The White House, the Food and Drug Administration and the Centers for Disease Control and Prevention made several announcements this week that signaled an expansive effort by the federal government to control the pandemic at a time when Americans are desperate for normalcy and caseloads are creeping up with winter’s approach.
Dr. Bertha Hidalgo, an associate professor of epidemiology at the University of Alabama at Birmingham, said that “in order to make it through this winter,” people would have to be diligent about getting boosters and understand that “some risk remains” as the pandemic drags on.
Here is a rundown of those developments.
Boosters for all adults.
The C.D.C. on Friday endorsed booster shots of the Pfizer-BioNTech and Moderna coronavirus vaccines for all adults, a move that brought tens of millions fully vaccinated adults a step closer to a third shot.
Boosters are recommended six months after the second shot of the Pfizer or Moderna vaccines. With this final step, boosters should be available this weekend, allowing many Americans to get a shot before the Thanksgiving holiday.
The new recommendations say everyone aged 50 and older — most of whom have other risk factors — as well as those 18 and older living in long-term care facilities “should” get a booster. Other Americans who are 18 and older “may” opt for one if they wish, based on individual risk and benefit.
Several advisers said at the meeting that they hoped the simpler age-based guidelines would ease some of the confusion about who was eligible for the extra shots.
An advisory committee to the C.D.C. unanimously voted in favor of the booster shots. Dr. Rochelle P. Walensky, the agency’s director, later formally accepted the recommendation.
Desperate to dampen even a dim echo of last winter’s horrors, the administration is betting that booster shots will shore up what some have characterized as waning immunity against infection among the fully vaccinated.
The F.D.A. authorized boosters of the Pfizer and Moderna vaccines for all adults on Friday, but the C.D.C. generally makes the recommendations followed by the medical profession.
Pfizer seeks to have its Covid antiviral pill authorized.
Pfizer asked the F.D.A. to authorize its antiviral pill to treat unvaccinated people with Covid who are at high risk of becoming severely ill, the company said on Tuesday.
The drug, which will be sold under the brand name Paxlovid and is geared toward older people and those who have obesity or medical conditions, could become available within weeks if authorization is granted.
It is meant to be dispensed by pharmacies, taken at home and reach far more patients than other Covid drugs that are typically given by infusion.
The Biden administration is planning to pay more than $5 billion for a stockpile of the pills, enough for about 10 million courses of treatment, after the company gears up production next year.
Senior federal health officials described the pill as a powerful new weapon against Covid. When given promptly to trial groups of high-risk unvaccinated people who developed symptoms of the disease, the drug sharply reduced the risk of hospitalization and death.
The U.S. plans to expand Covid vaccine manufacturing.
The White House, under pressure to increase the supply of coronavirus vaccines to poor nations, plans to invest billions of dollars to expand U.S. manufacturing capacity, with the goal of producing at least one billion doses a year beginning in the second half of 2022.
President Biden has pledged to fight the coronavirus pandemic by making the United States the “arsenal of vaccines” for the world. But national self-interest is also at work; as long as vaccination rates remain low in other parts of the world, allowing the virus to spread, dangerous new variants could arise and plunge the United States into crisis once again.
Loyce Pace, the director of global affairs at the Department of Health and Human Services, said that more than half of the world’s five million coronavirus deaths had occurred in low- and middle-income countries, and that vaccination rates in some of them were “in the single digits.”
Apoorva Mandavilli, Sharon LaFraniere, Noah Weiland, Rebecca Robbins and Sheryl Gay Stolberg contributed reporting.
VIENNA — Chanting “freedom” and “resistance,” thousands of Austrians marched through the heart of Vienna on Saturday, united in their anger at their government’s decision to impose a new lockdown and a sweeping nationwide vaccine mandate in an effort to squelch a fresh resurgence of the coronavirus.
The police in Vienna estimated that up to 40,000 people took part in the march, families and far-right groups alike. The protests were largely peaceful throughout the afternoon, but as dusk fell over the Austrian capital, skirmishes broke out between officers and groups of demonstrators.
The size of the turnout surprised officials and reflected the depth of opposition to the government’s efforts to crack down on those who continue to resist vaccination, nearly two years after the pandemic first reached Europe.
But with new infections multiplying among the unvaccinated in Europe, the president of Slovakia, Austria’s neighbor to the east, on Saturday became the latest to raise the prospect of mandating vaccines for all adults.
