December 2, 2020
David A. Wein, M.D. is the Chief of Emergency Medicine at Tampa General Hospital, System Medical Director for TeamHealth, and an Associate Professor at USF Morsani College of Medicine.
Rachel Elias Wein: So much has changed since our last Q&A back in August. I thought we’d start by focusing on what the arrival of the Pfizer and Moderna vaccines could mean on a personal level for our readers. Naturally, they’re very interested in the potential effects of this on commercial real estate, so we can touch on that as well.
Dr. David A. Wein: You bet, the situation is moving very quickly. Personally, I see the development of these vaccines in such a short timeframe as an incredible human achievement.
REW: Absolutely, can you tell us more about when we could expect to receive the vaccine? What does the process of rolling out the Moderna and Pfizer vaccines look like?
DAW: As of now [December 3], both Moderna and Pfizer have submitted applications for emergency-use authorization of their respective vaccines. What we’re hearing is that the FDA is likely to grant those requests by mid-December or thereabouts.
Within 24 to 48 hours of that authorization, we could see doses being shipped out to vaccinate what are being called ‘Phase 1A’ candidates—namely, healthcare personnel and residents of long-term care facilities.
I should add that the regulatory body in the United Kingdom just granted similar authorization to the Pfizer vaccine this morning. That means the United States may learn some lessons from early vaccine distribution in the United Kingdom.
REW: And what are some of the elements of the distribution plan in the United States?
DAW: Once the FDA grants emergency-use authorization, the U.S. military will coordinate the shipping process. The plan is to ship 40 million doses to the states by the end of the year—each person needs two doses, so that’s 20 million people fully vaccinated—and then the states will decide how to comply with CDC recommendations about who will get the vaccine first.
Maintaining the cold chain is an important factor. States are designating certain distribution centers that have access to the freezers needed to keep the Pfizer vaccine, in particular, cold enough to stay viable. It needs to be kept at minus 94 degrees Fahrenheit, to be exact.
REW: I was reading that hospitals will be able to thaw doses of the Pfizer vaccine and keep them in a regular fridge, but after that the vaccines must be administered within five days.
DAW: I believe that’s correct. I’m sure that will help logistically.
REW: So if there are healthcare personnel in your family, or maybe you have a parent in a long-term care facility, they could be receiving a vaccination pretty quickly.
DAW: Absolutely, and Tampa General will be one of the first sites in Florida to receive the Pfizer vaccine. So, as an emergency medicine physician, I could be receiving my first dose a couple of weeks from today.
There are roughly 21 million people across the United States who qualify as healthcare personnel under the CDC guidelines, and something on the order of 3 million people who live in long-term care facilities.
The next group, Phase 1B, is composed of essential workers. The CDC’s definition covers sectors such as education, transportation, corrections, food and agriculture, and police and firefighters.
With this group, reportedly something like 80 million people in total, we may see a little more variation among different states as far as the timetable for vaccination. For example, if a state has large numbers of people who work in meatpacking where many early outbreaks occurred, those workers may get early priority, perhaps closer to Phase 1A. The CDC fully anticipates some overlap between these first two groups.
REW: So that takes us to a bit over 100 million vaccinated by the end of February, roughly a third of the country. And the next phases are people who are older than 65 or have high-risk medical conditions, followed by everybody else, right?
DAW: That’s correct.
REW: So do you think it’s fair to say that by Q2 or Q3, we will see all Americans that wish to be vaccinated able to do so?
DAW: I think that timetable makes sense, but of course there are some caveats to keep in mind. We’d all like to flip a switch and have everything go ‘back to normal’ overnight, but that’s not how it works. For example, we know that people who get vaccinated will be far less likely to develop severe illness, but we don’t yet know whether they could still spread the disease to people who are still waiting to receive their shots.
I’m hoping we will get some answers to those kinds of questions as the Pfizer and Moderna vaccine trials continue to follow their original patients. But what that means for your readers, on a personal level, is that they will most likely need to continue masking up and social distancing for much of 2021. Even if they are personally safe due to vaccination, they’ll want to be mindful of the health and safety of others around them. There are also people who will be unable to be vaccinated, like pregnant women or people with certain other conditions, so we need to continue to be vigilant after being vaccinated.
REW: That’s of course impactful for our family as you will continue to treat Covid-19 patients and, at least for several months, the kids and I won’t be vaccinated yet. Are there any other important considerations here?
DAW: One thing I want to emphasize is that there have been zero safety concerns to date for the Pfizer and Moderna vaccines. That’s really great news that we should stop and appreciate.
And since we’re talking about individuals’ questions, a common one I get is, ‘If I had Covid-19, should I still get vaccinated?’ My answer is that you probably still should. If we know you have antibodies, maybe you are a slightly lower priority, but it’s a good idea to get the protection conferred by the vaccine.
People should also know that it is recommended that you not get the Covid-19 vaccine within 30 days of having received another vaccine. If you’re an essential worker, get your flu shot right away to avoid being excluded.
REW: Just shifting gears a bit, it seems to me that the gradual vaccination of the population in the quarters ahead could set in motion a return of traffic and sales to some of the hardest-hit parts of our business, such as fitness centers, office buildings, sit-down restaurants, dental clinics and theaters. Do you think that’s a reasonable perspective?
DAW: I will say this: Toward the beginning of the pandemic, if you had suggested to virtually anyone in science and medicine that we would have safe and effective vaccine ready for distribution in less than a year, they would have scoffed. That’s something that used to take four or five years. It’s always advisable to be cautious, but I’m encouraged by this news.
REW: It will be interesting to watch what happens with some of the shifts that have occurred in consumer spending. For the full-year 2020, restaurants are likely to lose close to $250 billion of sales, of which half will benefit grocery stores and the other half will stay with the consumer due to lower pricing for food at home. As the vaccinations progress, you could see more consumers start to go back to the office, shopping centers and stores in a major way. At the same time, we know that tens of millions of Americans have been converted to online grocery delivery and curbside pickup.
DAW: Regardless of how those trends play out, from a healthcare standpoint the key will be for everyone to continue to follow public health guidelines—masking up and social-distancing as recommended until we reach the point where that is no longer necessary—so that we can emerge from this as quickly and efficiently as possible.
NOTE: The second half of this conversation, which we’ll post in two weeks, drills into how progress on Covid-19 vaccination stands to affect grocery, office and other sectors of CRE. We’ll also look at what it could really mean for real estate if, as predicted, the average office worker spends two extra days working from home moving forward.
