Ask any scientist anchored in the real world, and they’ll tell you that, in general, the simplest of competing theoretical explanations is preferred to the more complex. That concept is called Occam’s Razor, and it is as applicable to supply chains as it is to scientific theories. But, as the vaccine distribution in the United States shows, it’s not always put to use.
According to the Washington Post, in many states, “governors have delegated the [COVID-19] vaccination process to a web of underfunded county health departments, along with hospitals, pharmacies, HMOs, and doctor’s offices. Each has devised its own sign-up system and made its own rules for who can get vaccinated and when.”
Clearly, we have made a difficult problem even harder by adding layers of complexity. So how would Occam design the vaccine supply chain network for COVID-19?
Since December, the logistics profession has shown that it can effectively get the COVID-19 vaccines to the point of need. Yet getting it to the point of need is not the same as satisfying the patient’s need. The challenges have lain in getting the vaccines administered. Consider what has happened in New York City with the city’s top-down mandated solutions. Five weeks into the city’s vaccination program, only 203,000 people had been vaccinated, according to The New York Times.
Three states have, however, rolled out highly effective programs, as highlighted in a recent Washington Post article: “In South Dakota, distribution of the vaccine has been limited to a small number of health care providers who meet via phone twice a week and can make decisions on the fly as conditions change. Connecticut has teamed with a well-established partnership network while using community ambassadors to advocate for the vaccine among populations where hesitancy runs high. And West Virginia has tightly coordinated its rollout, using the National Guard to speed supplies to where they are needed while streamlining the rules for who can get the shots.”
While South Dakota, Connecticut, and West Virginia have taken different approaches, they have a common principle: Anchor at the point of need, then integrate back to the supporting supply chain. And they also realize that solution sets need to be tailored to the circumstances and context. In an op-ed in The New York Times, an expert in West Virginia said, “Unlike many other states, we modified the national vaccine-administration plans to reflect regional realities.” West Virginia is one of the few U.S. states without a city of more than 100,000 residents. Because of its sparse density and a need for speedy distribution around the state, West Virginia decided to use the National Guard to augment its existing capability.
Some government officials are also considering utilizing existing private sector pharmaceutical networks. Florida Governor Ron DeSantis, for example, launched distribution of COVID-19 vaccinations in four counties through the grocery store chain Publix. According to Steven Anderson, president and CEO of the National Association of Chain Drug Stores, pharmacists nationwide have the capacity to administer 100 million doses of the COVID-19 vaccine once supply is available. These chains already understand inventory, turnover, shelf life, and refrigeration.
It seems that the federal government is beginning to understand the underutilized capacity in the private sector. Innovation is beginning to sprout, streamlining delivery processes and getting bureaucracy out of the way. Thousands of pharmacies across the United States will receive direct shipments of coronavirus vaccine in mid-February with a strategy intended to simplify the ability to get the shots, White House officials announced.
We could drive delivery through the private sector and let market forces, not bureaucrats, find the equilibrium between supply and demand. Look to your local pharmacies and grocery stores. We may already have a big part of the delivery solution right in front of us, and the Biden administration seems to be noticing.
Remember Occam’s razor.
Steve Geary is adjunct faculty at the University of Tennessee's Haaslam College of Business and is a lecturer at The Gordon Institute at Tufts University. He is the President of the Supply Chain Visions family of companies, consultancies that work across the government sector. Steve is a contributing editor at DC Velocity, and editor-at-large for CSCMP's Supply Chain Quarterly.