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Covid-19 News: Moderna, Pfizer and C.D.C. Updates

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ImageCredit…Jerome Delay/Associated Press

JOHANNESBURG — Moderna said on Thursday that it planned to build a vaccine manufacturing facility in Africa, news that was welcomed for the long-term but that does not address the continent’s immediate need for Covid-19 vaccines.

The company said that a new “state of the art” facility would eventually produce up to 500 million doses a year of Moderna’s mRNA vaccine, which has shown an efficacy rate of more than 90 percent in preventing Covid-19. The plant will, in time, also produce other Moderna vaccines, the company said.

Building vaccine manufacturing sites in Africa will increase the continent’s future access to the drugs. But it does not answer calls from African leaders and activists to waive patent laws that would give more drugmakers access to details on how coronavirus vaccines are produced. It also does not address the continent’s immediate Covid-19 vaccine shortages.

“It doesn’t necessarily solve our problems today,” Dr. John Nkengasong, the director of the Africa Centers for Disease Control and Prevention, said in a regular news briefing on Thursday. “The problems we have are quick access to vaccines, redistribution of vaccines, making sure that certain licenses are provided so that manufacturing can start regionally.”

Moderna’s announcement comes amid mounting pressure on biotech firms to share their expertise with manufacturers in countries that desperately need more coronavirus vaccine doses.

The drug makers Pfizer and BioNTech said in July that they had partnered with Biovac, a public-private partnership pharmaceutical company in Cape Town. In Gqeberha, the South African coastal city formerly known as Port Elizabeth, Johnson & Johnson has partnered with Aspen, a local manufacturer, in a fill-and-finish manufacturing process.

Moderna said that it expected to invest up to $500 million in its future site, and that its facility would manufacture the doses with fill-and-finish capacity, in addition to packaging facilities. It said it would now begin the process of identifying which country would host the plant.

“While we are still working to increase capacity in our current network to deliver vaccines for the ongoing pandemic in 2022, we believe it is important to invest in the future,” said Stephane Bancel, Moderna’s chief executive.

African leaders had already established the Partnerships for African Vaccine Manufacturing, which works within an existing “ecosystem” of Africa’s vaccine needs. Launched in April, it has political backing from the continent’s leaders, including Presidents Cyril Ramaphosa of South Africa and Paul Kagame of Rwanda.

Moderna, an American drug company, developed its coronavirus vaccine with billions of dollars in taxpayer money and received initial research and development funding from Covax, the vaccine sharing facility supported by the global vaccine alliance Gavi and the World Health Organization.

Credit…Joe Raedle/Getty Images

Lockdowns helped keep last year’s flu season historically mild in both the United States and around the world, but U.S. officials fear a more serious season this fall and winter, with unmasked people out and about far more, and nearly half of adults in a new survey saying they are unlikely to get a flu shot.

At a news briefing to release the survey data on Thursday morning, top health experts said they were particularly concerned that, with the coronavirus still coursing around the country, nearly one in four people at higher risk for flu-related complications indicated they did not intend to get the flu vaccine.

Dr. Rochelle P. Walensky, head of the Centers for Disease Control and Prevention, noted that while experts did not yet know how severely the flu would hit the United States this fall, other respiratory infections had already returned, including RSV, a common cause of pneumonia and bronchitis in babies and a serious threat to older adults. The C.D.C.’s latest weekly flu report shows that only one state, Wyoming, had reached a “moderate” level of flu cases.

Because the flu was almost nonexistent last year, Dr. Walensky noted, people do not have the protective immunity they might have acquired if they had gotten sick, and she urged that everyone age 6 months and older be vaccinated. “The Covid-19 pandemic is not over, and the risk of both flu and Covid-19 circulating could put additional strain on hospitals and frontline health care professionals,” she said.

The survey was commissioned by the National Foundation for Infectious Diseases, a nonprofit organization. Its medical director, Dr. William Schaffner, said that overall vulnerability to flu could be higher this year, “with relaxed Covid-19 mitigation strategies, increased travel and the reopening of schools.”

For the survey, more than 1,110 respondents 18 and older from all 50 states and the District of Columbia answered questions in mid-August that explored attitudes about the flu; Covid-19; pneumococcal disease, which can cause pneumonia, sepsis and meningitis; and vaccination intentions.

The answers revealed a tension between beliefs about the value of the flu vaccination and the intention to get one: 61 percent of respondents agreed that a shot was the best protection against the flu, but 44 percent said they were either unsure whether they would get one or did not intend to do so.

The coronavirus pandemic, however, has had a positive effect on behaviors that could help lessen the impact of the flu. Nearly half of those surveyed said that because of the pandemic, they were more likely to stay home from work or school if they were sick, and 54 percent said they would wear a mask at least sometimes during the flu season.

But there were racial disparities: 73 percent of Black respondents and 62 percent of Latinos said they would wear a mask during flu season, compared with only 46 percent of white respondents. Black and Latino respondents were also more likely to be worried about being infected with Covid and the flu simultaneously than white respondents.

Dr. Walensky said that the flu vaccination rate nationally had held steady over the year before, at about 52 percent, but criticized what she called a “disparity gap” in flu vaccination: 56 percent for white people versus 43 percent among Black people.

