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‘Where Was the Strategy for Getting People Ready to Start Taking the Vaccine?’

Gus Perna is a national hero, and no one talks about it. The now-retired Army four-star general served as chief operating officer for Operation Warp Speed, the Trump administration’s massive public-private effort to develop, approve and distribute a Covid-19 vaccine in the record time of less than a year. (The prior record, for the mumps vaccine, was more than four years.) At a time when U.S. generals are mostly famous for losing wars, Perna helped lead a mission that has saved easily a million American lives. Can any other recent endeavor involving the U.S. military say that?

One reason Perna’s not a household name is that Perna himself has laid pretty low since quietly retiring last summer, by which point the Biden administration had restructured and rebranded OWS as the Countermeasures Acceleration Group. Perna rarely speaks to the media these days and has largely avoided criticizing past or current U.S. leadership. But now, nearly two years after OWS launched on May 15, 2020 — with less than half of eligible Americans fully vaxxed and boosted, vaccine-evading variants circulating, confusing messaging on boosters and no OWS-like program speeding up the development of pan-coronavirus vaccines — Perna’s insights, which he offered WEBICNEWS in a rare phone interview from his home outside Birmingham, Ala., are essential. He knows what makes supply chains work or not; and he’s seen America achieve a near-impossible scientific and logistical feat only to fumble the messaging.

Consider that Perna, along with a team of about 100 people drawn mostly from the Defense Department and the Department of Health and Human Services, managed ultimately to set up a network of 70,000 sites across 64 jurisdictions around the country and get millions of doses of safe and effective vaccines to them — without knowing ahead of time which vaccines would be authorized and when, or, as it happened, how many doses would actually be available. As he publicly acknowledged, initial targets fell short, but deliveries scaled up rapidly, to the point that 100 million doses had been administered across the country by mid-March 2021, and by the time Perna retired in July, the Biden administration had just barely missed its goal to get at least a first dose to 70 percent of American adults.

Perna said he’s no longer monitoring the numbers, which are discouraging: Tens of millions of eligible Americans remain unvaccinated as Covid deaths continue to climb past1 million. But he described his biggest frustration of the Warp Speed enterprise: “Where was the long-term strategy for getting people ready to start taking the vaccine? … That was not part of the OWS portfolio. It’s a personal choice to get the vaccine or not. But where was the presentation to inform everybody, so that they could make the best decision? Where was the responsibility to not let this get politicized? … It just didn’t exist.”

This interview was edited for length and clarity.

Kathy Gilsinan: You had decades of experience with logistics in the Army. But I’m curious what the key differences are in approach between getting, say, materiel into Poland or out of Iraq versus getting a vaccine shot from a conveyor belt to a pharmacy.

Gustave Perna: It’s the same principles. You have to just focus on the purpose of what you’re doing. Always purpose first. On the battlefield, if you don’t get something there, where it needs to be, then there’s soldiers’ lives at risk. You don’t get them bullets on time, you don’t get them gasoline on time — it’s really [a] tremendous impact. Getting things before they need them, where they need them, so that they can exploit success, that’s what you’re really working for on the battlefield. The key is that the battlefield is very fluid, and you really don’t know where the enemy is, and where the friendly situation is going to be. So it takes a lot of intuition.

Gilsinan: I don’t know if this is different from what you would deal with in a battlefield context, but you have numbers moving around all over the place as to how many vaccine doses are even going to be available at certain times. How do you plan against that kind of uncertainty?

Perna: The great team that I had working with me — hand-selected people with talents in acquisition, contracting, supply chain, ERPs [Enterprise Resource Planning], communications — we were all focused on the delivery and distribution of the vaccine. That was our primary effort. It expanded from there. We had to do a lot of work to help expand manufacturing, to help sustain the supply chain. We implemented 19 Defense Production Acts — for minerals, for materials, for consumables, for equipment. Our real success was we took this flat organization of less than 100 people, and we partnered with industry: McKesson Trucking, UPS, FedEx, Pfizer. And we collaborated and developed a distribution plan that allowed us to execute under certain tenets.

One, we were going to deliver vaccine across the United States simultaneously to everybody allowed [subject to] the amount of vaccine that was available. So we went all the way to the Pacific Territories, Alaska, Puerto Rico. We were over in Europe, delivering to U.S. bases, South Korea. Anywhere there was U.S. personnel, we developed a system that allowed us to deliver vaccines.

We were constrained with the amount of vaccine that was coming off the conveyor belt at a time. We understood this. We knew that on the day that we had EUA [Emergency Use Authorization], we were only going to have a certain amount of doses. We developed a formula based on population, which allowed us to discern a percentage of that vaccine which would be delivered. Every week after the first week that number went up.

But the system we set up was based on the foundation and the collaboration of local and federal government and industry. We did this, really, with almost perfection. Never been done before. We opened up over 70,000 locations across the country that could receive and administer vaccine. We had to create data-use agreements with the states in order to put an ERP in place to track the vaccine. Then we had to validate the 70,000 locations through the CDC, so that they could receive it and administer it. Because our goal was, we wanted people to have access in places they were comfortable being: a local doctor’s office, a hospital, CVS, Walgreens, Wal-Mart.

Gilsinan: They say plans don’t survive first contact with the enemy. I’m curious what adjustments became warranted in those first few weeks and why.

Perna: That plan worked. We brought in Palantir. Palantir created a system that allowed us to see ourselves from manufacturing all the way down to the distribution sites. We had a very elaborate system up and running, to make sure nobody nefarious was trying to do anything. We had local security. We had cyber security. And then we did have to make some adjustments because of the environment. Two major snowstorms hit us within 30 days of our distribution. The first one we kind of worked around, no issues. The second one shut down our distribution hubs for about five days.

Leaders like Major General Chris Sharpsten and the personal leadership from McKesson, UPS and FedEx were involved. They just came up with solutions. We doubled the workload, and we administered everything out the following week. So, we doubled delivery. States and local governments were setting up hospitals, doctors’ offices, local sites to bring people in. Vaccine needed to be there. We couldn’t just [say] ‘Okay, we’ll get you that next week.’ We had to figure out how to get it to them when they needed it.


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