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How to deliver vaccines at –80°C and encounter other obstacles in the Covid fight

Many measures must be taken to end the coronavirus pandemic. Pharmaceutical companies will have to develop a safe and effective vaccine. Billions of people will have to agree to vaccination.

However, there are more plain challenges. Among them: The company may have to transport tiny glass vials thousands of miles, while also making them as cold as Antarctica in the depths of winter.

Many of the leading Covid-19 vaccines under development need to be kept below 80 degrees Celsius (less than 112 degrees Fahrenheit) from the start of the bottle to the preparation of injection into the patient̵

7;s arm. .

It will not be easy. Vaccines can be manufactured on one continent and then shipped to another continent. They will move between logistics centers and logistics centers, and then arrive at hospitals and other facilities that manage them.

Although US health officials have not approved any vaccines, preparations for a mass vaccination campaign are speeding up. The U.S. military and federal contractors are expected to play a role in the distribution process. However, a host of companies are scrambling to figure out how to maintain very, very cold vaccine doses.

Airplanes, trucks and warehouses will need to be equipped with freezers. Glass vials will need to withstand icy weather. Someone will need to make more dry ice.

J. Stephen Morrison, senior vice president of the research firm’s Strategy and International Research Center, said: “We are just beginning to understand the complexity of all these delivery aspects.” deliver.”

President Trump announced on Friday that by April, hundreds of millions of doses of unknown vaccines will be provided to all Americans. This timeline is more ambitious than described by his own consultant. The director of the Centers for Disease Control and Prevention, Dr. Robert R. Redfield, told a Senate committee on Wednesday that the vaccine will not be widely available until the middle of next year.

Of the three vaccines that have entered the third phase of testing, two of them (one produced by Moderna and the National Institutes of Health, and the other produced by Pfizer and BioNTech) require close to constant deep freezing. (They are made of genetic material that breaks down when thawed.) Another leading vaccine candidate developed by AstraZeneca and Oxford University must be kept cool, not frozen.

McKesson, a large drug distributor, won a major federal contract last month to help distribute the coronavirus vaccine. However, most of the work will fall to companies outside the medical and pharmaceutical industries. Major U.S. logistics companies, including UPS and FedEx, already have a network of freezers that can be used to transport perishable food and medical supplies. These companies have experience in delivering vaccines for other diseases, including seasonal flu.

However, the Covid-19 vaccination campaign may dwarf all previous campaigns.

UPS said it is building a so-called cold storage facility in Louisville, Kentucky, which is the company’s largest hub and can store millions of doses at sub-zero temperatures.

Creating an entire warehouse that can maintain a deep freeze will be too complicated and costly. Therefore, instead, a row of vertical industrial Stirling ultra-cool refrigerators are arranged in the warehouse, each of which can hold 48,000 vials. So far, there are 70 freezers, but the warehouse can hold several hundred. The Netherlands is also building a similar UPS center.

“I’ve never seen anything like this before,” said Wes Wheeler, UPS’s head of healthcare. “On a global scale, there is nothing better than this.”

At FedEx, vaccine preparation is led by Richard W. Smith, the son of the company’s founder, Fred W. Smith. Mr. Smith (Smith) is relatively young. He is responsible for the company’s airline operations in the Americas. During the H1N1 pandemic in 2009, he was responsible for the life science business of FedEx Airlines. Mr. Smith said that at the time the US government asked FedEx to prepare to help deliver vaccines, the company’s number of freezers around the world doubled.

He said: “Fortunately, the H1N1 virus has not reached the pandemic level that we think is possible.” “However, this allows us to really strengthen the cold chain infrastructure.”

In the years following this fear, FedEx expanded the supply of freezers and worked with the Federal Aviation Administration to obtain approval for its aircraft to carry more dry ice. (Dry ice emits carbon dioxide when it melts, making the air on the plane potentially unsafe for pilots and crew.)

Now, FedEx is adding freezers that can keep the temperature below 80 degrees Celsius in cities such as Memphis, Indianapolis and Paris. It is installing other refrigerated trailers in Oakland, California, Dallas and Los Angeles that can be used for vaccines that require refrigeration instead of refrigeration.

