Welcome to Prognosis. I'm Laura Carlson. It's day two hundred and sixty five since coronavirus was declared a global pandemic. Today's main story A vaccine is likely to start shipping around the US before the end of the year, but states are getting mixed messages from the federal government about how much of it they'll get, and that makes it hard to set up programs to give people the shots.
But first, here's what happened in virus news today. Nations across Europe are pushing ahead with fast track vaccine programs. The UK has approved of vaccine and is hoping to inoculate millions of Britons before year end. Spain aims to vaccinate up to twenty billion people by June, and Sweden expects to get enough doses next quarter to immunize a fifth of its population. The US posted another day of
record COVID nineteen infections and deaths. That comes as overburdened hospitals around the nation brace for a surge in cases after Thanksgiving. Coronavirus hospitalizations in New York topped four thousand for the first time since late May. New York City plans to partner with private companies to create an institute devoted to predicting and responding to future pandemics, according to
the city's mayor, Build A Blasio. Finally, California, the first state to tell residents to stay home to fight the coronavirus pandemic, may be about to do it again. Governor Gavin Newsom warned Thursday that the state would impose a new shelter at Home order if hospitals start running short of intensive care capac city that could happen in some areas as soon as this week. The order would be imposed in specific regions rather than statewide. If imposed, the
order would last three weeks. And now for today's main story. Weeks before states expect to receive their first shipments of COVID nineteen vaccines, they're getting conflicting messages from the federal government about exactly how many doses may arrive. Some governors have made splashy announcements about how much of FISER and bio en Tex vaccines they expect to get if the US Food and Drug Administration authorizes them this month. Other states can't provide a solid answer, but all of them
must submit orders and distribution plans. Friday, I spoke with reporter Angelical loveto about how the shifting expectations are creating all sorts of problems. Over the past few weeks, there's been a lot of anticipation about the rollout of COVID nineteen vaccines, with first doses available potentially very soon, but the gargantuan task of supplying vaccines to all fifty states raises a lot of questions about how this is going
to be achieved. What do we know about how states are liaising with the federal government in the US about how many doses they will need or the timeline for getting those doses. So we have heard from federal officials that at the very beginning, there will be six point four million of the fiser vaccine doses available, and those doses need to be spread out across all of the states, as well as a few cities and then oratories, as
well as five federal agencies. So all of those doses need to get spread out, and from what we have heard is that the federal government is giving estimates to all of those jurisdictions. However, we've heard that some of those numbers have been changing, and that's very frustrating, as you can imagine if you're trying to plan exactly what
you're getting and how you will build those out. As of today, all of those jurisdictions should have received their final numbers because they need to place their initial orders today as in Friday. That way, the federal government knows exactly who wants what day one, so as soon as
the FDA authorizes a vaccine, those shipments will start going out. Now, there are a lot of numbers and a lot of math involved in these calculations, obviously, and in terms of the individual states, how are they supp hosts to really calculate how many doses of the vaccine they will need. So that's a very good question, and unfortunately we have had a hard time figuring that out. We have asked Operation warp Speed exactly how those doses will be allocated,
and it should be a simple math problem. There's six point four million doses available initially, and those are supposed to be allocated by the adult population in each jurisdiction, so the number of people you have over the age of eighteen. However, we've asked for the master list of the allocations across the states and the five federal agencies, and we were not able to get such a list. So it's a little difficult to figure out exactly how
those how those doses are being distributed. We've gotten numbers from different states saying that these are the numbers we've received from the federal government. However, we have not been able to get of a comprehensive list, and so it sounds like there there isn't a unilateral confirmation that if a state says it needs so many doses, that may
not be the amount of doses they get right. And so, for example, we reached out to a bunch of different states in Michigan said that they couldn't give us a concrete number because in the past several days alone they had heard everything from a couple hundred thousand doses to under ninety thousand, and so, as you can imagine, that's
pretty frustrating if you're a state. However, it's almost certain that no state will receive enough vaccine doses right at the beginning to vaccinate even the priority group that they are supposed to start with, which is healthcare workers and long term care residents. And we've already seen an example of at least one state lobbying for more than it's supposed to get. So we have Wisconsin yesterday, the Democratic governor Tony Evers saying that you know, Republican lawmakers have
under the response and created a disaster. Therefore, he wants enough doses to vaccinate all four hundred and fifty thousand of the state's healthcare workers. Right now, he's only supposed to get about sixty doses, so you can see sort of the imbalance between what people are expecting and what
they'll need to cover everyone. However, I should also be clear that Operation warp Speed keeps saying that that is the initial allocation and that they will start increasing supply every week and distributing more supplies every week so that um, those quickly become available. You've mentioned, of course, that there are some different distribution plans, and these vary from state
