The UK is facing a key challenge this week to move from propaganda to reality. The rest of the world will be wary of the successes, but above all the mistakes, of the Boris Johnson’s government in trying to be the first to launch a mass vaccination campaign against covid-19. The British Army has launched a trial for distributing the treatment, dubbed “Operation Panacea”, as soon as it learned that the National Drug Regulatory Authority (MHRA, in its English acronym) had given the green light to a Pfizer and BioNTech vaccine. The pilot exercise was conducted at Ashton Gate Stadium in Bristol. It is one of the large logistics challenges that includes transporting the drug from the European continent to the island, storing it in facilities of unknown location to the public and subsequently distributing it to stadiums and congress centers, 50 hospitals and hundreds of medical clinics. “I am confident that all experts working closely together will be able to identify the easiest way for the vaccine to be available to anyone who needs it,” Professor Ugur Sahin, co-founder of BioNTech, told ITV.
The British media chased after all the trucks that came out of the Pfizer factory in Poorce, Belgium. None of them showed the identity of the body or the containers. Downing Street has taken extreme security measures to prevent theft or vandalism. Interpol has sent a warning to 194 police agencies around the world to be prepared for possible activity by criminal organizations seeking to do business with the vaccine. “They have begun planning how to infiltrate or break the distribution chain, while seeking out potential victims through fake websites that could pose a risk to human life,” warned international agency secretary-general Jurgen Stock.
Most of the trucks completed their journey to the town of Folkestone in central England after crossing the Canal through the Canal Tunnel. Hence, according to sources cited by various means, they were distributed in three laboratories on Public Health England (PHE, in its English acronym, English Public Health Management Authority).
As with any operation of this size, problems began to appear from the first minute and it was necessary to change plans and improvise solutions. The announced decision that the first to receive the vaccine will be nursing homes has been changed by the simple problem of arithmetic and temperature. The containers where the initial shipment takes place can store up to 5,000 doses, but regulatory authorities have so far only allowed them to be divided into packages of up to 975 units. They are the ones that can be stored in a dry ice thermal sensor container, designed by Pfizer. The vaccine should be stored at -70 ° C. Most of the thousands of nursing homes across the UK are barely a few dozen people, so without detailed planning you run the risk of consuming large doses of a product that takes no more than six hours to transport in a conventional refrigerator. The first to recognize the problem was the Government of Wales for Home Rules, which in a public statement acknowledged that “in practical terms, at this time, we are not able to distribute this vaccine to residences”. Pfizer also acknowledged the problem, but its managers say the drug, once stabilized at its final destination, is able to maintain its effectiveness for up to five days at temperatures between -2º and -8º. MHRA is expected to give approval in the next few days for the division of the pieces and appropriate design of the distribution.
The director general of NHS primary health care in England, Nikita Kanani, sent a letter this Monday to hundreds of local medical centers warning them to be prepared by December 14th. “Each of you must be prepared to distribute 975 doses to priority patients from that date – those over 80 who can attend on their own or those with previous pathologies that increase the risk.” You should get the vaccine quickly in the days after giving birth. “We can guarantee only three and a half days of vaccination from arrival at the center, as long as it is properly stored at a temperature of -2 of -8º,” Kanani warns in the document.
Several members of the English healthcare staff interviewed by EL PAJS at the end of this week indicated that the decisions were still in a very centralized phase and that they had barely had any talks with their superiors warning them to start preparing for support. In his letter, Kanani explained that the NHS leadership “is working closely with the Clinical Engagement Groups (CGGs) to identify which centers will be ready to start vaccination this week.” CCGs are the administrative nuclei of the NHS that locally organize the necessary health care. The criterion for priority selection will be the concentration in the relevant areas of citizens over the age of 80, although the CCG was also asked to “consider situations of inequality or poverty” when choosing 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 be vaccinated,” Frank Atherton, the Welsh government’s chief medical adviser, told the BBC. “We must mitigate the priorities and adjust them to the operational reality so that we can distribute the vaccine in an efficient and safe way.”
The British government now acknowledges that the operation will have to start in its easier stages and that the first doses will have to be distributed in large army-controlled centers (up to 100,000 weekly doses each, as calculated by the NHS) and in 50 selected hospitals across the country. Atonathan Van Tamme, the NHS chief medical adviser in England and the man to whom the Johnson administration owed all communications in the fight against the coronavirus, acknowledged that nursing homes would again have to wait, and that they were likely to be the main beneficiaries of a vaccine developed by the University of Oxford and Astrazeneka that is much easier to transport and store than Pfizer. “As soon as it is legally and technically possible to bring the vaccine to the residences, we will do it,” he said. “But it is a complex and fragile product. “This is not yogurt that can be put in and out of the fridge several times.”
The response of the dwellers, tragic victims of the mistakes of the Government during the first wave of the pandemic, is blunt. Vic Rainer, CEO of National Care Forum (The organization that concentrates the majority of non-profit centers for the elderly), sought to find an answer to the problem: “Being the first Western country to approve a vaccine against covid-19 is a remarkable fact. “But now we have to invest all our energy and ingenuity to make sure that the most vulnerable are the first to receive it,” he said.
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