WASHINGTON — Roughly six weeks from retirement, U.S. Army Materiel Command chief Gen. Gus Perna was sitting at home in Alabama on a Saturday in May 2020 when he got the call. It was Gen. Mark Milley, the chairman of the Joint Chiefs of Staff.
It had been just a few months since the coronavirus pandemic took hold in the continental United States. Milley had called to ask Perna to delay his retirement (already put on hold by more than a year) to run the operation to develop and deliver COVID-19 vaccines and therapeutics to the American population.
The effort was dubbed Operation Warp Speed. Milley offered him some time to think about taking the job, but Perna told him, “I don’t need any time. I’m ready to do it.”
Perna immediately began thinking through the gargantuan process and how his long career in the Army, particularly his command of logistics, could help pull the country out of the crisis. Defense News spoke with Perna in a recent interview, in which he reflected on the achievements of Operation Warp Speed as well as the lessons learned.
This interview was edited for length and clarity.
How did your experience at Army Materiel Command and as an Army leader ready you for this unprecedented task?
Our strength is that we can see things at different levels strategically, operationally and tactically. We have clarity and vision. If we don’t get it right the first time, we’re able to adjust, we’re agile and adaptive. We know how to identify what we think is the end state, and then visualize it and then work left to figure out what has to be done.
We’re also very good at operationalizing things to achieve the effects that we want. You don’t go to war and sit at the port; you go to war and you figure out how to defeat the enemy. Then the third thing is: We know how to put a plan together to get there. We use the military decision-making process — something on which we’re trained as young officers. We come up with courses of action and we assess risk against them. We decide and we move out, and when they don’t work out, we adjust. It’s probably the greatest attribute we have because we have never done this in the country before.
On that Saturday morning, I got [out] my notebook and started going through the military decision-making process: Define end state, work left, started thinking through what the plan would be, and started writing notes. My thoughts matured rapidly as we got into the process. I worked through my role with my co-leader [Dr. Moncef Slaoui, a former head of the vaccines department at GlaxoSmithKline]. At the end of the day, he was an expert — a world-renowned expert scientist in developing vaccines. I consider myself a world-renowned expert in logistics and sustainment. He was a good partner to me as we developed our processes and procedures for developing infrastructure, garnering materials and then eventually the distribution.
In an interview with Defense News, the American Medical Association president, Dr. Gerald Harmon, praised Operation Warp Speed as one of the “greatest scientific achievements of our lifetime.” What made this such a success story?
Here’s why I think at the end of the day, we were successful. One: We had a clearly defined purpose. Our purpose was to develop, manufacture and deliver safe and effective vaccines and therapeutics to the American people.
Two: We had absolute priority and resources to do the mission. I had that with both White Houses because my tenure extended through both. I had absolute priority and resources. This is so important. How many people get missions where they are given 100% priority or 100% of resources? I wanted people, people came; I needed funding, funding came; I wanted priority and materials, equipment and support for infrastructure came.
Three: We had unity of effort, and this is really important for everybody to understand. It was the U.S. government, it was academia, our world-renowned scientists and it was industry. This is what they do every day. It wasn’t us trying to figure it out in the back of some tent. It was these world-class pharmaceutical companies that were already doing this.
We worked with six industry partners to develop six different vaccines. There was a significant amount of people who were in different stages of making a vaccine because of the great homework that they’d already been doing to set the foundation before we were involved. We needed vaccines that demonstrated the right numbers, i.e., were they going to be effective. We needed a vaccine that could be produced in a relatively rapid time within our regulatory guidance. If it was successful, we kept it; if it wasn’t successful, we were going to eliminate. Then we needed to have enough volume. Our goal was initially 300 million [shots]. That changed to 600 million when it went to a two-shot regimen.
Once we figured out who the six companies were, we had to make sure we had the logistical infrastructure to do 30,000 people in a trial. We needed statistical data to demonstrate that the vaccines were going to be safe and effective.
Then manufacturing. All these partners had facilities of some type, but maybe not at the right volume. We helped build actual capability and capacity, whether it was directly with the pharmaceutical company or it was a supporter, because pharmaceutical companies make the vaccine, but then they give it to another company to put it in the vials. It was all about volume, how fast were we going to get it and how fast could we get it out to the American people. We [used Defense Production Act authorities] 19 [times] in our tenure. We had to manage that supply chain to achieve the effects that we wanted. We had to manage the materials to make the vaccine. We had to manage the equipment for expansion capacity. We had to manage the consumables, whether it was tubing or plastic bags that actually produced the vaccine, or whether it was needles and syringes or vials to put the vaccine in.
I used to tell the team that when we manage the supply chain, we have to be offensive and defensive in our efforts. Offensively, we had to manage everything across the six primary vaccine makers. We had to make sure they had enough for when they needed it to make the vaccine. In making the vaccine, all six companies needed many of the same things. We had to make sure nobody hoarded, that everybody got what they needed when they needed it. We had to go all over the world to get this stuff — a lot of it came from overseas.
How did you formulate a plan to distribute vaccines?
