September 28, 2022

The global effects of the coronavirus infectious disease (COVID-19) are dramatic, as the pandemic affects social, political, economic, and healthcare elements in many nations at the same time. The true cost of this pandemic has yet to be determined, not just in terms of human lives and suffering, but also in terms of the mental impact and wider economic slowdown. The preceding insights provide compelling evidence for turning continuing experiences into actionable lessons and improving population health, as well as healthcare delivery and support.

Several tasks must be prioritized during a pandemic, including the need to study the disease, improve patient treatment, and prevent further transmission. As a result, COVID-19 bolstered the importance of diagnostic testing and mass immunization in epidemic management. Ending the epidemic necessitates the correct use of diagnostic tests in large quantities, as well as the timely use of the data to aid in the implementation of appropriate medicines, vaccination programs, and, ultimately, the prevention of further spread. As the number of COVID-19 cases outside of China increased in February 2020, the first bottlenecks in the global logistics network emerged, with healthcare and laboratory supply chains becoming increasingly reliant on what was happening in other nations. An overview of the issues in healthcare logistics in relation to COVID-19 is offered here, with a focus on the requirement for diagnostic tests during the first wave of the pandemic and the demand for vaccines during the second and following waves.

Diagnostic tests and logistics

For a few months, global supply lines were significantly hindered (February to April 2020). Natural catastrophes such as floods and earthquakes have occurred in the past, and the resilience of healthcare logistics and supply lines has been investigated in that setting. These included looking at the best methods for finding and installing parallel logistics service providers, as well as researching ‘temporary facilities’ to deal with disaster recovery. The majority of the scenarios, however, were limited to a specific scale and location, and did not contemplate a pandemic, which is far rarer but far more devastating. The surge in testing demand, combined with the implementation of lockdowns, posed a significant logistical challenge, as the right supplies needed to get to their designated laboratory destinations in a short amount of time, and supply chains needed to stay active and then dissipate and re-activate as quickly as conditions dictated.

Manufacturing would be directly impacted due to the supply chain’s tight interoperability and the initial (physical and economic) lockdown of China, which represents a low-tier supply base for a substantial portion of global manufacturing operations. As a result, early in the pandemic, a twofold bottleneck occurred in terms of getting biological materials as well as primary supplies for production. Later on, the diagnostic tests’ transportation, storage, and distribution posed considerable obstacles.

Aspects such as a test’s shelf life, the temperature tolerance of the test components, and simple qualities like the size and weight of the packages were all crucial factors affecting distribution ease. Many federal and international reactions supported the necessary changes in healthcare manufacturing and logistics services, as well as emergency finance measures that were frequently used to reduce the impact of the interruptions.

Vaccination campaign logistics

It is obvious that the entire global population cannot be tested (repeatedly) or vaccinated in its totality at the same time, thus decisions must be taken to prioritize patient groups or populations at higher risk of infection (for example, healthcare workers). These groups’ logistics must be designed and implemented once they have been identified. Over the last few decades, mass vaccination initiatives have proven to be effective in controlling and eliminating infectious diseases, particularly in low- and middle-income nations. The effectiveness of such campaigns hinged on a variety of operational factors, including the availability of publicly available data, the promotion of strong cooperation between national and district levels, timely training of healthcare personnel, and post-campaign evaluations.

Vaccines, well-defined vaccination sites, and vaccinators are all part of the logistics of any mass vaccination program. For a successful vaccination administration, all three of these factors must be present. Importantly, vaccine distribution necessitates strict cold-chain management from the producer to the vaccinator, which is especially difficult with certain of the COVID-19 vaccines. Additional obstacles include the unique storage conditions of some of the most popular COVID-19 vaccines, which are based on mRNA. Although the infrastructure to support these from a logistical standpoint may exist on the manufacturer’s R&D side, it is unlikely to be available across the whole distribution and point-of-care chain. To define the actual demand and size during the roll-out campaign, intelligent calculations on what the manufacturing supply will be during a specific term, the number of vaccines, and potentially limited stock are required.

The International Society for Biological and Environmental Repositories (ISBER), the Society for Cryobiology, and other academic networks, societies, and private companies with specialized expertise in this area include the International Society for Biological and Environmental Repositories (ISBER), the Society for Cryobiology, MHRA approved warehousing UK, and others. As a result, the mass vaccination campaign’s success would be contingent on the formation of expert coalitions/task forces within countries or specific geographic areas. The lessons learned from the first wave of the pandemic, as well as the methods used to overcome logistical obstacles in the provision of diagnostic testing, provide a useful blueprint that can be followed and developed upon during the second wave and following vaccines. The expertise in cold chain logistics already exists, but it needs to be brought to the forefront so that it can become a key component of the solution.