I like your optimism, and what you said isn't incorrect about Ebola at the time, but I don't think it's correct about our current situation. How many locations globally have this level of refrigeration? Given that there would be high demand for it, wouldn't prices on any available refrigerators exceed what even the most altruistic companies and organizations could pay?
This still needs to be solved. We have a lot of entrepreneurs, investors, and engineers reading this, so let's not be hasty in hand-waving over something serious.
* The largest chilled supply chains, for things like frozen food, don't get anywhere near -80°C
* The question of what to do in poor countries is very much unsolved
On the other hand:
* Developed countries have at least some cryogenic supply chain in place, for things like fertility medicine.
* You can get a surprisingly long way with couriers transporting insulated boxes full of dry ice (or liquid nitrogen).
* The prize on offer here is absolutely huge, because lockdown is so expensive. $10 billion a day buys a heck of a lot of couriers.
This is by far not the challenge covid19 poses to the world. It wasn't when it was China's local and regional problem, and it is not after it spread out of China and became a pandemic.
Objectively, at most Covid19 causes a slight increase in the global death rate, and this is only observed during the initial spread before herd immunity kicks in. Ww2 killed about 90 million people in 6 years, while covid is bound to have killed about 1.3 million in one year.
It should be substantially less difficult than winning WWII, which again - we were capable of scaling up industrially to accomplish.
> this is only observed during the initial spread before herd immunity kicks in
When will that be? NYC's new spike is demonstrating even their enormous outbreak didn't generate enough of it.
It's a global pandemic. Order them from anyone who can make them at scale. Coordinate with the WHO to avoid silly bidding wars.
Even dry ice in coolers is low tech but gets you a lot of time considering storage for the second booster dose will be centralized.
The risk is real though. Breaks in cold chain storage have inactivated vaccines have been documented to leading to outbreaks in other disease states. Still, at this point, from my boots on the ground perspective -- so far, so good.
1. https://www.nytimes.com/2020/09/18/business/coronavirus-covi...
Surely there's got to be some existing shipping indicator to track if a shipment has exceeded the temperature limits during transit. Even just a vial filled with a liquid that freezes at e.g. -70C would work just by tipping it upside down when frozen.
- https://www.gavi.org/vaccineswork/cold-supply-hot-demand
I don't have much more on that front, but it's worth a look to see what well developed agencies are aiming at.
You could easily localize COVID-19, just make a vaccination passport. No entry to a country if you're not vaccinated.
> How many locations globally have this level of refrigeration
Almost all developer countries, urban centres, where majority of people live anyway.
At -80C?
Edit: There are hardly storage places right now for these temperatures.
> At -80C?
Absolutely. This is a solved problem.
You can buy dry ice at your local supermarket. I buy meat from a ethical farming operation that ships their product in insulated packages packed with dry ice. There's almost always dry ice left over. I made a bottle bomb out of the remainder once.
Every major medicine manufacturing company will already have had supply chains in place to deal with this for other medicines.
Storage is a red herring. It won't last more than a day in any given medical facility.
Well, as long as the temperature is under zero, all is fine - otherwise the 4 kilometers of ice under your station might pose a problem.
A breakdown scenario in a rural area could mean 1000s of wasted doses
Don't you think Western countries are ordering many thousands more doses than they actually need?
Breakdowns happen - places don't need to have perfect infrastructure in order to warrant treatment.
Once the world is open the US and UK will be happy to say that they were able to cancel some unused vaccine supply if it turns out not needed. (which will be easy - between focusing on poor countries and moving production to something else (or winding down) as they recognize the need is gone they will be willing to end those contracts not completely filled. Politically it is a money saving move.
Of course the above assumes best (or at least) case. There are many ways things can go wrong. If all approved vaccines need a booster every 6 months things will be very different. (this is an unlikely but still possible very worst case)
They should be able to put out a general announcement and get thousands to get the vaccine if they need to. A lot of people who can get off work on short notice if there is an emergency. Obviously not everyone, but thousands can be redirected to someone else on short notice. Of course this requires emergency shipments to those who should have got the original, but the breakdown would require that anyway.
I don't know what the thawing protocol is though - this is a real concern that needs to be handled. I assume those who deal with the logistics have plans and backup plans that account for all of the above.
"Once a provider receives that vaccine, it really starts the clock that the vaccine needs to be administered within five days of when it's put in the refrigerator"
Source: https://www.cbsnews.com/news/coronavirus-vaccine-distributio...
Any you get a week after thawing it to use is anyway, so you don't need the cold storage where the end user is. I don't know what the thawing protocols are of course.
Those I don't think the doc even needs a fancy cooler, if I understand correctly they need to thaw this first, by the time the individual doc gets it they need to be thawing it and then using it quick. (I don't know what thaw procedures are though)
But I think you're overlooking something rather important: Storing liquid nitrogen in a vacuum flask only keeps the liquid nitrogen cold for hours or days. It doesn't keep the thing cold that you're cooling with liquid nitrogen.
The week you get to use it is after the dose has been created. If it's brought below temperature for any length of time, it can presumably DESTROY the dosages affected by temperature.
See the current flu vaccine storage protocols, for example: https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/vac-sto...
"Regular temperature monitoring is key to proper cold chain management. Store frozen vaccines (Varicella, MMRV, and Zoster) in a freezer between -58°F and +5°F (-50°C and -15°C). Store all other routinely recommended vaccines in a refrigerator between 35°F and 46°F (2°C and 8°C). The desired average refrigerator vaccine storage temperature is 40°F (5°C). Exposure to temperatures outside these ranges may result in reduced vaccine potency and increased risk of vaccine-preventable diseases."
Source: I work in vaccines, and our company works on thermostable formulations, among other things.
This maybe _was_ the problem in the beginning of the pandemic. Now, it's in the general population and will spread even if you ban all airplanes and repurpose airports into petting zoos.
Sure some places will find total vaccination the best option, but places with out the infrastructure and money can simply do one lockdown that isn't compromised again by air travel.
China is an example that would have left the pandemic if not for the need to resume Air travel.
It’s a difficult problem, but a solved one.