Patsy Stinchfield, a nurse practitioner at Children’s Minnesota, a pediatric health care system, and the president-elect of the infectious disease foundation, said that it was safe for people to get flu and Covid shots — including boosters — at the same time.

Dr. Walensky also raised alarms about a decline in the flu vaccination rates among young children, to 59 percent from 64 percent the year before. In the 2019-2020 season, she said, 199 children died from the flu, about 80 percent of whom were not vaccinated.

Credit…Allison Zaucha for The New York Times

With deadlines for health care workers to take coronavirus vaccinations either passed or quickly approaching, only a fraction of those workers across the United States are risking their jobs by not complying.

The consequences that employers warned of are becoming reality.

UCHealth System in Colorado fired 119 people this week. Kaiser Permanente, based in California, has suspended more than 2,200 employees. And 400 workers have resigned from the Henry Ford Health System in Detroit rather than get inoculated.

On Friday, UCHealth, a nonprofit system serving the Rocky Mountain region, sent the last of several email reminders to the 119 employees — 0.5 percent of its work force — who had not received a vaccination or a medical or religious exemption. They had already been removed from weekend schedules and were notified this week of their termination.

“Certainly we would have liked 100 percent compliance,” Dan Weaver, the vice president of communications, said in an interview on Wednesday. He said that the terminated employees had been “encouraged” to reapply for their positions if they got vaccinated.

Kaiser Permanente, one of the nation’s largest nonprofit health plans, announced its vaccination requirement on Aug. 2, when 78 percent of its work force had already been inoculated. A spokesman said this week that the level had risen to more than 92 percent.

Still, about 1 percent of Kaiser’s work force across the country — approximately 2,200 workers — were put on unpaid administrative leave because they had not met the requirement, the spokesman said. They have until Dec. 1 to get vaccinated to be able to return to work.

The Henry Ford Health System required its employees to comply with a vaccination requirement by last Friday. The system said on Tuesday that 99 percent of its 33,000 employees had been fully vaccinated, were soon to get their second dose or had received medical or religious exemptions.

About 400 employees have resigned over the requirement, but new hires have already made up for the loss, officials said.

At Henry Ford, Bob Riney, the chief operating officer and president of health care operations, said that people who had left the company could reapply once they were inoculated.

“We are doing all we can to keep those doors open,” Mr. Riney told reporters. “Whatever their choice, we wish them the very best and appreciate the years of service they provided our community and organization.”

Northwell Health, New York State’s largest health care provider, said on Monday that 1,400 employees — less than 2 percent of its staff — had declined to get vaccinated against the coronavirus and had to leave their jobs.

President Biden announced a mandate on Sept. 9 that requires workers at nearly every hospital and health system in the country to get vaccinated or be tested weekly for the coronavirus.

Credit…Yana Paskova for The New York Times

One week after requiring more than 650,000 hospital and nursing home workers to get at least one dose of the vaccine, New York State’s pioneering mandate for health care workers is moving into a second and likely more difficult phase: requiring at least 250,000 home health care workers to get at least one dose of the vaccine before Friday or face the threat of losing their jobs.

While the first phase of the mandate was widely viewed as successful in pressuring thousands of nurses, doctors, technicians and orderlies to get the vaccine, many industry officials say they fear this second phase will result in thousands of workers simply quitting their jobs and finding new work in restaurants, retail or other industries. Most home health care aides, many of them immigrants, are paid about minimum wage and could find jobs paying similar wages elsewhere.

Without enough workers to go around, patients recovering from stints in the hospital or older New Yorkers who rely on long-term aides for assistance with everything from grocery shopping to bathing could find their care reduced or ended. The shortage could also exacerbate patient backlogs at hospitals, which often discharge patients with the support of in-home care.

“Even a small percentage of home care workers no longer working will impact thousands of homebound individuals,” said Dan Savitt, the president and chief executive of the Visiting Nurse Service of New York. “The rough math here is for every 1 percent of full-time aides unavailable, there are about 1,500 Medicaid members that will be impacted.”

Credit…Brendan Mcdermid/Reuters

Countries in the Asia-Pacific region this week became some of the first after the United States to secure supplies of molnupiravir, the pill that the pharmaceutical company Merck says could halve the risk of hospitalization and death from Covid-19.

Merck said in June that the United States had agreed to buy enough pills for 1.7 million treatments, at a cost of $1.2 billion. This week, Australia, Malaysia, Singapore and South Korea said that they had reached agreements with the drug maker to buy the pills, even though their regulatory agencies have yet to approve the drug. Thailand and Taiwan are also in talks with Merck to buy them, Reuters reported.

While many nations in Asia had a slow start at vaccinating against Covid-19, countries including Malaysia, Singapore and South Korea have now administered more vaccine doses than the United States per capita. Merck’s treatment, the first oral antiviral drug that can be taken at home, is expected to help limit the impact of future outbreaks and reduce the need for costly hospital treatment.

A patient would take four capsules twice a day for five days, or 40 pills total.

Prime Minister Scott Morrison of Australia said on Tuesday that his government had agreed to buy 300,000 courses, pending regulatory authorization, which could happen in early 2022.

