Transporting COVID-19 Vaccine: Why the talk about India being cold chain ready is really hot air

Health Tips

Some of the COVID-19 vaccine makers have announced temperature integrity of 2-8 degrees Celsius, some say -20 degrees, while Pfizer’s drug is benchmarked at -70 degree Celsius. (Representational image: Reuters)By Vikram Murthy, 

“The time to prepare for COVID-19 Vaccine Transport is now” – UNICEF Cart before the horse, or horse before the cart could be an apt analogy as we begin to pinch ourselves and realize the vaccine for COVID-19 is real and will be here soon.

For too long, and rightly so, because of the tragedy caused by the pandemic, we have focused only on developing the cure. A trifle late, but never too late, to examine the challenges in finding the right cart, to transport the vaccine across thousands of kilometres, into every city, town and village across India. In a highly modernized country like ours, in which almost all car makers provide AC as standard fitting, it may seem strange to discuss finding the right commercial vehicles for transporting the vaccine. Well, more than a cool interior, what we need is a refrigerated truck, which can preserve vials at the prescribed temperature, and more advanced than the type used to transport frozen food.

Being part of the vehicle air-conditioning and fleet refrigeration industry for over 30 years, I have been observing with diminishing disbelief the scant attention given to the oncoming transportation bottleneck. As India gets set to cheer the vaccine campaign, as health officials gear up with priority lists (frontline workers, co-morbid high-risk category, senior citizens and more), let’s examine challenges endemic to cold chain logistics, for which answers must be found before vaccine distribution commences at the national level.

Big, Medium, Small: As per recent estimates, India requires more than 11,500 refrigerated vehicles to distribute the vaccine. How many do we have now? Fifty percent at best is all we can muster, if we want trucks and LCVs that will pass a fitness test and cooling test.

As the vaccine must reach rural areas through not so wide or motorable roads, we will have to rely on light commercial vehicles and vans for the last mile. Refrigerated vehicles in this category are too few and far in number, and those on the road are already in use by farm-to-home grocery transporters.

Mind the Gap: A refrigerated vehicle is built to keep contents frozen or chilled. It may carry fresh produce, cut flowers, medicine, ice cream, fish or meat and the temperature inside can be set as low as -10 degrees Celsius to -15 degrees Celsius if the product is ice cream.  Some of the COVID-19 vaccine makers have announced temperature integrity of 2-8 degrees Celsius, some say -20 degrees, while Pfizer’s drug is benchmarked at -70 degree Celsius. While the real gap in the cold chain will be known when the Government zeroes in on the drug, it is better to anticipate, repurpose existing vehicles and start building fresh movable assets that are time and temperature sensitive.

Route Planning: A plane on ground can stay air conditioned only up to a point. Likewise, the refrigerated vehicle must move more and stop less if the interior temperature has to be maintained. This means, once stocked with vaccine, the delivery to a tertiary or primary health centre must be made same day. A night halt, a favorite rest time for the trucker, could result in the drug being compromised (unless the operator can find auxiliary power, a luxury restricted to on-ground aircraft).

Vehicle Fit out: No doubt our Nation’s innovative truck and other commercial vehicle manufacturers are aware of the shortage and have planned ahead even before reading this viewpoint. However, the gap cannot be closed so fast and so easily.

Because of bumpy roads, air suspension is recommended for the vehicle (can’t have glass vials bobbing). To create a sub-zero interior in the cargo hold (we call this the refrigerated container), dry ice, which is liquified carbon dioxide, is injected in metered quantities, and cooling starts when dry ice evaporates. The mindset, technology, infrastructure and experience to seamlessly create this outcome are currently not available in-house with most vehicle manufacturers.

This means outsourcing this part to a domain expert, and there are not many in the market.

Unprecedented Scale

It is not as though India has not been transporting vaccines that need a controlled environment. As part of the Government’s Universal Immunisation Programme, vaccines are being dispatched nationwide, protecting children, adolescents and pregnant women from measles, polio, encephalitis, TB and more. To eradicate COVID-19, the Government is initially planning to transport 400-500 million doses which will cover approximately 20-25 crore people by July 2021, a scale that has never been attempted before.

Safety and Security

Fleet drivers will need to receive training from now, not after vaccine reaches the market. Pre-cooling is a critical phase before the vehicle begins its journey and drivers must be sensitized to the unwavering goal of stable temperature. Being a life-saving drug that will be in short supply during the launch phase, safeguards such as vehicle-tracking and visual monitoring must be planned to eliminate theft and pilferage during transportation.

GoM and GoE

For quick action and integrated execution, the Government of India has appointed a Group of Ministers (GOM) to tackle COVID-19, as well as a National Expert Group on Vaccine Administration. The Prime Minister has also instructed States to set up a vaccine task force at the district and block level. In addition to the above, and factoring the magnitude of the vaccine project, the government can consider appointing a group of experts (GoE) from the private sector – drawn from pharma, logistics, fleet refrigeration and healthcare. I would deem it an honor to serve on such a committee as a mobile refrigeration professional.

Separate the grain from the chaff

It’s urgent and important to take a reality check on transportation. It is all fine to read quotes from leading logistics providers and drug makers on how they have geared up for the challenge. A deeper study will reveal vehicle shortage, dearth of trained personnel and lack of cold rooms at the end point.

In the final analysis, if we accept the problems endemic to cold chain logistics, if we acknowledge that ultra-cold is what we seek and not hot air promises, the answers will appear soon, like the vaccine did to a world praying for a miracle. The writer is a domain expert in vehicle air-conditioning and pioneer in fleet refrigeration in India.

(The writer is a domain expert in vehicle air-conditioning and pioneer in fleet refrigeration in India. Views expressed are personal.)

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