WASHINGTON – When President Trump talks about efforts to provide the coronavirus vaccine to millions of Americans eager to resume their normal lives, he often says he “relies on the military” to make it happen.
Mr Trump gave the impression that the troops would pack vials, transport them from factories to pharmacies, and maybe even administer injections. And, at times, military officers working on the vast interagency program to move those doses of vaccines from drug companies to doctors’ offices have indicated the same.
In reality, the role of the military has been less public and more pervasive than this characterization suggests.
When companies did not have the physical spaces to conduct their drug trials, the Department of Defense acquired trailers and permits to create pop-up medical sites in parking lots. When a required piece of plastic or glass was scarce, the military used a law passed during the Korean War to force manufacturers to bring it to the fore. If a hurricane hits somewhere, blocking trucks, the military has ready the transport.
But the distribution of vaccines will largely be left to their producers and commercial transport companies. Black Hawk helicopters will not land near the neighborhood pharmacy to drop off doses. No troops will administer fire.
“It’s extremely unlikely that anyone in government will touch a vaccine, whether it’s loading a truck, unloading a truck, moving dry ice, or actually injecting the vaccine before the Americans get it. get, ”said Paul Mango, deputy director of policy. to the Department of Health and Human Services and the main spokesperson for Operation Warp Speed, the federal multi-agency consortium to speed up vaccine implementation.
However, he added, “all the logistical details you could think of, needles, syringes, swabs, bandages, dry ice”, could be obtained through the government procurement process, and often more quickly. than by the private sector.
Dozens of Defense Department employees are spread across government offices involved in the effort, constituting a large portion of the federal staff dedicated to the effort. These numbers have led some current and former Centers for Disease Control and Prevention officials to complain in private that the military’s role in Operation Warp Speed was too important for a task that is, at its core, a task. public health campaign.
“Frankly, it was mind-blowing to watch,” said Paul Ostrowski, director of supply, production and distribution for Operation Warp Speed. He is a retired army lieutenant general who was chosen to manage the logistics of the program by General Gustav F. Perna, the COO of Operation Warp Speed.
Arguing over volunteers for four fast-track vaccine trials – a chore in any circumstance – became even more difficult during a pandemic, when it was often impossible to ask hundreds of thousands of subjects to sit in wards. waiting for hospitals and other health care centers. The Pentagon has helped three companies – AstraZeneca, Moderna, and Janssen – set up pop-up sites to conduct trials at 63 sites across the country.
Necessary for each site: Double width trailers equipped with wheelchair ramps and septic tanks. In addition, some will need to be hurricane proof.
These are the types of things the military can get quickly through their contracting system, as well as the permits needed to put everything in place. “We have the ability to build large-scale housing capacities around the world at any time,” General Ostrowski said.
Military officials can call companies, he said: “And say, ‘I need X number of trailers, and I need them immediately.'” Staff on his team “are working in working closely with all city officials to make sure we have all certificates and all codes are addressed, ”he said.
The two pharmaceutical companies currently leading the vaccine race, Pfizer and Moderna, have estimated they will have 45 million doses, enough to immunize 22.5 million Americans, by early next year. Since they have started making vaccines awaiting federal approval, they should be ready to start shipping them within days of obtaining them.
But some companies have been hampered by a lack of excess manufacturing capacity in the United States and a shortage of many products needed to manufacture and package vaccines. For raw materials, the military was able to take advantage of its force of contraction, as well as the Defense Production Act, a law dating from the Korean War that allows the federal government to impose some control over the private sector.
“Everyone is asking for this substance or this product,” General Ostrowski said. “That’s what we do, we understand the capture of supply chains.”
Operation Warp Speed issued six Defense Production Act orders to companies to take the lead for certain supplies, such as the large vats needed to produce a vaccine. In October, the government granted $ 31 million to manufacturer Cytiva to expand production of the tanks.
“There are only a number of producers of these products in the world,” General Ostrowski said. “We were able to make sure they knew where the priority was.”
Military officials also had the smart idea – if it works – of coordinating the delivery of vaccines to pharmacies, medical centers and other vaccination sites by sending kits full of needles, syringes and alcohol wipes. Vaccine manufacturers will be alerted when kits arrive at a vaccination site so they know how to ship doses. After the first dose has been administered, the manufacturer will be notified so that they can send the second dose with the patient’s name attached several weeks later.
But when it comes to the Herculean task of distributing vaccines, much of the task will fall on manufacturers to transport vaccines from loading docks to pharmacies and doctor’s offices.
While governors can use their National Guard units in their immunization programs, the military is the least likely to play a role in transferring vaccine doses – and troops are certainly not expected. help administer the vaccines, although Mr. Trump has suggested they will. .
“I was surprised when Trump spoke about the Defense Department releasing any vaccine,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territory Health Officials, who has been deeply involved in the vaccine planning process. “There is no role for the military there. And if there were, we would be angry about it because we are the defenders of states.
Concerns about vaccine conspiracy theories are even more of a reason to keep the military out of sight, Dr Plescia said. “There was a lot of concern about the reluctance to get vaccinated, and having a group of soldiers around wouldn’t be very helpful,” he said. “Even the participation of the National Guard could have a downside.”
As one of the largest suppliers of liquid injectable drugs in the country, Pfizer already has an extensive network of commercial shippers that help move its drugs from its Michigan manufacturing facility to suppliers across the country. This will be all the more important with the company’s coronavirus vaccine, which must be kept at a temperature below zero.
The military has spent hours conducting tabletop exercises to help think about how the program might go wrong and how it might need to step in to help.
“The government has offered its full support and is ready to help overcome any obstacle,” said Amy Rose, spokesperson for Pfizer. Of the six companies developing a vaccine, the pharmaceutical giant was the only one to reject federal funding.
Pentagon planners have looked at a range of risks associated with the distribution of a vaccine, from large-scale protests that could disrupt traffic to poor weather conditions. The military says it can use its planes and helicopters to deliver vaccines to remote locations, but only if no other means of transport is possible.
The army will also monitor vaccine distribution through an operations center. “They will know where each dose of vaccine is,” Mango said on a call with reporters. “If a dose of vaccine is likely to expire, they will guide its movement to another location.”
General Ostrowski said this specific assignment was worth delaying his retirement. “It is very important to our nation and our world,” he said. “I couldn’t think of a better challenge and something nobler than being able to do it.”
Abby Goodnough contributed reporting from Washington.