With a COVID-19 vaccine on the horizon, Ottawa’s next challenge will be getting it to 38 million Canadians

OTTAWA—In the United States, it’s called “Operation Warp Speed” — a massive, army-led effort to ensure swift purchase, distribution and delivery of a safe and effective COVID-19 vaccine, once one is approved.

In Canada, you could call it Operation Wait Speed.

The Liberal government promises Ottawa will be ready as soon as the new year to distribute a vaccine to provinces that will in turn deliver it to Canadians high on the priority list.

Anita Anand, the minister responsible for nailing down the logistics of that “complex” operation, said Tuesday that “all options are on the table” — including calling on the military — to get that job done.

But the country’s largest pharmaceutical distributing company, McKesson Canada, is warning that the federal government faces a “Herculean task” to distribute a vaccine to nearly 38 million people, in part because it lacks the deep freeze storage capacity required by two of the leading vaccine front-runners engaged by Canada.

McKesson says it is “most concerned” that two of the vaccine companies Canada’s signed with — including Pfizer/BioNTech which produces the promising vaccine that raised hopes Monday — require either ultra-frozen (minus 80 C) or frozen (minus 20 C) storage and transportation conditions.

“The existing public and private vaccine supply chains in Canada are not equipped to support frozen and/or ultra-frozen COVID-19 vaccines at scale,” the company said in a written statement.

The company estimates Canada would require 1.7 million cubic square feet of frozen and/or ultra-frozen warehousing space for 75 million doses — roughly the size of about 500 tractor-trailers. It is impossible to get a clear picture from federal officials of how much capacity now exists.

Asked how many of the ultra-frozen units Canada has, Howard Njoo, Canada’s deputy public health officer, told the Star Tuesday that “we can’t tell you the number, we have to buy them.”

Even McKesson, the biggest player in pharmaceutical distribution in Canada, only has very limited capacity for frozen vaccines, said president Dimitris Polygenis — and none at all for ultra-frozen.

“Our frozen infrastructure is limited to a single refrigerator-sized freezer,” said Polygenis, who added that the company’s ability to transport frozen drugs is “limited.”

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McKesson Canada’s American parent company is at the heart of the U.S. government’s vaccine delivery project, Operation Warp Speed. It is the centralized distributor and will bundle a vaccine with syringes, needles and other supplies, and deliver the kits to point-of-care sites across the United States once the FDA approves a safe and effective vaccine.

Its Canadian subsidiary is among 70 other private sector companies in talks with Ottawa to create a public-private supply chain that can get vaccines “in the arms” of Canadians as Prime Minister Justin Trudeau said Tuesday, once they are available.

But there are many more challenges ahead in what Trudeau admitted will be a “complex” job.

Among them:

• Health Canada must first independently review test data provided by a vaccine developer before approving it. The Canadian regulator is notoriously conservative, but the federal government has asked and empowered the agency to begin “rolling reviews” of data as it comes in. That’s happening in the case of three vaccine candidates: Pfizer, Moderna and AstraZeneca.

• Ottawa has not yet signed contracts with distributors and transportation partners to push out the vaccine supply to provinces and territories, although Anand says that process is underway. Her department says it aims to have contracts signed by the end of November.

• The federal government will not decide where doses go and who gets them first. Provincial and territorial governments are responsible for the front-line delivery of health care and although Ottawa released guidelines last week stating the elderly, those at high risk, health-care and essential workers should be first in line, the final say falls to them.

• Decisions remain about how the provinces will deliver the vaccine into people’s arms. Dr. Robert Brunham, director of the British Columbia Centre for Disease Control’s research laboratory and a member of Canada’s vaccine advisory task force, says provinces and territories are able to deliver the vaccine using not just hospital or health-care workers, but also pharmacists or maybe even the army. “You don’t need a Ph.D or an M.D. to give a vaccination,” he said.

• Canada does not have a dedicated IT platform to track vaccine distribution and administration. Canada’s chief public health officer Dr. Theresa Tam said Tuesday that “intensive” talks with provinces are ongoing to “map out” the “needs” and “gaps,” but she downplayed the advantage of a centralized database, saying “there has to be a balance because you can’t sort of (be) putting up entirely new IT platforms in the middle of an emergency.”

• McKesson Canada wants Ottawa to consider giving exemptions from certain Health Canada cold storage regulations in order to allow the use of alternative freezer space, refrigerated storage, and transportation to house and distribute large volumes of refrigerated, frozen, and ultra-frozen vaccines. However, based on material it has shared with potential bidders, the federal government appears to be reluctant to relax those rules.

So far, Canada has signed contracts with seven vaccine suppliers, including with the Pfizer-BioNTech group that reported promising results Monday that buoyed many infectious disease experts.

Those contracts add up to “a minimum” of 194 million potential doses up to “a maximum” of 414 million doses, Anand said.

Ottawa would be in line to receive vaccines in the first part of 2021 if all goes well, ranking Canada with the European Union, Ireland, Japan, New Zealand, Australia and “many other countries,” according to Anand.

While Anand would not say what kind of timeline it would take before all 38 million Canadians have access to a vaccine, her department’s information material has told potential distribution contractors that “Canada expects the work to continue through at least the second quarter of 2022.”

Anand defended what she called an “aggressive” vaccine procurement strategy, saying the Liberal government has already bought 90 million syringes and 100 million needles, “sharps” containers, 90 million alcohol swabs, 75 million bandages and gauze strips and 90 million alcohol swabs.

Tonda MacCharles is an Ottawa-based reporter covering federal politics for the Star. Follow her on Twitter: @tondamacc

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