In Vienna, members of far-right groups and others threw beer cans at officers and set off pyrotechnics at points along the route, police officials said. At least five people were arrested, they said, and several others were written up for violations involving failure to wear masks, or for displaying stars like those the Nazis forced Jews to wear during the Holocaust.
At other points along the route, demonstrators banged on drums and rang cowbells to express their frustration at measures aimed at halting the rampant surge of the coronavirus, including a nationwide lockdown starting on Monday. Many of the protesters complained that their leaders had failed to do enough before imposing the drastic measures.
Demonstrators gathered in Milan and Rome on Saturday evening to protest Italy’s coronavirus health pass on the 18th consecutive weekend of such rallies. Organizers considered a strong showing necessary to prove that they were a force to be reckoned with.
But the paltry turnout in Rome — a few thousand vaccine skeptics decrying “dictatorship” at a protest at the Circus Maximus — and the inability of demonstrators in Milan to dominate, or even reach, squares where they lacked a permit, again showed that the opponents of the health pass are a small minority, and not a powerful movement.
Nevertheless, police officers were out in force to protect shops and prevent violence. Store owners have lamented that the protests disrupt business, especially as Christmas shopping is ramping up.
After an initial large rally in Rome in October that was hijacked by violent neofascists and a burst of activity in Trieste, a northeastern port city, the demonstrations have diminished. Italy suffered through one of the world’s worst outbreaks early in the pandemic, and by now, most of the Italian public has embraced vaccination. And while the country is experiencing part of the Europe-wide surge in cases, the bump in its caseload has been relatively small.
Roberto Burioni, a leading virologist at San Raffaele University in Milan, attributed Italy’s success in keeping down its Covid numbers partly to its aggressive vaccination campaign — more than 73 percent of the population is fully inoculated — and partly to its early intervention with the health pass. Requiring that certificate, known as a Green Pass, has allowed Italy to avoid more draconian measures, he said, such as the nationwide lockdown being imposed in Austria starting next week.
Mr. Burioni also said the strict measures in the Green Pass, which is required for entry into bars and clubs, had perhaps motivated Italy’s younger people to get vaccinated.
“What is surprising is the rate of vaccination for people between 19 and 29,” he said, putting the rate at nearly 84 percent. “It is very high.”
As Italian officials continued to urge people to get inoculated against the virus, the government on Friday reported success in delivering third vaccine doses to people, with 160,000 doses administered in 24 hours. But roughly 6.7 million Italians over age 12 remain unvaccinated, in a country of just over 60 million people.
When the Green Pass was introduced last month, it was the toughest such measure in Europe, requiring the entire Italian work force to be vaccinated, have recovered from the virus or have frequent negative tests to earn a paycheck.
The government has said that it has no plans to toughen up the pass. But some top ministers and many politicians in the country’s northern regions, which share border with Austria and other countries in which cases are soaring, are urging that the swab option be taken away, essentially mandating vaccinations.
Austrians took to the streets on Saturday to protest a newly announced nationwide lockdown and a plan to make coronavirus vaccinations compulsory, and demonstrators gathered in Germany, Italy and Switzerland. The previous night in the Netherlands, rioters set fires on the streets of Rotterdam and attacked police officers at a rally against Covid measures.
A year and a half after the coronavirus swept through Europe with devastating effect, prompting strict lockdowns, the continent is once again the epicenter of the pandemic. And as governments increasingly return to measures limiting public life and introduce vaccination requirements, protests pushing back against those rules are also rising.
With infections soaring and antiviral drugs to treat the coronavirus not yet available, governments have doubled down on calls for people to get vaccinated, including with booster shots. They have also shifted from voluntary measures to mandatory ones as they lose patience with people who are resisting inoculation.
Frustration among members of the public appears to be growing on both sides. Although recent anti-vaccine protests have fizzled in countries like France and Italy, they have flared up in the Netherlands, where a three-week partial lockdown is in place in an attempt to quell a fourth wave of coronavirus infections.
The highest concentration of cases in Europe is in the central part of the continent. Austria, the Czech Republic and Slovakia are each averaging around 10,000 cases a day, and infections are also high in Hungary and Croatia. Case levels are similar in the Netherlands and Belgium.
