COVID-19 vaccines were developed at an astonishing rate — not just one but two, with a third on the way. Unfortunately, the distribution effort hasn’t happened with the same speed or seriousness of purpose.
From the beginning, the vaccine rollout lacked focus and direction, resulting in waste, miscommunication, queue jumping and bureaucratic delays. And while inoculating tens of millions quickly is by no means a trivial undertaking, like all efforts with too many cooks in the kitchen, the more tools and capabilities we develop, the less ability we have to execute truly complex programs.
Now, with the new administration planning to distribute 100 million vaccines in 100 days, could the logistics solution be as simple as implementing best practices in leadership, communication and technology? The answer is yes — and here’s how to achieve it.
Establish leadership. To be successful, fast, clear and competent leadership is needed at all levels. With qualified leaders in charge throughout each phase of the process, they must be given a mandate to make rapid decisions as needed. Without this authority, the inaction we’ve already witnessed will continue. This doesn’t mean a free-for-all, but the New York example of penalizing those who administered doses to recipients not on the priority list will only lead to more inaction, as people won’t feel empowered to make decisions. Additionally, all leaders need to have a shared vision and collective understanding of what needs to be delivered — a mission that all participants work to accomplish.
Communicate and act with urgency. COVID-19 has taken over 400,000 lives in the U.S., so it feels counterintuitive to think it necessary to create a plan for communicating urgency — but it is. Unfortunately, the need to spark concern about sticking with the status quo hasn’t been communicated at the necessary level of concern. This was made clear when vaccination sites in New York City were only open for 10 hours per day. With a trained staff on scheduled shifts, more people could have gotten the vaccine over a shorter period of time. Urgency in words, attitude and decision-making is required for everyone in the vaccine rollout supply chain to act with speed, which is imperative to achieve herd immunity. To vaccinate 50% of the U.S. population by the middle of the year will require roughly 2 million administered doses per day for five and a half months. Assuming that the pharmaceutical companies will be able to deliver that many doses, the complexity of getting these shots into arms is very high. Yet at the moment, very few states and counties are ready for it. Each day we delay makes it harder to reach the vaccination target.
Fund the rollout as we did the research. Trillions of dollars have been committed by governments to keep their economies afloat, and billions to research, develop and manufacture the vaccines. It’s inconceivable that adequate resources for the rollout aren’t available. Clearly, state and local governments, as well as large parts of the broader healthcare industry, have been hit hard and are struggling for resources, hamstrung by requirements for balanced budgets. But getting people vaccinated quickly is a matter of national security, and critical to bringing economies at all levels back on track. This isn’t about the market, although the market can be a factor in achieving the mission. There are potential synergies to leverage the unemployed, as well as businesses that are struggling or temporarily closed. We will need to ensure that people are competent, but not every person in this effort requires a medical degree. We also need drivers, facility managers, data-entry staff, observers, and many more.
Ensure logistics capability. Simply agreeing that things need to happen won’t make it so, and there’s no question that pulling this off will be a very complex effort. However, many components are already in place or in progress. Existing infrastructure and organizations can be leveraged, so we’re not starting from scratch. The critical elements are planning and the various logistics components that need to be coordinated, including the recipients of the shots (first shot and booster), the actual vaccine with supplements (syringes and personal protective equipment), facilities where vaccinations will be administered, and people to execute the operations.
Pivot with purpose. In an emergency, it’s okay to go off book to even things out. Currently, activity is unbalanced, with empty vaccination sites in some areas and long lines elsewhere. Clear and frequent communication is required to fully utilize available capacity and vaccines. There are problems with doses being wasted, which shouldn’t happen (beyond a small percentage of acceptable loss). A vaccine dose administered to a non-prioritized person is better than one that goes down the drain. Mechanisms should be established to administer any leftover doses to whoever is available to receive them. Of course, that requires more administration, but every bit helps. All of this should be a 24/7 operation, which in turn will require additional coordination between crews.
Focus on technology, data and reporting. In 1947, New York City managed to vaccinate 6 million people within a month. That was a different time, and while a similar feat seems possible in 2021, it won’t happen without the effective deployment of relevant technology and use of data. Various platforms, apps and solutions exist, some specifically developed for this purpose. They must be utilized for this effort to succeed. Data-driven decision making is also key in an effort as complex as this. The need for booster shots and the availability of different vaccines requires data collection at the administration site. Another major benefit of data collection (and subsequent analysis) is feedback and the opportunity to learn, share and course correct where needed.
The COVID-19 vaccination effort is off to a false start, but it isn’t hopeless. The most important element, the actual vaccine, has been delivered and is becoming available in larger quantities. What’s necessary now is defining a mission and aligning all relevant parties to delivering that mission. This is the prerequisite to putting into place the means for getting the vaccine into as many people’s arms as possible, as fast as possible. With strong, authoritative leadership that embraces all aspects of the logistics supply chain, as well as technologies that will expedite patient care, we can do this. Let’s go!
Ben van der Schaaf is a partner at Arthur D. Little.