Smith said: “The demand for this is huge.” “We know this will be a very important market.” Citibank analysts agreed, and he hinted in a recent report that FedEx stock is a very important market. Good investment, the business of transporting vaccines is likely to be profitable.

As if the challenge is not arduous enough, the world is facing an imminent shortage of dry ice, which is an unexpected side effect of the pandemic.

Dry ice is something that emits cold smoke and attracts school-age scientists. It is made of carbon dioxide, which is the most common by-product of ethanol production.

However, ethanol production fluctuates based on gasoline demand. This spring, with the whole house service coming into effect, people began to reduce driving. As a result, the production of ethanol has fallen, and the supply of carbon dioxide has also fallen.

In April, Richard Gottwald, chief executive officer of the Compressed Gas Association, sent a letter to Vice President Mike Pence warning that there was “a serious risk of carbon dioxide shortage.”

Five months later, “the ethanol industry has still not rebounded,” Mr. Gottwald said in an interview. “We see shortages.” This makes dry ice difficult to obtain.

Throughout most of the summer, Marc Savenor, the owner of Acme Dry Ice in Cambridge, Massachusetts, which supplies medical companies, has had low carbon dioxide emissions. The supply was the most stressful period he has seen in his 42-year business, which forced Mr. Savenor to ration dry ice.

“It’s like McDonald’s without hamburgers,” he said, adding that carbon dioxide seems to be more abundant in recent weeks.

UPS and FedEx are dealing with the problem themselves. FedEx has already produced machines that can produce dry ice in its warehouses, and UPS said it is considering adding these machines.

These companies must also provide delivery employees with special training and equipment, such as gloves, to handle cold items.

Pfizer designed a special box to transport its desired vaccine. These boxes are about the size of a large cooler and will contain hundreds of glass vials, each vial containing 10 to 20 doses of vaccine. The pill box is equipped with a GPS-enabled thermal sensor, so Pfizer can know where the pill box is and how cold the pill box is. (If the temperature is too high, workers can add dry ice.)

All of this leads to another problem: glass often breaks in extremely cold conditions.

Earlier this year, Corning, a 169-year-old glass manufacturer in upstate New York, issued a warning to officials of the Department of Health and Human Services that there are not enough cold-resistant glass bottles to handle frozen vaccines. Said Brendan Mosher, Corning’s head of pharmaceutical technology.

Corning proposed a solution. The new pharmaceutical grade glass that can withstand the lowest temperature can produce millions of vials. In June, the government signed a $204 million contract with the company to increase its production of special vials. This new type of glass is made without boron, which is a common component in conventional glass and can cause contamination of any substance in the vial.

Mr. Mosher said Corning used federal grants to triple the capacity of its Big Flats, New York, facility. Speed ​​up the construction of glass furnaces in New Jersey; and speed up the construction of another plant in North Carolina. Corning is hiring 300 workers and said it is expected to start producing hundreds of millions of glass vials next year.

Even with enough dry ice, cold storage and sturdy vials, daily pharmacies are unlikely to be equipped with large quantities of vaccines that require ultra-cold storage. However, they may be able to keep Pfizer’s refrigerator at hand, and Moderna’s vaccine can be stored at less extreme temperatures a few days before use.

In a speech to the White House Coronavirus Task Force last month, disease expert Kathleen Dooling of the CDC said that strict temperature requirements “will make it difficult for community clinics and local pharmacies to store and manage.” She Said that the vaccine must be “distributed in centralized locations with sufficient equipment and high throughput.” It is not clear where these sites will be or who will administer the vaccine.

That’s only in the United States. For many developing countries, vaccines that require strict temperature control will be contraindicated. A recent study conducted by DHL and McKinsey found that about 2.5 billion people in 25 countries have access to cold vaccines. In most parts of Africa, South America and Asia, super freezers are scarce and will be excluded.

Mr. Morrison of the Center for Strategic and International Studies said: “The result is a heightened bias towards rich and powerful countries.”

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