“Vaccines and new treatments like this will boost our national plan to safely reopen Australia and keep Australia safely open,” he said in a statement.

Malaysia has struck a deal to secure 150,000 treatments, its health minister, Khairy Jamaluddin, said on Thursday. “This complements our successful vaccination rollout,” he said in a tweet, adding that the ministry would continue to buy more treatment options.

South Korea secured enough pills for more than 20,000 treatments and is continuing talks with the company to secure more, the office of Prime Minister Kim Boo-kyum said on Wednesday. The government has budgeted to buy 38,000 doses of the drug in total this year and next year, it said in a statement.

Singapore also secured a deal to purchase the drug, Merck said in a statement on Wednesday, according to Reuters. The health ministry confirmed the deal to Reuters but did not disclose the number of pills citing commercial sensitivities.

Merck did not immediately respond to an early morning request for comment by telephone and email.

Merck has said it plans to seek emergency authorization for the pills to be used in the United States. Initially, the drug might be available only for people considered high risk, such as older people or those with comorbidities, though experts say that the pills could eventually become more widely available.

White House officials have said that people should get vaccinated even if Merck’s pill cuts deaths. Vaccination “remains far and away our best tool against Covid-19,” said Jeff Zients, the White House coronavirus adviser.

Credit…Doug Mills/The New York Times

President Biden is traveling to Chicago on Thursday to talk about vaccine mandates.

Chicago was picked in part because it is the home of United Airlines, one of the first major carriers to require shots for its 67,000 U.S. employees. Other airlines have followed with similar requirements, including American Airlines, Southwest, JetBlue and Alaska Airlines.

Jeff Zients, the White House coronavirus response coordinator, announced the trip on Wednesday and said that Mr. Biden would focus on the success of vaccine mandates.

Mr. Biden said last month that he would use his presidential powers to require two-thirds of American workers be vaccinated against the coronavirus. That included a private sector to mandate that all companies with more than 100 workers require vaccination or weekly testing.

He also moved to mandate shots for health care workers, federal contractors and most federal workers, who could face disciplinary measures if they decline to be inoculated.

Mr. Biden will talk about the impact that those requirements are having, Mr. Zients said.

“We believe that vaccination requirements at workplaces are very effective and an efficient way to ensure people are vaccinated or tested,” Mr. Zients said.

United Airlines has said that it would terminate about 600 employees for not complying with its vaccination requirement. About 99 percent of its U.S. work force has been vaccinated, according to the airline.

Credit…Laurence Kesterson/Associated Press

Over a 15-month period of the pandemic, more than 120,000 children in the United States had a parent or caregiver die from Covid-19, a loss that more severely affected racial minorities, according to a modeling study published in the medical journal Pediatrics on Thursday.

The study estimated that for every four Covid-19 deaths between April 1, 2020, and June 30, 2021, one child lost a parent or caregiver. The finding suggested that the ongoing pandemic, which has claimed more than 700,000 American lives thus far, could leave tens of thousands of children dealing with trauma for generations to come.

“It’s not just one of 500 are dead; one of 500 American children have lost their mommy or daddy or grandparents who took care of them,” Dr. Susan Hillis, the lead author and a researcher and epidemiologist at the Centers for Disease Control and Prevention, said in an interview.

In addition to the 120,630 children who were estimated to have lost a primary caregiver — a parent or grandparent responsible for providing housing, basic needs and care — 22,007 lost a secondary caregiver, or a grandparent providing housing but not most basic needs, the study projected. Dr. Hillis said the loss of such grandparents could lead to homelessness.

The new findings aligned with research that has repeatedly demonstrated that racial minorities have been disproportionately vulnerable to the pandemic.

According to the study in Pediatrics, one of every 168 American Indian/Alaska Native children, one of every 310 Black children, one of every 412 Hispanic children, and one of every 612 Asian children have lost a caregiver, compared to one in 753 white children.

Credit…Jon Chol Jin/Associated Press

The World Health Organization said on Thursday that it had resumed shipments of medical supplies to North Korea to help its Covid-19 response, in what appears to signal a relaxation of the closed-border policies enforced by Pyongyang early in the pandemic.

The agency said that its shipments of medical supplies, together with international supplies destined for North Korea, had become stranded in China after Pyongyang sealed the country’s borders in January 2020 when Covid-19 was declared a public health emergency of international concern.

North Korea’s Ministry of Public Health told the agency several months ago that it would allow the stranded supplies to be transported through the northern Chinese port of Dalian, a W.H.O. spokesman, Tarik Jasarevic, said in an emailed statement.

As a result, the agency had sent some of the medical supplies and equipment to the North Korean port of Nampo, he said.

North Korea has not reported any Covid-19 infections, and it turned down several offers of vaccines, including ones from the United Nations-backed Covax facility and from Russia. But North Korea’s leader, Kim Jong-un, said in June that lapses in his country’s anti-pandemic campaign had caused a “great crisis” that threatened “grave consequences,” according to the state media. He did not clarify whether he was referring to an outbreak within the country.

The W.H.O. said its shipments to North Korea included health kits, medicines and other medical supplies that would support essential health services at primary health care centers.

