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Coronavirus pandemic | Countries must prepare sustainable logistics to deliver COVID-19 vaccine: Expert

Pawanexh Kohli, Honorary Professor of Post Harvest Logistics at the University of Birmingham in the UK, said the pandemic has left everyone 'flattening the curve' by self-isolating to buy time for healthcare networks to cope with expected inflow of patients.

March 28, 2020 / 01:01 PM IST
Representative Image

Representative Image

While social distancing and self-isolation can delay the spread of COVID-19, developing a vaccine and laying out the strategy to deliver it to every citizen in the world is crucial to stop the pandemic, a logistics expert says.

Pawanexh Kohli, Honorary Professor of Post Harvest Logistics at the University of Birmingham in the UK, said the pandemic has left everyone 'flattening the curve' by self-isolating to buy time for healthcare networks to cope with expected inflow of patients.

"We appear to have no other recourse against this invisible enemy, but to consciously isolate from unnecessary proximity until a vaccine is developed," Kohli said in a statement.

He believes a COVID-19 vaccine could be delivered either this year, if testing is fast-tracked, or next year.

Depending on how the disease spreads in the coming months, Kohli said, a conscious decision might be taken to waive some standard trials and safety procedures, adding that it will be a "tough risk assessment call."

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COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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However, he said there is no scope to bypass the logistics that will ensure that the vaccine reaches every infected region of the world as a priority.

"Nations must ready themselves for the vaccine, and plan an extensive delivery mechanism," he cautioned.

But Kohli feels even today, the existing vaccination system for well-mapped viruses does not necessarily reach every person in need.

For the coronavirus vaccine to reach everyone on the planet this state of affairs needs to be reassessed, said Kohli, who also acted as the Chief Advisor to the Department of Agriculture & Farmers' Welfare on post-harvest management, cold-chain and supply chain.

"While today we worry about hospital equipment and beds as we dampen the infection, shortly we will have to ensure the vaccine is available in every remote hamlet and village around the world," he said.

According to Kohli, ensuring the availability of a future coronavirus vaccine for everyone may be the only way to stop the novel coronavirus in its tracks, and get civilisation back on its feet.

"We cannot afford to ignore that the next trouble spot will be executing a globally networked delivery mechanism for the COVID-19 vaccine," he said.

However, to achieve this, Kohli said storing the vaccines within specified temperature ranges in different parts of the world is crucial.

"Effective refrigeration is essential to preserve food and medicine. It underpins industry and economic growth, is key to urbanisation and makes agriculture sustainable," the professor, who is also the founding CEO of India's National Centre for Cold-chain Development (NCCD), said.

Kohli believes that the protocols to follow will be similar to those for the Influenza vaccine, which must be kept between 2 degree Celsius and 8 degree Celsius, while in transport and storage.

While the current system may be designed to cope with the existing scale of vaccination for different diseases in each country, he feels the scale of COVID-19 vaccine outreach will be in multiples of present status.

Kohli said this hurdle provides an opportunity for creating a different logistic structure for delivering vaccines.

"Each pharmaceutical outlet could be enabled to store and inject the vaccine – perhaps even at outlets in shopping malls, universities, offices, or theatres," the Post Harvest Logistics professor said.

"Doing so, will immediately multiply the delivery points of the vaccine, and avoid crowding existing hospitals and clinics," he added.

In this new structure the professor believes a few million individuals can be quickly trained to inoculate people, with each vaccination recorded with an extensive database collated.

"Not a single person can be bypassed," Kohli said.

He believes such a process will require a mobilisation even exceeding the scale that India executes for its elections.

An important part of process, according to Kohli, is that private operators handling refrigerated products will have to safely process vaccine loads.

Responsibility for the COVID-19 vaccination program, he said, should fall in the lap of governments, with each ensuring that all its citizens are inoculated, adding that the process cannot be left entirely to private players.

Kohli said the cold-chains that do not handle medical supplies must familiarise themselves with related protocols and be ready to roll into action.

"If they need additional equipment or monitoring tools, they must prepare a list in advance and inform local health services. Health authorities must develop an appropriate platform to keep record of each vaccination," Kohli added.

In the long run, he said, a permanent network of infrastructure and people may be needed.

"We have the time to be ambitious and must plan for resilient and sustainable solutions," Kohli said.
PTI
first published: Mar 28, 2020 12:55 pm

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