We wanted to make sure the 50 states, eight territories and six major cities all received a portion of the vaccine, fair and equitable across the board. So we developed a mathematical formula. This was really, really important in the climate of the day, and I’ll just leave it at that. It was based on adult population at the time because we knew we wouldn’t have approval for adolescents. Every week we designed a program where we knew, once it was first approved, we were going to exponentially increase volume every week. So week one was 5 million, but then week two was 7.5 million, etc. But the mathematical formula allowed us to figure out how to deliver it, allowed states to figure out how to plan for locations.
Second thing we had to do — and the country is not set up for this — we had to create places to receive the vaccine. Now you say: “Oh, General, the flu vaccine goes out every year.” Well guess what? Not everybody gets the flu vaccine. We went from 7,000 locations to over 70,000 locations where the vaccine could be delivered. To do that, every location had to be validated by the [Centers for Disease Control and Prevention].
They had to get certified and they had to get approved for receipt and execution of the vaccine. We went to the experts again. There’s three main medical vaccine distributors: Cardinal Health, AmerisourceBergen and McKesson. We talked to them, understanding that we did not want to dilute other medical supplies that were being delivered like heart medicine, cholesterol medicine, etc. We went to McKesson eventually — they were our main distributor.
Then here was the brilliance of the effort: We brought in FedEx and UPS. These two companies — open competitors — worked together to figure out how to be an end-to-end solution. So the vaccine went right from manufacturers and then we delivered it all the way down to the 70,000 locations. The vaccine got approved; 24 hours later, it was being delivered throughout the entire country. It went to the Pacific territories all the way up to Alaska and Maine, right down to Puerto Rico, and all the way across the country. It went there simultaneously. That was such a huge victory for us.
There was no system in America that allowed us to watch [vaccines and therapeutics] go from manufacturer through distribution down to administration. We created that system: Tiberius, [a software system designed to track vaccine distribution, that allowed us to] see every drop of vaccine. I could see it at every place we were making it. I could see it at every distribution site. I could see when they were low. We knew when people weren’t using it.
What didn’t go well?
Our communication strategy was ineffective, and it was poorly executed strategically, operationally and tactically.
We really worked hard with the states, the territories, the cities. We talked to them several times a week, we ran weekly rehearsals. Some of those states, territories and cities did magnificent jobs, some didn’t. I’m not going to go any deeper than that. But I made an assumption, and the assumption was not a good assumption. I adjusted it and I ended up putting things in place, but it’s not like I was a four-star general in the Army and I had two-star division commanders who were executing. We have different forms of leadership, different types of leadership, different cultures of leadership that we were working with in the execution phase — some very good and some not so good. We had to adapt to that.
It was an incredibly challenging time. COVID-19 was a big deal. We didn’t know what it was, we didn’t know where it was going, we didn’t know if we’d come up with a solution. But failure was not an option. Could we have made up a more challenging time period than in the middle of an election period? Think about that. And it wasn’t a midterm election, it was a presidential election; it was a big frickin’ deal. And it became polarizing. It was a challenge.
How do you see the government or our country adopting practices from this experience for the next pandemic or something else?
We have the greatest medical community and scientists in the world, and I had the great pleasure of meeting so many of them. We operate at such a high standards. It’s so well regulated. We ought to be proud of that.
With that said, do I think we could do things better? Yes, I do. We ought to challenge ourselves, challenge the status quo to that end, whether it’s our processes for execution, how to do trials to how to do delivery, to management, etc. We ought to sit down as a country and think through this. It should start at the federal level. There ought to be a bipartisan review. [From the beginning], we started collecting all of our after-action stuff. We collected every briefing, every decision, everything we did, every recommendation, and we logged it and put it together for future use.
[The result of a review] could be directing some type of organization that provides unity of command but at the very least, unity of effort. It could be something that directs an operational concept that would cover all these things from how to set up the campaign plan for execution if something ever comes back. We have to make the decisions about do we have dedicated infrastructure. Do we have dedicated partners that are part of the team? Do we have dedicated supply chain support, whether it’s materials, consumables or equipment? I think we ought to take advantage of a bad situation and not let this happen to us again.
What can the Army learn from Operation Warp Speed? What elements of this process would you inject into Army functions?
I couldn’t see myself tactically or operationally, physically. Tiberius [did that]. We were competitive [in] the acquisition process, but I didn’t play games. I didn’t spend five years developing requirements. I didn’t have time to put them through this budgeted development phase. You only have so much money so you can only do so much. I needed it all. I needed it immediately. And I got it. Tiberius was created from scratch. Maybe five years from now, they’ll need something different, but I didn’t worry about that.
We spend too much time trying to figure out how we’re going to not only fight 20 years from now, but also fight today. Then we develop these requirements that are out of control, then we try to buy it with a budget that’s piecemealed with technology that changes almost daily.
What Army Futures Command is trying to do for the Army is the right way to go. I would tell you though, the Army in its totality, there’s still a significant number of programs that are not being run by [Army Futures Command], so what process are we going to use? How are we going to define requirements? How are we going to ensure things get done? How are we going to stop trying to solve world hunger with a budget that’s piecemeal and an enemy we might not even know is coming 10 to 20 years from now? That was my biggest lesson learned.
Jen Judson is an award-winning journalist covering land warfare for Defense News. She has also worked for Politico and Inside Defense. She holds a Master of Science in journalism from Boston University and a Bachelor of Arts from Kenyon College.