The agency said it had been told that these supplies remained under quarantine in Nampo.

Credit…Shawn Rocco/Duke Health, via Reuters

WASHINGTON — Pfizer and BioNTech said on Thursday morning that they had asked federal regulators to authorize emergency use of their coronavirus vaccine for children ages 5 to 11, a move that could help protect more than 28 million people in the United States.

The companies have said they were submitting data supporting the change to the Food and Drug Administration. The agency has promised to move quickly on the request and has tentatively scheduled a meeting on Oct. 26 to consider it. A ruling is expected between Halloween and Thanksgiving.

Parents across the United States are anxiously awaiting the regulator’s decision, which could affect family life and the operation of schools. Clearance depends not only on the strength of the companies’ clinical trial data, but on whether they can prove that they are able to properly manufacture a new pediatric formulation.

Dr. Janet Woodcock, the acting F.D.A. commissioner, said last week that children might require “a different dosage or formulation from that used in an older pediatric population or adults.”

Pfizer has proposed giving children one-third of the adult dosage. That might require adding more diluent to each injection or using a different vial or syringe. The company was expected to describe the method it intended to use in its submission to the F.D.A.

Credit…Sameer Al-Doumy/Agence France-Presse — Getty Images

Covid screening tests in France will no longer be free for unvaccinated people starting on Oct. 15, according to the French authorities, a change that signals a new phase in the government’s strategy to quell coronavirus infections by encouraging people to get inoculated.

Unvaccinated people will now essentially have to pay to enter cafes, restaurants and theaters, because under a law enacted this summer, entering many indoor venues requires proof of being fully vaccinated, of a recent negative test or of a recent Covid-19 recovery.

Tests will remain free for vaccinated people.

The introduction of the health pass prompted large protests over the summer, with demonstrators including people calling it an infringement on their freedom, vaccine conspiracy theorists, and activists on the far left and the far right.

The law also includes mandatory inoculation for health workers — representing about three million people in France — by Oct. 15. Although most have received at least a first vaccine dose, some have held out. About 3,000 health workers have been suspended as a result, the government said last week.

A sharp decline in the number of protesters and a surge in vaccination rates in recent months suggest that President Emmanuel Macron’s gamble to increase restrictions to encourage vaccination has paid off.

But with vaccination rates lagging again in recent weeks, the government renewed its mixture of mandates and inducements — including an ad campaign promoting the “desirable” effects of vaccines — to encourage people to get vaccinated.

France, one of the most vaccine-sceptical countries in the world, has now fully inoculated nearly 70 percent of its population against the coronavirus, one of the highest rates in Europe, according to data from The New York Times.

Covid tests for unvaccinated people will cost $25 to $50, according to French press reports.

“It is no longer legitimate to pay for unlimited comfort tests at taxpayers’ expense,” Prime Minister Jean Castex told the newspaper Les Echos last month, adding that tests prescribed by a doctor and those for minors would continue to be reimbursed.

“The rationale,” he said, “is to reimburse tests linked to real medical reasons, and to keep encouraging vaccination.”

In August, Germany also announced plans to end free Covid tests for the unvaccinated, scheduling the change for Oct. 11.

Credit…Sakis Mitrolidis/Agence France-Presse — Getty Images

Greece will lift some pandemic restrictions in regions where coronavirus cases have been the highest, its health minister said, starting on Saturday.

The move, initially implemented for two weeks, is part of a drive to grant greater freedoms to people who are fully vaccinated against the virus and to encourage a large unvaccinated population to get shots.

“Red areas” across much of northern Greece and some parts of central Greece implemented restrictions last month including a nighttime curfew from 1 a.m. to 6 a.m. and a ban on music in bars and restaurants, in attempt to quell a fourth wave of the virus.

Under the relaxed rules, as well as being able to play music, restaurants and entertainment venues will be allowed to host standing customers, the health minister, Thanasis Plevris, said at a news conference on Wednesday.

They will be open only to people who can show proof of vaccination or of recent recovery from Covid infection, however. Unvaccinated people will remain barred, in line with restrictions introduced last month that are scheduled to remain in place through March.

Those measures bar unvaccinated people from indoor venues, including cafes and restaurants, and oblige unvaccinated workers to undergo regular coronavirus tests at their own expense.

Mr. Plevris said the relaxation of the rules starting this weekend was not an effort to punish unvaccinated people.

“The philosophy is not that some people are being favored over others,” he said. “The measures for the unvaccinated are adequate. Those who are vaccinated can have greater freedoms.”

Vaccine hesitancy is relatively strong in Greece, where 57 percent of the population of nearly 11 million has been fully vaccinated, compared with about 63 percent in the wider European Union, according to the European Centre for Disease Prevention and Control.

Credit…Aaron Nesheim for The New York Times

Even as parents in the United States wrestle with difficult questions over vaccinating their children against the coronavirus, families in other countries have been offered a novel option: giving children just one dose of the vaccine.

Officials in Britain, Hong Kong, Norway and other countries have recommended a single dose of the Pfizer-BioNTech vaccine for children ages 12 and older — providing partial protection from the virus, but without the potential harms occasionally observed after two doses. On Wednesday, Sweden and Denmark joined the ranks, announcing that adolescents should get only one jab of the Moderna vaccine.

