zero temperatures.

In order to get around that, Pfizer has developed specially built

deep-freeze "suitcases" that can be tightly sealed and shipped even in

non-refrigerated trucks. But while Pfizer may have solved the problem of

how to ship the frozen vaccine, these highly engineered shipping

containers create other problems, particularly for the hospitals,

pharmacies and outpatient clinics that will have to administer the

vaccinations to hundreds of millions of Americans.

"The reality is

there has never been been a drug that required storage at this

temperature," said Soumi Saha, a pharmacist and director of advocacy at

Premier, which acts as a purchasing agent for hospitals across the

country. "The administration and distribution effort will require an all

hands on deck."

Pfizer faces hurdles in distributing coronavirus vaccine

• Pfizer's shipping container can be refilled with dry ice. But it
  likely will have to be in pellets not blocks, and a refill, which could
  cost a few hundred dollars, will only extend the life of deep-freeze
  suitcase by five days.
• Hospitals can buy ultra-cold freezers,
  which will keep the vaccinations up to six months. But few hospitals or
  pharmacies have the specialty freezers, which can cost as much as
  $20,000 each, and are in short-supply. Manufacturer K2 told CBS
  MoneyWatch the wait for its ultra-cold freezers is now six weeks.
• Pfizer's
  vaccination requires two doses 21 days apart, making it more
  complicated to deliver the required number of treatments with doses
  going to waste. 

Moderna's vaccine also must be shipped

frozen, although at comparatively less frigid -4 degrees Fahrenheit.

Still, that will require the company to secure hundreds of refrigerated

trucks, while the vaccine can only be kept in a standard refrigerator

for up to seven days.

   Pfizer has designed a specialty box that can hold 1,000 doses of its COVID-19 vaccine at nearly 100 degrees…

Pfizer declined to offer specifics about the plan to distribute its

vaccine. While the government is technically in charge of the overall

vaccination effort, the company has opted to distribute its own vaccine.

Pfizer has received $1.95 billion from the Operation Warp Speed to

manufacture and distribute the first 100 million doses. The government

will remain responsible for distributing syringes and other medical

supplies needed for the vaccination effort.

In a statement to CBS

MoneyWatch, a spokesperson for Pfizer said the pharmaceutical giant has

"developed detailed logistical plans and tools to support effective

vaccine transport, storage and continuous temperature monitoring."

Emily

Gerbers, director of business development at MDLogistics, which

specializes in cold-storage supply chains, said that it's not just

vaccines that have to be shipped, but also COVID-19 treatments and

antibodies. The pandemic supply chain has been growing and adapting, but

it's been hard for companies like hers to keep up with demand, she

said.

"We are talking to people every day looking for solutions,"

Gerbers said. "There is so much need for COVID services. You can't build

it fast enough."

Another possibility is for vaccines to be stored

in centralized deep-freeze warehouses before being moved to hospitals.

But real estate brokerage firm JLL said cold-storage facilities make up

less than 2% of the overall logistics warehouse market, and that until

recently there has been very little investment in the market, making

available space a problem. The vacancy rate for existing cold storage

facilities is less than 5%. 

"The pandemic threw demand way out of

supply for the cold supply network," said Mehtab Randhawa, a researcher

at JLL. "Pfizer's vaccine requires a very specific cold storage

requirement that might not align with what is out there."

 

Premier's Saha said that hospitals still lack some basic information

from Pfizer about the shipping container, such as its exact dimensions.

Hospitals have also not yet been notified if they will serve as

distribution points. Many are waiting for such notice before deciding on

whether to invest in ultra-cold freezers or staff up for mass

vaccinations.

Saha said many university hospitals do have

ultra-cold freezers, but they typically are in their laboratories and

would require permission from local health inspectors to be repurposed

for vaccine storage. And while the government has said it will cover the

costs of the vaccine, it's not clear if hospitals and other providers

will be reimbursed for the extra costs needed to store and quickly

distribute the vaccines. 

Already struggling rural hospitals might not have the funds to afford the extra costs,

or serve large enough populations to make distributing 1,000 doses in a

week to 10 days feasible, especially in the first phase of the

vaccination effort when not everyone will be eligible.

"It's a

logistical nightmare for rural communities," Saha said. "But no one is

immune to the challenges distributing the vaccine poses for the medical

industry."

[woolybanana]

So far, no valid reasons for the slow roll out of the programme. It is being held up by atrophied and bloated bureaucracies which are unable to respond.

[Catalpa]

[quote user="NormanH"]I'd like to invite you both to explain exactly how you would envisage the logistics of vaccinating people in the thinly populated rural areas of France, given that the vaccine[/quote]

That is a problem - whether the country is the US or the UK or France... but...

...in most countries, the locations with the worst (or, from the virus's pov, the best) transmission rates are the major cities. Start the vaccinations there (Paris, Lille, Marseille, Toulouse, Lyon) while the problem of distribution to the smaller towns and more remote areas is addressed and solved. If that causes a dismayed "what about us" reaction outside the main cities, that starts to solve the resistant to the idea of a vaccination problem.

