While the rest of the country has been counting votes, an Army general named Gus Perna has been counting doses of vaccine. He is in charge of Operation Warp Speed, the catchy title given to the crash program to inoculate 300 million Americans against the coronavirus by next spring. For those of you longing to reclaim a semblance of your previous life, it may not seem all that speedy, but it is compared to the five to ten years it usually takes to field a new vaccine. Once approved, it will not be a silver bullet. Just as with the annual flu shot, some of us will still get sick. But it should make enough people immune so that the virus runs out of places to go. That would give this country what it badly needs right now – a shot in the arm.
David Martin: So if this distribution of vaccine is– doesn’t go according to plan, where does the buck stop?
General Gus Perna: Me. Conversation’s over. It’s pretty easy, me. I hold myself 100% personally accountable to that end.
After a career as an Army supply officer, General Gus Perna was two months away from retirement when President Trump tapped him last May to lead Operation Warp Speed.
60 Minutes went into his operations center where the plan to get the vaccine out to 300 million Americans is being orchestrated by military specialists brought in from across the country.
General Gus Perna: We literally built the team, this collaboration, as we were going. There was no doctrine, there was no strategy, there was no structure of people to this end.
Perna tracks progress in what he calls deep dives with leaders from the military and the Department of Health and Human Services. And he does not want to hear happy talk.
General Gus Perna: It’s not about, you know, a façade of everything is good. We need to understand what is not right, and we need to get it right.
He works out of a non-descript Washington office with none of the trappings that usually go with four stars.
General Gus Perna: You know, these are all the meetings that I’m doing today. I’m already up to number eight (LAUGH) with you.
Perna describes himself as a hard-working “B” student, on a steep learning curve to master the jargon of the pharmaceutical industry.
David Martin: So I’ve uncovered one of your dirty little secrets here, you gotta cheat sheet–
General Gus Perna: I do.
David Martin: –over here.
General Gus Perna: (LAUGH) I do–
David Martin: This is all the drug jargon?
General Gus Perna: It is. I’ve started five notebooks of things– I listen every day– to what’s being said, and then I spend a good part of my evening googling these words, so that I can participate– preferably at an intellectual level– but at least in an understanding.
On his whiteboard is one possible scenario – the all important approval by the Food and Drug Administration of a vaccine developed by Pfizer, followed by approval of another from Moderna.
David Martin: What is D-Day?
General Gus Perna: Is the day that– we deliver the first round of vaccine– for Pfizer.
That’s when it would start to get complicated because if approved, the Pfizer vaccine will require patients to receive two separate shots – 21 days apart.
General Gus Perna: We know it’s a two-dose vaccine, so we want to ensure that we can manage the– the delivery of the first dose and ensure the delivery of the second dose– while we simultaneously integrate new rounds of doses being delivered to the American people.
On top of that, the Pfizer vaccine, which could be ready next month, has to be kept very cold until it is used.
Paul Ostrowski: Basically -80 degrees Celsius, which is 94 degrees below zero Fahrenheit.* Very cold.
Paul Ostroswki is a West Point graduate who retired from the Army this summer and became Perna’s civilian deputy.
Paul Ostrowski: We have to make sure that we send that particular vaccine to the right places, that either have that capacity or the ability to do the dry ice– that we’ll need in order to keep it cold.
In the Warp Speed operations center, Marion Whicker, who came from making tanks for the Army, showed us the go/no-go board for what parts of the country are ready to handle an ultra-cold vaccine.
Marion Whicker: The Virgin Islands has already reported in that they don’t have ultra-cold freezers. That’s okay. And that they don’t have an ability to dry ice. But what we do know is that we can very quickly move dry ice from Puerto Rico.
David Martin: The more I hear you talk, the bigger this operation gets.
Marion Whicker: Absolutely, sir.
David Martin: It’s not just delivering vaccine.
Marion Whicker: No. We wish it was that easy.
David Martin: This country did not do a good job of containing the virus. Why should we expect you to do a good job of distributing a vaccine?
Paul Ostrowski: Because we’ve learned from the past. And we’re hopefully gonna do a heck of a lot better job this time.
David Martin: Are you ready to go if a– vaccine is approved tomorrow?
General Gus Perna: Yes, we are.
David Martin: What’s the first order you’re going to give?
General Gus Perna: It’s a simple command of, “Execute.”
David Martin: So once you say, “Execute,” how fast does it get out there?
General Gus Perna: Within 24 hours.
David Martin: Do you have doses of vaccine already stockpiled?
General Gus Perna: Yes, we do.
David Martin: How many do you have stockpiled?
General Gus Perna: I’m holding on to that number right now because I wanna not create anxiety and we need to work through the details. A month from now, I’ll have more.
Operation Warp Speed is also stockpiling kits of the needles, syringes and alcohol swabs needed to give the shot. The medical distribution company, McKesson, says it already has produced enough kits for 88 million shots.
Paul Ostrowski: The idea is the kit will marry up with the vaccine. And they will go together as one package to provide that capability to an administration site.
Because this is a once in a century pandemic, the vaccine is already being manufactured in bio-reactors inside sterile facilities like this one at Emergent BioSolutions in Baltimore. Even though it has not yet been approved by the FDA. Vice President Sean Kirk says it can take up to six weeks to produce a single batch.
Sean Kirk: It then leaves here and moves to another facility where it gets filled into the final vial presentation you’re used to seeing when you’re getting a vaccination at the clinic.
