BALTIMORE (AFP) - A warehouse in the United States city of Baltimore may seem an unlikely place to help save the country from the Covid-19 pandemic, but Mr Brian Gallizzo is prepared to do just that.
"We are ready, we have our tanks full," Mr Gallizzo, chief financial officer for the six-decade-old family firm Capitol Carbonic, told Agence France-Presse.
How his company will help is by keeping things cool - extremely cool.
Capitol produces dry ice, a necessary component to distribute pharmaceutical giant Pfizer's Covid-19 vaccine, which could receive government approval soon.
Pfizer called Capitol because it was on the hunt for the quarter-inch pellets it spits out of a machine resembling a giant spaghetti maker in its Baltimore warehouse.
The dry ice pellets are needed to keep Pfizer's vaccine at just the right, very chilly, temperature.
US regulators will decide next week whether to allow Pfizer to become the first major drugmaker to deploy its vaccine, and manufacturers like Capitol Carbonic are already finding themselves involved in one of the most important medical supply chains in history.
The vaccines from Pfizer and others nearing approval appear to be the US' best chance for ending the world's largest Covid-19 outbreak, which is again surging to alarming levels nationwide.
But getting shots to people nationwide will be a logistical undertaking that will test the capabilities of the world's largest shipping firms, the small businesses that undergird the US dry ice supply and the many other companies in between.
"We've never experienced anything like this before in the history of vaccine administration in the US, let alone globally," said Mr Omar Chane of PricewaterhouseCoopers' life sciences management consultancy.
Anticipation for a vaccine's approval is particularly high in the US, where Covid-19 has killed some 270,000 people and infected more than 13.6 million.
Several vaccines are under development, but the candidate from Pfizer and German firm BioNTech is nearest to approval and at the centre of the US government's immunisation plan.
Assuming it is approved, 6.4 million doses could be distributed, starting soon after Dec 10, with 40 million available by the end of the month.
However, that vaccine also has the strictest temperature requirement of minus 70 deg C, about 20 deg C warmer than the lowest temperature on earth recorded, in Antarctica.
Dry ice is the best way to maintain that temperature range, but it is a complicated substance made of solidified carbon dioxide that begins turning to gas as soon as it is manufactured.
In a basketball court-sized warehouse filled with the howl of super-cold machinery at work, Capitol Carbonic makes tens of thousands of pounds in a typical day.
They range from as large as a block to as small as a grain of rice, including the pellet that Pfizer expressed interest in.
The drugmaker plans to move its vaccine in a special container packed with dry ice that can be opened only briefly twice a day and lasts for 15 days.
Shippers are readying for it: FedEx says it has received special permission to transport dry ice by air, while UPS said it is going to install dry ice makers in some of its warehouses.
But at minus 79 deg C, dry ice is not easily made, and the unanswered question for Mr John Dillinger, Capitol's general manager, is how the containers will be kept cool.
"The nature of dry ice is, as soon as you make it, it starts to go away. What happens if a CVS or a Walgreens gets it, and 11 days have gone and their suitcase has run out of ice?" he said, referring to the two pharmacy chains set to administer the Covid-19 vaccines.
In the months before it heard from Pfizer, Capitol Carbonic was having a challenging year in which demand spiked, thanks in part to homebound consumers ordering more food for delivery and shipments that needed to be chilled by dry ice.
But the carbon dioxide it relies on comes as a by-product of petrol refining, and with fewer people driving, supply was squeezed.
"Honestly, this year was extremely unprecedented," Mr Gallizzo said.
Other vaccines under development can be stored at higher temperature ranges - for some, around that of a normal refrigerator.
Candidates include one from British drugs group AstraZeneca and the University of Oxford, and another from Moderna and the US National Institutes of Health.
But experts say even those may require dry ice to keep them cold in transit.
"Every time it moves through the hands of a materials handler, the external ambient temperature gets warmer, which impacts the temperature of the box," said Dr Glenn Richey, a supply chain management professor at Auburn University.
Barring renewed business shutdowns, Mr Gallizzo is confident the dry ice industry can keep up with demand, but he is less sure about the rest of the supply chain.
"It's going to be a matter of figuring out how to get it to the customer," he said. "That's going to be our biggest issue."