Perhaps, with more and more people accepting the vaccines and cautiously returning to a more 'normal' life, the antivaxers will see that there's little to be feared and plenty - for themselves, their families, their communes, their businesses, social culture - to be gained.

The number of obstacles put in the way of administering the vaccine won't help France. I'd line up for the vaccine this morning - if the option were there - but I or someone I love may die while waiting for French beauracracy to convince those who're more scared of the vaccination than the virus to apply a little logic and common sense.  

There were a further 26,000+ cases identified in France yesterday. Even allowing for under-reporting earlier in the week, the figure is climbing again.

[nomoss]

Here is the schedule for vaccinations published by Ameli on Dec 28th. It's pretty vague.

Vaccination contre la Covid-19 : tout savoir sur la stratégie, le calendrier et les vaccins

[mint]

Axel Khan (quoted by Norman in an earlier post) is himself disapproving of la stratégie.  He says very clearly that it is "mauvaise"

Anyway, everybody who needed to know was aware of the problems of storage and distribution.  So, why make such a big thing of the country having received millions of doses and that everything is ready for the roll-out?  Macron will be on tv again this evening talking about transparency.  If this is transparency give me muddled every time.

I don't expect the whole programme will be progressed without a hitch but I WOULD like a proper and credible explanation of why France has this massive problem that does not seem to be such an obstacle in Germany and the UK?

If any country has vast, sparsely populated areas, then the US must have more than its share of those.  But even they are vaccinating at speed with Biden himself being seen on tv accepting his dose.

I see that there was a message going out to the 35 000 mayors in France, urging them to be an example to their people and getting their jabs with all the attendant publicity wherever possible.  But our poor mayor who would be willing enough is himself probably reduced to frustrated inactivity like everyone else.

PS I have seen lots of square boxes called cryo-cubes used to transport the Phizer vaccine. I thought what an appropriate name for these dinky boxes which looked smaller than my neighbour's cool box that he transports his lunch in everyday[:D]

[Lori]

I share your sentiments Mint.  If the anti-vaxxers are having an actual impact on the roll out of the vaccine in France, I find that unacceptable.  They have already said the vaccine is not obligatoire, so let those of us who want it have it. 

And yes, they have known about the logistics of the roll out for a while now.  The U.S., U.K., Israel and so many other countries don't seem to have a problem ramping things up. 

[mint]

Now that people in the public eye are voicing their dissatisfaction, we could only hope that the government would be forced to change its strategy.  Here's hoping....

[url]https://www.sudouest.fr/2020/12/31/covid-19-15-a-20-millions-de-francais-seront-vaccines-mi-2021-assure-un-depute-lrem-8242021-11265.php/[/url]

[woolybanana]

One, declare a state of Emergency to give the requisite powers, two, get the Army medical service to use their mobile medical units, three request all doctors and medical nurses, testing labs etc to block book complete days for vaccinating, including pharmacies. Transport the vaccine in freezer trucks in the boxes, such as the huge ones used for supplying supermarkets ( there are enough to keep the food supply going as well), as well as cargo planes of practical. Vaccinate those who are willing, come to the refusniks later as this takes pressure off the system.

It takes less than five mins to jab people, so make appointments or have walk-ins.

There is plenty of advice available on TV or radio and information can be given at the door.

There is a solution there somewhere.

This is loke Mc Connell holding up the $2000 survival money for the US population on the grounds that it costs too much. He is right, when they are dead it will cost less.

[pomme]

As mentioned in Le Figaro today https://tinyurl.com/ybgqn4f5

There are two cumulative factors explaining this relative delay:

The centralised French health organization is poorly adapted to the limiting factors of the messenger RNA vaccine which require specific storage (-80 degrees) conditions and therefore the delivery needs very strict and planned deadlines, almost dose by dose. So it is necessary to establish the list of potential candidates for vaccination (residents and professionals), at the latest 5 days before the date of delivery, in order to be able to communicate to the the precise number of doses required and to ensure the necessary support services.

[cajal]

This time I will post this on the correct thread

Tuesday afternoon my wife and I were at a pharmacy to receive our annual flu vaccination.

This is the 2nd year we have taken up the Amelli offer and last year we were done during the 2nd week of November.

"Why

so late in the season this year?" you might ask. Because of the much

higher uptake of the offer this year demand has outstripped supply. 

This particular pharmacy received their 2nd batch of the vaccine on

Saturday and as we were there then we were able to make an appointment

for Tuesday.

While we were awaiting the injections I observed

there were 5 dispencing units open for business and all had lengthy

queues waiting to be served. This was, I would add, just a 20 minute

snapshot on one Tuesday afternoon in December.

And the

significance to this anecdote? If there was to be an annual global award

to present to the nation with the highest hypocondriac percentage per

head of population we all know which nation would annualy sweep the

board. France???

For the "ministère de la Santé" to quote "Face

à un très fort scepticisme dans la population française, nous avons

fait le choix de prendre le temps nécessaire pour installer cette

vaccination." is nothing more than a crock of ....(insert your own

expletive). We all know how surveys can be manipulated to generate the

result an organisation/state requires to enable them to or not to

implement their own particular agenda.

However, I do concur that to distrbute the doses  under the necessary conditions will be a logistical nightmare for someone.