to state. That although there is a focus on getting the vaccine first to those specific communities like frontline workers, what are some of the other different distribution plans we've seen among the various states in terms of who will receive this vaccine first. Right, So, earlier this week, the CDCs Vaccine Advisory Committee met and finalized its inner recommendations so they will meet again whenever a vaccine is authorized, that healthcare workers and long term care residents should be
the first to get vaccinated. However, that sounds easy, it's not, because if you're only getting enough vaccine doses to cover a fraction to those people, you have to make some hard choices about who you'll start with and where you'll send those doses. So we have heard that some states are viewing this differently, because some of them say, let's start with the healthcare workers, because they're the ones who are at the greatest risk of being exposed and possibly
catching the virus. But other states are saying, let's start with the long term care residents because they're the ones who are getting infected the most, and if we can um tame those infections, then we can help the healthcare workers. So hopefully we'll get to a place where there are enough doses to vacate everybody simultaneously among those groups. But there could be some states where they're starting with one group or starting with the other um as we start
this process. Now, these are just some of the logistical hurdles that each state is facing right now, But of course there are other maybe even broader questions about the materials needed for this vaccine as well as storing and transporting the vaccine. And I was wondering if you might go into some of those other logistical hoops that the states are facing now to to receive this vaccine and
distribute it. So it's all but certain that Fiser's vaccine candidate will be the first one to receive FDA authorization, assuming of course, that the FDA does authorize it. And that vaccine is very difficult to distribute and to handle because you need to keep that vaccine candidate at negative NIE need four degrees fahrenheit. What that means is that
you need these special freezers to store them. The large health systems typically have those, which is why at the beginning you will almost certainly see large health systems receiving doses. If you don't have those freezers, you need to keep them in this special container that Feiser has created and will ship out the doses in. And these containers are kept cold with dry ice. And if anybody out there is familiar dry ice, you know that it's difficult to manage.
There are specifics. You can only open the container a few times a day. Or else you run the risk of the dry ice vaporizing. So they require a lot of different handling instructions and it's not just as easy as getting it there and leaving it on the shelf. Have there been any, say, trial runs in just seeing how these supply lines or distribution chains work when it does come to getting the vaccine out to the various states. Yes, so there have been test runs to practice shipping the
vaccines as well as the ancillary supply kits. So these kits will include things like syringes, masks, things that you'll need to actually give the vaccines. So over the past few weeks, there have been test shipments and they haven't included any real vaccines or any real supplies, but rather empty containers. And we've heard from at least two states who said that they got their test shipments of the vaccines,
but not of the ancillary supply kits. So North Dakota and Colorado both reporting that they didn't receive those shipments. Um Colorado even said that their kit went to another state because of a label printing error. We reached out to McKesson, which is the company responsible for creating and sending the kits, and they said that this was part of the normal process and that this is why you test things. They've addressed the issues and they confirmed that
they fixed them. And so of course we are just discussing the very early rollout of this vaccine, but this eventually will be ramped up to vaccinating the general population.
Millions more people to receive these doses. What are some of the other possible logistical challenges we might see once that, once that distribution plan scales up, right, So the irony here is that we're spending so much time talking about whether people are ready for day one that it's easy to lose sight of the fact that day one could actually be the easiest day because at the beginning, you know, we're only talking about six point four million doses getting shipped,
and in the grand scheme of things, that's really not that many. We could quickly come to the point where, you know, many more doses are being shipped, as well as vaccine doses from multiple companies, So this could quickly quickly increase in scale, and of course with scale comes complexity. Are you making sure that they're going to the right places, Are you making sure that the people giving them are
tracking everything correctly. Are you making sure that people who got the first shot are coming back in for their booster shot. These are all things that will quickly increase in complexity and are really vital to making sure that actually go smoothly, because, like you mentioned earlier, this is a huge, huge effort and there are so many moving parts that will need to be accounted for throughout this whole process. That was Angelica Levido, and that's it for
our show today. For coverage of the outbreak from one bureaus around the world, visit Bloomberg dot com slash Coronavirus and if you like the show, please leave us a review and a rating on Apple Podcasts or Spotify. It's the best way to help more listeners find our global reporting. The Prognosis Daily edition is produced by Top for foreheads Jordan Gaspure, Magnus Hendrickson, and Meat Laura Carlson. Today's main story was reported by Angelica Levito. Original music by Leo Sidrin.
Our editors are Rick Shine and Francesca Levi. Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.