Health officials in those countries are particularly worried about increasing data suggesting that myocarditis, an inflammation of the heart, may be more common among adolescents and young adults after vaccination than had been thought.

The risk remains very small, and significant only after the second dose of an mRNA vaccine. But the numbers have changed the risk-benefit calculus in countries where new infections are mostly lower than in the United States.

Advisers to the Centers for Disease Control and Prevention reviewed data on myocarditis in June and unanimously voted to recommend the vaccine for children ages 12 and older, saying that the benefits far outweighed the risk.

Myocarditis was among the concerns that led the Food and Drug Administration to ask vaccine makers this summer to increase the number of children in clinical trials. The issue is likely to be the focus of intense discussion when agency advisers meet next week to review the evidence for vaccinations of children ages 5 to 11 years.

Credit…Ash Adams for The New York Times

The coronavirus seems to be in retreat in the United States, with instances of hospitalization and death both falling.

Although some states, such as Alaska, Maine and New Hampshire, are still seeing high figures, the number of virus cases across the country is down about 25 percent compared with a couple of weeks ago.

So, what stage is the country in with the pandemic? And how will developments such as a new antiviral treatment and the availability of booster shots affect things?

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Listen to ‘The Daily’: The State of the Pandemic

What can the U.S. expect from the coronavirus this fall? And what do we know about booster shots and a possible new treatment?

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Back to The Daily

transcript

Listen to ‘The Daily’: The State of the Pandemic

What can the U.S. expect from the coronavirus this fall? And what do we know about booster shots and a possible new treatment?

astead herndon

From The New York Times, I’m Astead Herndon in for Michael Barbaro. This is The Daily.

As Covid cases continue to drop in much of the country, I spoke with my colleague, Apoorva Mandavilli, about what to expect this fall and what we know about booster shots and the possible new treatment for the virus. It’s Thursday, October 7.

OK, so before we get too far into the Covid questions, can you tell me the landscape? Where are we at in terms of cases in the United States right now?

apoorva mandavilli

This is the one time that I can give you some good news. The cases are actually going down. And hospitalizations, deaths— we’re seeing decreases across the board. And that’s really welcome news, because we had been seeing these numbers go up for weeks and weeks. And it seems like we’ve finally turned the corner. I don’t want to speak too soon and say that we’re going to go all the way down. We may plateau. Other countries have done that. But at the moment, it’s looking pretty good.

There are some states still that are seeing some high numbers and increases— Maine, New Hampshire, Minnesota. And things are pretty bad still in some places like Alaska. But for the most part, most states, including the Southern ones that had really big waves are seeing a downturn.

astead herndon

When you say down, what do we mean specifically? What are those numbers?

apoorva mandavilli

So across the United States, we are seeing something like 100,000 cases a day. And that’s about a 25 percent drop from a couple of weeks ago. So that’s really good. And hospitalizations are down, too. They’re down about 20 percent.

And the best part I think, is that the deaths have gone down. We were at a high of something like 2,200. And we’re now at 1,800, which is still a lot. But it is on the decrease. So that’s really nice to see.

astead herndon

Yeah. Yeah. I feel like I’ll take all the Covid good news I can get.

apoorva mandavilli

Exactly, right?

astead herndon

You know, I’m soaking this in. Is this just because of vaccinations? Is it just more Americans are getting vaccinated, therefore cases are going down? Is this just one-to-one causation or is there something else happening here?

apoorva mandavilli

Yeah, so this is a very interesting and very complicated question. Why are the cases going down? I don’t think we really know. The virus seems to go up and down in these waves. A lot of the time, though those are in two or three-month cycles. Sometimes they’re longer.

There are a lot of different explanations that I think probably contribute. Like almost everything else in this kind of science, it’s not one thing, right? Maybe it’s that people change their behavior when they see the cases going up, and they hear about packed hospitals and I.C.U. units. Maybe people start being more careful when they know that their kids are going back to school.

We also don’t know as much about the virus as we think we do. There’s something about the Delta variant and about this virus in general, where it seems to need a certain number of people to infect before it really takes off. And maybe it’s that it doesn’t find quite as many people, and so it dies out, and then comes back again later when people stop being careful. So all these things have to sort of play together for the virus to go up or down.

astead herndon

Do we know anything more about the Delta variant now? Have we learned anything about how it operates?

apoorva mandavilli

We’re learning more about how this virus operates in general and about how some of the newer variants seem to be working. So recently, there were these couple of studies that were super interesting. They basically said that the virus seems to be evolving to be better at airborne transmission. And I want to be careful when I say the word evolve. I don’t mean that the virus is smart and knows what it’s doing and is heading towards something. It’s more that when there’s a variant that is very good at something, there’s a higher chance that that will get selected and become the dominant variant. And it seems like with Alpha, the scientists were able to show that Alpha is much better at being transported through these tiny little aerosols, which is what keeps the virus afloat for a long time in indoor spaces.