On Friday night, police officers in Rotterdam fired warning shots and used water cannons against hundreds of protesters who were demonstrating over the country’s pandemic restrictions. Seven people were injured and dozens were arrested amid what the city’s mayor, Ahmed Aboutaleb, described as “an orgy of violence.”
In Austria’s capital, Vienna, skirmishes with law enforcement officers broke out as thousands protested on Saturday over a vaccination mandate that is set to come into force in February and a nationwide lockdown that begins on Monday.
Those actions, which were announced on Friday and would have widely been considered unthinkable just months ago, are the strongest recent measures taken in a Western democracy to tame the pandemic. Austria’s populist Freedom Party, which called for Saturday’s protests, compared them to the type of rules imposed in a dictatorship.
Neighboring Germany, where case numbers have soared in recent weeks, largely among children, teenagers and unvaccinated adults, will also see lockdowns in some of the states with the highest levels of infection. Already restrictions are in place for the unvaccinated.
As to whether a general lockdown could be reinstated in the country, the acting health minister, Jens Spahn, said on Friday that “nothing should be ruled out.”
Portugal may also face new lockdown restrictions, its prime minister said on Friday, and the Czech Republic, which is facing its highest caseload since the pandemic began, will require proof of vaccination or recent recovery from the virus for entry into restaurants, bars and hair salons starting on Monday.
In the Netherlands, the government has said it wants to introduce a law allowing businesses to exclude unvaccinated people, even if they test negative.
Amid the turmoil of the last two years — a period that included a deadly pandemic, mass layoffs, an ugly presidential election and an attack on the United States Capitol — some of the fiercest political debates in America have been waged over a nearly weightless piece of fabric: the face mask.
American officials were slow to embrace face masks as a strategy for slowing the spread of the coronavirus. When they finally did, masks became a potent symbol of the pandemic — a common-sense public health measure turned political flashpoint and a visible reminder that life was anything but normal.
Now, with the summer’s Delta surge in the rearview mirror and the vaccination of school-age children underway, many Americans are wondering when the masks might finally come off.
“The best science does support mask-wearing as a valid strategy to reduce Covid-19,” said Dr. Stephen Luby, an infectious disease expert and epidemiologist at Stanford University. “The issue is: Well, how long do we do this, and in how many contexts?” He added, “Do we all wear masks the rest of our lives?”
Some public officials are already mapping out an endgame. On Tuesday, Mayor Muriel Bowser of Washington, D.C., announced that indoor mask requirements would be loosened. The next day, Florida lawmakers passed a bill banning school mask mandates, which some districts had already abandoned.
Eric Adams, New York City’s mayor-elect, “wants to drop the mask mandate in schools when health officials determine it’s safe,” his spokesman said in an email.
That time has not yet come, experts said.
“Cases are starting to rise again, and we have not yet conquered this virus,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles. “We may be tired of Covid and Covid restrictions and public health measures, but this virus is certainly not done with us yet.”
The vaccination campaign team from UNICEF arrived in a small motorboat last month in the flooded village of Wernyol, not far from the capital of South Sudan, and met with elders under a tree on a small patch of dry land.
The team was ready with a briefing sheet about coronavirus and the vaccine, hoping to pre-empt what they assumed would be a flurry of questions, but first and foremost, what the elders wanted to know was: When will the rains stop? In recent years, it has sometimes felt as if rain is the only thing some South Sudanese have ever known. The result is the worst flooding in parts of South Sudan in six decades, affecting about a third of the country.
For most of the 11 million people in this landlocked nation in east central Africa, one of the poorest countries on Earth, the coronavirus pandemic is not at the top of the list of problems.
Many people have fled Wernyol and other villages in the state of Jonglei, while those who remain have lost their crops, their livestock and their homes. With fish almost the only food available, malnutrition is rampant, as is disease.
In Pawel, another submerged village a few hours down a river that only a few years ago was a road, the village leader, James Kuir Bior, 50, was a little skeptical with the U.N. representatives about how the coronavirus vaccine stacked up against all the village’s other needs.
“We need medicines and nets,” Mr. Bior said as a thin covering of clouds overhead hinted at still more rain. “Now all we can think about is how to get out of this flooding.”
Pregnant women who had Covid-19 when they delivered their babies were almost twice as likely to have a stillbirth as healthy women who did not have Covid, according to a Centers for Disease Control study released on Friday that examined more than 1.2 million deliveries in the United States from March 2020 to September 2021.
