When Ebola spread through West Africa in 2014, a global network of researchers opposed seemingly impossible work.
Not only did they have to develop and test the Ebola vaccine (something that has never been done), but there was a problem with circulation.
The deadly virus had reached cities without power and without access past narrow dirt roads that would have been impossible during the rainy season.
The vaccine they intended to use had to be kept very cold: around -80 degrees Celsius, or four times colder than a household freezer.
They had to find a way to store the vaccine safely for up to a week without electricity.
And they had three months to find a solution.
Eventually, they created what is really a space-age thermos that can sustain Antarctic winter temperatures for weeks on end.
The Arktek is esky with insulation so good that it can be filled with ice and left in the warm desert sun for up to a month without dropping a step.
As Australia prepares to roll out the recently approved Pfizer vaccine at -70C, the story of how these researchers overcame technical hurdles to successfully roll out a vaccine could also hold vital lessons.
Better esky build
By the end of 2014, the Ebola situation was dire. Thousands had died in West Africa and the virus had spread to the USA and the UK.
But there was good news: a vaccine would be ready within months.
In December 2014, the World Health Organization called on a company of entrepreneurs, Intellectual Ventures (IV), to solve the problem of how the vaccine should be distributed without power, while also storing it safely at -80C.
Daniel Lieberman, a mechanical engineer at the company at the time, was part of the team assembling in a building near Seattle.
“We turned to Arktek,” he said.
Intellectual Ventures developed the Arktek a few years earlier to distribute polio vaccines in powerless places in response to a challenge from Bill Gates, who gave the nickname the “prime life” invention.
The design uses hollow barriers, fiberglass and a glossy interior coating to reduce heat transfer between the warm exterior and cold interior.
Frozen ice blocks are used in semicircular containers for cooling.
“Our design was extremely tight in terms of leakage,” Mr. Lieberman said.
Unfortunately, it was only good for vaccines stored between 2 and 8C.
Getting a job at -80C was a “huge problem”, Mr Leiberman said.
In December 2014, they began work. They had until March.
Solves the cooling problem
The researchers were focusing on finding a better way to cool the Arktek – a so-called “thermal battery”.
In the original Arktek, this battery contained only frozen water.
Frozen carbon dioxide or dry ice, with a surface temperature of -78C, was an option, but there was not enough in West Africa to do this job.
Stumped and desperate for a solution, they turned to a class of obscure chemicals called phase change substances (PCMs). These are synthetic molecules designed to freeze or melt at certain temperatures.
Experimenting with different ingredients, they found a combination of alcohol and frozen water at -75C – good enough for their purposes.
“It turns out you can create ice packs of almost any temperature you want, you can’t use water, you have to use something else,” Mr Lieberman said.
Within months, modified Arkteks full of PCMs were deployed to West Africa.
Between April and December 2015, 8,000 health workers were vaccinated against Ebola.
Three months later, the epilepsy was announced.
Largest distribution of ultra-cool vaccine in the world
Just two years later, Ebola returned – this time in the Democratic Republic of the Congo (DRC) in Central Africa.
Authorities acted swiftly – cases were recorded in the city of Mbandaka, near the capital Kinshasa, a city of 14 million.
With 16 Arkteks and a few ultra-cold freezers to deliver PCM cold bricks, health workers fitted more than 300,000 people in just over two years.
When the roads were flooded and cars could not get through, it was reported that Arkteks was trapped in canoes or behind motorcycles.
The DRC program, which ended epilepsy, remains the largest release of ultra-cold vaccines, according to GAVI, an alliance of governments, drug companies and charities that organize global vaccination campaigns.
“The heroic efforts of Congolese vaccines, logistics and health workers have resulted in more than 300,000 people in the DRC and neighboring countries consenting and receiving the vaccine,” a spokesman said.
“In an equatorial area with occasional electricity, poor roads and few health clinics, this can be an inevitable challenge.
“[DRC’s success] shows that it is possible, at least on this scale, but also very complex. “
Esky updated for COVID vaccine circulation
When the Pfizer COVID vaccine is released at -70C, the Arktek can be re-installed.
Mr Lieberman, who now owns the non-profit GH Labs, has changed the machine to use dry ice, which he says the thermal batteries are better and more accessible in many affected countries. COVID affects.
“There are many, many, countries with reliable carbon dioxide, and dry ice production capacity,” he said.
Pfizer already uses dry ice to carry its ultra-cold vaccines, but their cooler boxes are not as solemn as the Arktek, according to Mr. Lieberman.
Made of cardboard and foam, Pfizer’s ‘thermal shippers’ can hold doses for 15 days while being refilled with dry ice every five days.
The Arktek, by contrast, lasts up to four weeks between relays, Mr. Lieberman said.
“It has a heat melt rate 10 to 15 times less than something like a Pfizer cool box – that kind of size rule,” he said.
A backup solution for remote areas of Australia?
It remains to be seen whether the Arktek is needed to roll out super-cold COVID vaccines in Australia or anywhere else in the world.
Earlier this week, Australia agreed to use the Pfizer vaccine, with its first job in February.
Circulating the Pfizer vaccine to remote areas will be a challenge – each ‘thermal receptor’ has 5,000 doses that need to be dissolved together.
Once melted, they must be refrigerated and used within five days.
If a box were to melt in a small town or community, most doses would be consumed.
Health authorities plan to avoid the worst complications by distributing the Pfizer vaccine alone from 30 to 50 municipal and regional hospitals.
Very remote areas, such as some communities in the northern region, are more likely to receive the Oxford-AstraZeneca vaccine, which can be stored regularly. fridge.
Nevertheless, GH Labs is working with GAVI and the Bill and Melinda Gates Foundation to look at ways in which the Arktek could be used to roll out the Pfizer vaccine more widely.
Mr Lieberman said one idea was using the Arktek as part of a ‘hub and speak’ model.
“The Pfizer box reached a central location and then you would use other devices like the Arktek to distribute it more regionally within a country,” he said.
Some countries have ordered Arkteks for the COVID vaccine distribution.
Aucma, the Chinese company that manufactures US $ 2000 machines, said it would double production this year to meet higher demand.
The President of the Australian Association of Rural Physicians, Dr John Hall, said the Arktek would be “absolutely” useful in the final phase of delivering the Pfizer vaccine to remote areas.
“If there is no backup solution for delivering Pfizer, we will see major disadvantages for rural and remote Australia,” he said.
“All it takes is that a prime producer is at fault and we see a delay of weeks or months.”