And they think that Delta may be even better at that. And what that means is basically, we should all be wearing better masks in certain situations, especially in sort of crowded, indoor spaces. This study looked at different kinds of masks. And it said a thin cloth mask or a surgical mask only cuts the virus levels by about half. So at least in some crowded indoor spaces, we might need to be wearing something a little bit better than that, like an N95 that will really filter out almost all of the virus in order to stay safe.

astead herndon

I’ll probably have to drop my favorite fashion mask based on this new understanding.

apoorva mandavilli

They do have some very fashionable masks with filters in them. Those work very well, too.

astead herndon

Oh, maybe my outfits are back on. OK, another question I had was to seek some updates on the tools we’ve been using to combat the virus. Last week, it seemed, from my very unscientific, untrained eye, that we got some good news about a potential pill that you could take to treat infections. Can you tell me more about it?

apoorva mandavilli

Yeah, this is a pill from the company Merck. And it’s an antiviral, meaning unlike the vaccine, it’s for people who already have Covid. And early an infection, if they take this pill, it really cuts down their risk of getting severely sick. The name of the pill— I’m not even going to really try to pronounce. It sort of molnupiravir. But the cool thing about it—

astead herndon

A for effort. I appreciate it.

apoorva mandavilli

I tried. But the cool thing about it is that it’s named for the hammer that’s wielded by Thor, the Norse God.

astead herndon

Oh.

apoorva mandavilli

So they were really going for some symbolism here. And I think that in that way, it actually is a game changer. It’s the first of these antiviral pills that we’re going to see that will really change the way that Covid is treated, especially in parts of the world where the vaccine hasn’t really made it yet.

astead herndon

So this is the first treatment that has shown promise in terms of mitigating Covid infections once someone gets sick that’s in a pill form?

apoorva mandavilli

Right. It cuts down their risk of both hospitalization and death by half, but when given to high-risk people. And it has to be given early an infection. So there are some caveats. But you know, those are usually the people who end up in the hospital. So it just gives them another option.

And it may also be an option for people who have been vaccinated already, have a breakthrough infection, and ended up in the hospital again because they are much older, or they have weak immune systems. This gives them another option beyond monoclonal antibodies, which is the thing that we’ve all known about for months. That one is a little harder to give to people. You have to be hooked up to an IV. And this is a pill, so that makes a big difference.

astead herndon

So when will we know if this pill will be approved? And when will it actually be available for doctors to give to patients who have Covid?

apoorva mandavilli

Well, so these are just the clinical trial results that Merck announced last week. And so Merck still has to apply to the F.D.A. for emergency use authorization. And then once the F.D.A. authorizes it, it can start to be prescribed.

Most countries are not waiting for that. The U.S. has already put in an order for 1.7 million doses. And Australia has bought a bunch of doses. And Thailand has bought a bunch of doses. There’s kind of a mad scramble to buy as many of these doses, even before the drug has gone through the approval process.

But this is really just another tool for us. You know, this is mainly also for high-risk people who might get really sick. It’s not that anybody who gets Covid is immediately going to be able to go get a pill. It may not do much for them.

And you also have to get it pretty early on in the illness. So there are some caveats.

And vaccination is still really the best long-term strategy for any person, or for any whole society to keep this virus at Bay.

[music]astead herndon

We’ll be right back.

Apoorva, let’s talk about booster shots. What’s the status of the F.D.A.‘s approval on booster shots? And who qualifies for the extra jab right now?

apoorva mandavilli

Right now, the only booster that is authorized is Pfizer. And it is only authorized for certain groups of people, so older adults, people who have high-risk conditions one kind or another, and for people who are in certain high-risk jobs, like if the job puts them at heavy exposure of the virus.

What is not yet authorized is the Moderna booster or the J&J booster. So for people who got Moderna or J&J the first time around, the C.D.C. has asked them to wait, but not for long. Moderna and J&J have both applied to the F.D.A. for authorization. And those conversations are happening next week. So it’s possible that if everything goes well, those boosters will be authorized within a week or so. And then, people who got Moderna and Johnson & Johnson can also go get a booster.

But the other thing that’s happening next week that I think is really interesting is that the F.D.A. advisors are going to hear results of some studies that the N.I.H. did on what it looks like when people mix and match vaccines. So like, if somebody’s got Pfizer the first time around, and now they want to go and get Moderna, or they got J&J the first time, and now they want a Pfizer booster— next week, they’re going to discuss these new results. And it’ll be really interesting to see what they say. There is some evidence that mixing and matching vaccines might actually be a good idea.

astead herndon

I feel like we have heard so consistently about just the different types of vaccines. And I’ve heard very little about that question of mixing and matching. You’re saying it’s a real possibility that when it comes to these booster shots, someone who got Pfizer could get a Moderna booster, or someone who got a Moderna could get a Johnson & Johnson booster?

apoorva mandavilli

It’s a real possibility. I mean, we don’t know what these results look like next week. But you know, it’s already happening in the U.K. and in some countries in Europe, where they gave AstraZeneca to begin with. They are now authorizing Pfizer boosters, so people who got AstraZeneca are getting Pfizer.