While stillbirths were rare overall, representing less than 1 percent of all births, 1.26 percent of the 21,653 women with Covid experienced a stillbirth, compared with 0.64 percent of women without Covid. Even after adjustments were made to control for differences between the groups, women with Covid were 1.9 times as likely as healthy women to have a stillbirth.
The risk of stillbirth has been even higher for women with Covid since the Delta variant has been dominant: While the risk of stillbirth for women with Covid was 1.5 times as high as that of healthy women before July, when Delta became dominant, it was four times as high from July to September. As many as 2.7 percent of deliveries to women with Covid were stillbirths during the period studied while Delta was dominant.
“There had been reports suggesting an increased risk, but stillbirths are hard to study, because luckily they are uncommon,” said Dr. Denise Jamieson, the chief of gynecology and obstetrics at Emory Healthcare. “This is some of the strongest evidence of the increased risk, and probably the strongest data pointing to the risks specifically tied to Delta.”
The C.D.C. strongly encourages pregnant and breastfeeding women and women planning or trying to become pregnant to be vaccinated against Covid, but resistance has been strong, even though pregnancy is on the C.D.C.’s list of health conditions that increase the risk of severe disease.
Studies have shown that pregnant patients who are symptomatic are more than twice as likely as other symptomatic patients to require admission to intensive care or interventions like mechanical ventilation, and they may be more likely to die. They are also more likely to experience a preterm birth.
Another C.D.C. study issued on Wednesday described the cases of 15 pregnant women in Mississippi who died of Covid during their pregnancy or shortly afterward, including six who died before the Delta variant became dominant and nine who died from July to October, while Delta was dominant.
Of the women who died, nine were Black, three were white and three were Hispanic. The median age was 30. Fourteen of the women had underlying medical conditions, and none were vaccinated. Five of the deaths occurred before vaccinations were available.
Portugal’s government is preparing to add some new restrictions after registering its worst Covid numbers in months.
A rise in infections in the country, which has one of Europe’s highest coronavirus vaccination rates, comes as winter approaches and more people remain indoors, although inoculations have been shown to vastly limit infections and their severity and inoculated people have been protected from hospitalization in intensive-care units and death from the virus.
“The pandemic, unfortunately, is not yet over,” Prime Minister António Costa said on Twitter.
On Friday, Mr. Costa held his first special meeting with the country’s top health experts in two months to discuss introducing new measures. He said the rules would be presented to lawmakers early next week.
President Marcelo Rebelo de Sousa said this past week that it was “evident” that Portugal needed to reinstate a requirement that face masks be worn in outdoor public spaces. Currently, face coverings are compulsory on public transit, in shopping malls and in spaces like concert halls. All bar and restaurant employees are also required to wear masks.
Still, Mr. Costa said recently that his government was not contemplating a return to the state of emergency that was in place at the start of this year, when Lisbon’s hospitals became overwhelmed with Covid-19 patients. Under that status, people were allowed to leave home only in exceptional circumstances and were forbidden to travel outside their municipalities.
Portugal’s Covid infection rate has crept up recently, with 2,371 new cases registered on Friday, although they remain far lower than when the country’s numbers peaked earlier this year. In January, Portugal was registering more than 10,000 cases a day, an acute situation that prompted the government to seek emergency assistance from other countries, including Germany.
Inside Good Room, a nightclub in Brooklyn, people were dancing to techno and mingling with strangers, while outside, rain poured down on a line of partygoers that snaked down the block. It was Friday night, and the event was sold out.
“It’s nice to know places like this still exist,” said Caitlin Widener, 33, as she stood near the bar, reflecting on what she had missed about Good Room while it was closed for nearly 18 months because of the pandemic.
Things may be somewhat back to normal for its patrons, but the club, which reopened in September, is struggling. Its managers still must pay 18 months of back rent, maintenance and reopening costs, all of which total about $500,000, said Josh Houtkin, Good Room’s booking director.
Good Room is not alone. Many New York City clubs that survived the pandemic are now drawing large crowds but are still plagued by debt and uncertain futures. Many have had to rethink their business models, while others have shut down entirely.
“This industry is crucial to our economic and cultural well-being,” said Ariel Palitz, the senior executive director of New York City’s Office of Nightlife. “It is our backbone of the city, and without its recovery, the city can’t recover either.”