To

add, it seems that the state is capable of organising national

manoeuvers by delivering 100,000 extra police and gendarmes on to the

streets of France tonight to control any partying, celebrations or raves which might develop. Just saying.

[woolybanana]

Well, put it this way, for every day of delay, x thousand people will die!

[NormanH]

https://www.lefigaro.fr/vox/politique/retard-dans-la-vaccination-on-paye-un-envahissement-de-la-bureaucratie-depuis-des-annees-au-detriment-des-soins-de-terrain-20201231

[pomme]

NH: Seems to be the same article I gave a short link to this morning with a snippet of the content

[nomoss]

[quote user="pomme"]NH: Seems to be the same article I gave a short link to this morning with a snippet of the content[/quote]

Annoying when people don't look at previous posts, isn't it [:D]

[mint]

Macron has recovered sufficiently from his sick leave to now order the vaccination programme to be carried out more rapidly.  There is an article in sudouest.fr that I tried to copy and paste but can't seem to do it.  Not difficult to find, about half way down the front page.

[Lori]

Yes, well at this point, I will believe it when I see it.

[idun]

On one of the UK calculators it says that I should be getting my vaccination from the 22 May to the middle of June.

Husband from mid March to mid May.

Unless there are terrible reports about the vaccinations and terrible allergies etc, we will be having them.

I do not know what is happening in France with all this. Feels strange that it is not being rolled out and being taken up.

As was said by wooly, get the armed forces involved, I really think in any country it would be a good idea. The logistics getting people to the vaccination point and medics to do it. France is so vast, that I do not know how they could do it it any other way at the moment.

This isn't something that can wait, everyone needs to get this done, unless their health dictates that they cannot, and well IF they catch covid, what state will they be in then?

And those mask refusers, what would they say in hospital with covid damaging their lungs and struggling to breath, no oxygen as it comes via a mask, cannot wear a mask.

[CeeJay]

Just a simple practical point but presumably I will be contacted by CPAM or my MT when my turn comes around for the vaccine, or is it some other body?

[mint]

[url]https://www.sudouest.fr/2021/01/04/covid-19-516-personnes-vaccinees-au-1er-janvier-le-gouvernement-promet-d-accelerer-la-cadence-8250255-11265.php[/url]

Here is the present state of play, except it's no playful matter[6]

[pomme]

CeeJay wrote: Just a simple practical point but presumably I will be contacted by CPAM or my MT when my turn comes around for the vaccine, or is it some other body?

Last week it was said they would be sending out invitations, presumably in much the same way as is done for the flu vaccinations. There was no more detail, but presumably that was going to contain a reference to seeing your doctor so you could be told everything about the vaccine and to give your approval.

They must now be considering changes to the original plan?

[NormanH]

I think that they are now considering  vaccination centres instead of having it done by the MT.

There is another thing that might be changed, the  4 days period between having it all explained and actually being inocculated  during which one could change one's mind.

That has caused considerable delays in the EHPADS where some of the residents  have Alzheimers...

[mint]

Thank you, Norman, that is good to know.

I reckon that, if they use our salle des fêtes for our village, the mayor would get all the oldies in our village done in 1 or 2 days max.  The mairie knows who we are; after all, they organise an afternoon get-together once a month during normal times, with transport for all those unable to go under their own steam.  Also, they get our Christmas hampers delivered every year without fail[:D]

As the UK has found out with test, track and trace, a large-scale operation is more efficiently done on a local level and not centralised.  When the UK were using a "super lab" somewhere in Milton Keynes, all our local laboratoires did the testing all over France.

Please don't attack me by saying I am demonising the UK as an expat, I have never considered myself an expat, rather an immigrant.  And I do think that, at the very least, the UK is vaccinating people instead of dithering and faffing about as the French have done to date.  I like to think I talk about the reality as I see it.

Alas, I had such hope when they appointed that specialist doctor in overall charge but we have heard zilch about him lately?

[cajal]

[quote user="mint"]

Alas, I had such hope when they appointed that specialist doctor in overall charge but we have heard zilch about him lately?[/quote]

I expect he will still be accepting the fee that the appointment offered for such a position.

[Lori]

I just don't get it.  With each day that passes, it seems like no real progress is made.  If France does have the 500,000 doses they say they have, why aren't they being used?  Its like one of the recent articles said, at this rate of vaccinating we'll have finished in 5000 years..

Maires making salles ready as vaccination centers, begging the State to send the doses for those who want the vaccine is also a sorry state of affairs.  Of course, I am glad they are doing what they're doing and speaking to the media about it, but it is just another reminder that this is not working as it should.

https://www.bfmtv.com/sante/covid-19-des-maires-proposent-leur-aide-pour-accelerer-la-campagne-de-vaccination_AV-202101040127.html

[nomoss]

[quote user="NormanH"]

I think that they are now considering  vaccination centres instead of having it done by the MT.

There is another thing that might be changed, the  4 days period between having it all explained and actually being inocculated  during which one could change one's mind.

That has caused considerable delays in the EHPADS where some of the residents  have Alzheimers...

[/quote]

What vaccination are you talking about?[8-)]