And there’s reason to think that that works well. There was a study that looked at what happens when you combine Pfizer and AstraZeneca. And people did very well. And we’ll find out next week when we look at what it looks like when you mix Pfizer with J&J, or J&J and Moderna, and all those combinations that we have here in the United States.

astead herndon

OK, so we’ve been talking about vaccinations and booster shots for adults. But there’s a big chunk of the population that haven’t gotten vaccinated, which is kids 12 years old and under. What is happening on that front? And where are we in the process of getting full approval for kids to take the vaccine?

apoorva mandavilli

We will get emergency authorization for the Pfizer vaccine for kids 5 through 11 probably in a few weeks. Pfizer already came out and announced that the results look really good. And usually, it takes a few weeks after that for the F.D.A. to look at all the data and make a ruling. So we will probably see something fairly soon. For kids even younger than that, it’s probably going to be later this year, maybe even early next year for us to see vaccines.

astead herndon

Will kids need to get two shots like adults do?

apoorva mandavilli

Kids may need to get two shots like adults do, yeah. That’s the plan at the moment. There are countries that are offering just one dose to kids 12 and older. And the thinking there is that they want to wait and see what the safety data look like a little bit longer term for the second dose.

You may have heard that some people seem to have heart problems after getting the second dose of the vaccine. It’s super, super rare. But it’s been seen mostly in young men. And so what these countries are saying is, we don’t have very high rates of Covid right now. And we don’t think that our kids are at very high risk of Covid. And so we’re going to give them one dose, which still gives some protection. And we’ll wait to see about the second one.

Obviously, the situation is very different here in the U.S., because we’ve had very high rates of Covid. And we’ve had a lot of kids get infected. And we’ve had 500 kids die of Covid.

The C.D.C. looked at all of the available data couple of months ago and decided that the benefit far outweighs the risk. And the risk of getting heart problems from Covid is a lot higher. So here, I think the C.D.C. will probably still come down on the side of, for us, two doses is the safest option. And a couple of experts I talked to also pointed out that we don’t really know that the one dose does a lot— that it is effective, or how long that protection lasts.

astead herndon

While we’re peppering you with questions that have been on our minds about Covid, I wanted to ask about the upcoming flu season. Last year, there was talk about a “twindemic,” that you could have the double whammy of flu and Covid hitting the country at the same time. And that never really transpired. We had a pretty mild flu season. What’s the expectation for this year?

apoorva mandavilli

We might not be so lucky this year.

astead herndon

Hmm, why’s that?

apoorva mandavilli

So we didn’t really see a “twindemic” last year, because a lot of us were still social distancing, not really going out, wearing masks, really terrified of the virus. But this year, that’s different. A lot more people are vaccinated. We are back to being much more social. A lot more people are going back into work, and schools are open.

So all of those things mean that the flu virus also has more chances to spread. And so the doctors that I’ve spoken to are all recommending that people do go and get the flu vaccine this year.

astead herndon

So Apoorva, with all of these developments, we are still going into the winter— a time when people are indoors more, and the time that I know inspires a lot of fear among some public health officials— what can we expect over the next few months?

apoorva mandavilli

I know you guys always want me to predict on this show. And I really can never do it. What I will say is that we shouldn’t be so excited about these numbers going down that we think this is the end of Covid for us. We’ve done that so many times, and we’ve been wrong every time.

We still have something like 70 million people who are unvaccinated in this country. So there is plenty of room for the virus to still get around. And if we stop being careful, if we move indoors, we stop wearing masks, we start socializing heavily again, the virus will probably come back. A lot of experts I’ve spoken to have said we should expect to see the numbers go up in the winter like we did last year, although of course, the peaks hopefully, will not be anywhere near as high as what we saw last year.

astead herndon

But if you are in an area that has high vaccination rates, low case rates, and you are vaccinated, can you sort of go on with your lives as is? It seems like in some places, there is a real moment of respite from the virus.

apoorva mandavilli

And I think that’s real. You know, that respite is justified. If you are vaccinated, and you’re wearing a mask in crowded indoor spaces, you’ll probably be OK. And as we’ve seen for most people, the vaccines are still really powerful for preventing hospitalization or death.

So unless you are in a very high-risk category, there’s no reason to go back to the way we were living last year. But I would just say we probably still need to continue to be careful in some places, continue to wear a mask in some situations, continue to meet people outdoors as much as possible. Just do these little things that we know go a long way towards keeping ourselves and everyone around us safe.

astead herndon

Thank you. I appreciate your time.

apoorva mandavilli

Thanks.

astead herndon

We’ll be right back.

[music]

Here’s what else you need to know today.

archived recording

As some of you may know, I started my career as a malaria researcher. And I longed for the day that we would have an effective vaccine against this ancient and terrible disease. And today is that day, an historic day.

astead herndon

On Wednesday, the director general of the World Health Organization announced the approval of the first malaria vaccine, a long-awaited breakthrough in the fight against the disease.

archived recording

Using this vaccine in addition to existing tools to prevent malaria could save tens of thousands of young lives each year.

astead herndon

Malaria kills about half a million people each year, most of them in sub-Saharan Africa. And among them, 260,000 children under the age of five. The W.H.O.‘s endorsement is the first step to worldwide distribution of the vaccine.

archived recording

We still have a very long road to travel. But this is a long slide down that road.

astead herndon

And congressional Democrats and Republicans are working on an agreement to temporarily raise the debt ceiling to avert a high-stakes fight over the country’s ability to pay its debts. Democrats received an offer from Republican Senate Leader Mitch McConnell to pass a short-term increase of the debt ceiling into December, delaying the deadline for the U.S. to default on its debt.