Emergent is shipping most of that vaccine to what’s known as a fill finish line run by a company called Catalent and its chief commercial officer, Karen Flynn.
David Martin: You’re basically the bottling plant for vaccines.
Karen Flynn: That’s correct, and it’s a very sophisticated operation.
One of Catalent’s lines can bottle up to 400 vials a minute with each vial containing five to ten doses.
Karen Flynn: The situation that we’re facing right now is just what we call the need for speed.
David Martin: How many shifts are you running right now?
Karen Flynn: We are running 24/7 seven days a week and, you know, really it’s an all out effort to keep the lines running.
David Martin: Are you worried about the security of the stockpiles?
General Gus Perna: We have taken extraordinary precaution in this area. . . Not only for maybe some nefarious effort but also natural – hurricanes, tornado, etc. right? It’s such a commodity to us we’re taking the full steps to make sure that the vaccine’s secure.
David Martin: Armed guards?
General Gus Perna: Yes.
David Martin: Armed guards at sites where the vaccine is stockpiled?
General Gus Perna: Yes.
David Martin: Once it starts moving, whether on a truck or a plane, is it going to be under guard.
General Gus Perna: Yes. That’s as far as I’m going to talk about it though, right? Because you don’t want to lay out all the plans. But the answer is yes.
Most of the vials will be shipped by the same companies that deliver packages to our homes every day.
Richard Smith: We’re prepared to deliver to every zip code in this country.
Richard Smith runs FedEx Express in the U.S., which is already operating at peak volume to handle the surge in online shopping caused by the pandemic.
David Martin: You’ve got another peak coming because of Christmas, and you’ve got another peak on top of that because that’s when we expect the vaccine to start being distributed.
Richard Smith: Correct. And yet I’m still sleeping at night.
David Martin: But you’ve got to have concerns.
Richard Smith: Well, I’d be crazy if, I, if, you know, if I didn’t say that this was a herculean effort and didn’t recognize how monumental it is, and may yet be.
David Martin: Will you be able to track all the moving parts?
General Gus Perna: Yes, I feel 100% confident of that.
David Martin: Will you be able to bang your fist on the table and say, “What happened to that shipment that was going to Good Samaritan Hospital in Baltimore?”
General Gus Perna: Yes, and not only that, I’ll know after it gets there how fast they’re administering the doses that they were given.
Perna’s ability to do that depends on a software program called Tiberius, which is supposed to link databases from across the government and the shipping companies into one unified picture that everyone can see.
Deacon Maddox: You can turn on where your hospitals are, where your pharmacies, your nursing homes and where all of your enrolled providers are inside that… inside that jurisdiction.
But when Deacon Maddox, a newly-retired army colonel, briefed Perna on how ready Tiberius is for D-Day…
Deacon Maddox: This capability didn’t exist two months ago.
General Gus Perna: S**t (LAUGH).
Deacon Maddox: So, there are some things we need to work through.
Deacon Maddox warned that once the vaccine starts flowing the amount of data Tiberius has to keep track of will multiply.
Deacon Maddox: What we’re doing right now to get ready for the first dose is the easy part. When you get into the subsequent doses. . . that’s when this gets really hard.
Just over 150 miles up I-95, in a room papered with urgent to-do lists, New Jersey Health Commissioner Judith Perisichelli and her task force will be faced with distributing the vaccine in the midst of a grim new wave of the virus.
Judith Perisichelli: Today we are reporting 2,472 new cases. That’s the highest we have been since our March-April surge… My biggest fear is that we’re dealing with a surge in our hospitals, in our emergency rooms, at the same time that we’re trying to vaccinate. And the hospitals will have to spend their time taking care of people and that will impact the staffing of vaccine sites within our hospitals which we rely on.
In New Jersey alone, the goal is to vaccinate 4.7 million people, beginning with health care workers.
Judith Perisichelli: We’ve set a very aspirational goal of 70% of the adult population being vaccinated within six months, so depending on how many vaccination sites we have we might be vaccinating between 60,000 and 80,000 individuals a day in New Jersey.
David Martin: Has Operation Warp Speed given you any indication of how many doses of vaccine you’re going to get?
Judith Perisichelli: The assumption is about 100,000. If it’s a two-dose regimen that will be separated into two doses so it would be 50,000 individuals.
David Martin: How many people do you have in that high priority health care worker category?
Judith Perisichelli: 500,000.
David Martin: You’re not even close.
Judith Perisichelli: No. No.
Persichilli is confident operation warp speed will eventually provide all the vaccine New Jersey needs. But she worries whether enough people will show up to get vaccinated.
Judith Perisichelli: We surveyed 2,000 health care individuals, physicians and nurses and we know that over 60% of the physicians said that they would get the vaccine. We know that about 40% of the nurses said that they would line up to get the vaccine.
David Martin: That sounds awfully low.
Judith Perisichelli: Nurses I guess are skeptical.
David Martin: What does that say about your general population?
Judith Perisichelli: There is a lot of vaccine hesitancy.
David Martin: How much have you spent so far?
General Gus Perna: As of today, I think I’m at $12 billion. But I have projected that we could spend as much as $26 billion.
David Martin: What’s your worst nightmare?
General Gus Perna: We get vaccines to the American people and they don’t take them. Shame on us. “Hey, I was already sick, I don’t need it.” Shame on us. “Hey, I don’t believe in vaccines.” Shame on us… Just shame on us and it does keep me up at night.