The deal gives Democrats more time to focus on passing President Biden’s ambitious agenda before finding a permanent solution for the debt ceiling. Economists warn that if the U.S. is unable to pay its debts, there will be dramatic consequences for the global and domestic markets.

Today’s episode was produced by Jessica Cheung, Rachelle Bonja and Eric Krupke. It was edited by M.J. Davis Lin and Lisa Chow and engineered by Chris Wood and contains original music by Dan Powell and Marion Lozano. Our theme music is by Jim Brunberg and Ben Landsverk of Wonderly.

That’s it for The Daily. I’m Astead Herndon. See you tomorrow.

[music]Credit…Jeff Chiu/Associated Press

Last month, President Biden asked the Occupational Safety and Health Administration to write rules that would require companies with more than 100 employees to mandate coronavirus vaccinations or weekly testing. But with OSHA still going through a lengthy rule-making process, which could take several more weeks, the White House is urging companies to act now.

Several big employers have imposed mandates since Biden’s announcement, including 3M, Procter & Gamble and the airlines American, Alaska and JetBlue. But many others, like JPMorgan Chase and Walmart, have yet to issue broad requirements. The OSHA standards would require reluctant companies to introduce mandates.

Executives continue to be worried about losing employees and managing the cost and complexity of vaccinate-or-test mandates. Retailers are eyeing the run-up to the holiday season, which is crucial to their yearly sales and for which finding labor was already set to be a challenge because of the pandemic.

Analysts at Goldman Sachs estimated last month that the vaccine requirements announced by the White House will apply to about 25 million unvaccinated workers in the United States and boost the number of vaccinated individuals by 12 million — or 3.6 percent of the population — by March. Based on those estimates, Goldman’s analysts expect that 82 percent of the total population, and 90 percent of adults, will have their first dose by mid-2022. To date, 65 percent of all Americans have had at least one dose.

President Biden is headed to Chicago on Thursday to make the case that vaccine mandates are crucial to the economic recovery. He plans to meet with Scott Kirby of United Airlines, a pioneer in corporate vaccine mandates, and to visit Clayco, a construction company set to announce its own mandate.

As Mr. Biden tries to sell the mandate, OSHA is working on the time-consuming process of writing standards that pass legal muster. The president’s mandate for large employers would affect more than 80 million workers.

The White House said at the time of Mr. Biden’s announcement, in early September, that the OSHA standards would take weeks, which is a typical timeline for an emergency standard. This process includes a number of steps, like demonstrating that workers face a grave danger at work and that a rule is necessary to address the danger.

Almost a month from the initial announcement, OSHA standards could still be a few weeks away, as it works through a long list of questions that business groups, like the Chamber of Commerce and Retail Industry Leaders Association, have about the finer points of vaccine mandates. A few of the issues include:

  • Will independent contractors count toward the 100-employee threshold?

  • Who will pay for testing? Companies? The government? The unvaccinated?

  • Will vaccine mandates include boosters, if approved?

Even after OSHA finalizes its rules, some employers wary of mandates may not act, betting that they won’t be punished because of the agency’s limited enforcement resources or that the standards could get bogged down in court.

“Some companies are looking at it and saying, ‘Great that those employers had a good experience. I don’t know if we’ll have the same experience,’” Douglas Brayley, an employment lawyer at Ropes and Gray, told The Times’s DealBook newsletter. “Or, they may look at it and say, ‘Great, they had a 91 percent vaccination rate, but we are so thinly staffed we couldn’t possibly lose 9 percent of our work force.’”

As executives await for more details, a cottage industry has emerged to help companies with everything from testing to tracking vaccinations. Smaller employers, in particular, are worried about managing the new requirements, given their limited resources.

ReturnSafe, a software company that can integrate building access systems with vaccine records, said it had gone from an average of 40 to 60 people booking a meeting via its website every week to almost 300 requests per week after President Biden’s announcement. ADP, a payroll processing company, has updated its “return to workplace” software to add features to track vaccination status and weekly Covid testing. Labor lawyers are walking companies through the complex task of handling requests for religious exemptions to vaccine mandates.

The White House released details on its mandate for federal contractors this month, which gives those workers until Dec. 8 to comply. The guidelines are stricter than the proposed rules for private employers: For example, there is no option for the unvaccinated to submit to regular testing instead of getting inoculated. A White House official said that the administration expects many companies ultimately to announce vaccine-only policies.

United Airlines, which announced a mandate in August, recently reported that 99 percent of its workers had been vaccinated and that it had received 20,000 applications for about 2,000 flight attendant positions, a much higher ratio than before the pandemic. Tyson Foods reported a 91 percent vaccination rate ahead of a November deadline, compared with less than 50 percent before its mandate announcement in August. These figures challenge the concerns among some employers that mandates would cause workers to quit, particularly in industries facing labor shortages.

Noam Scheiber contributed reporting

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