A large clinical trial has found that a common and inexpensive antidepressant lowered the odds that high-risk Covid-19 patients would be hospitalized. The results, published on Wednesday, could open the door to new guidelines for the drug’s use both in the United States and globally.The drug, fluvoxamine, has been safely prescribed for nearly 30 years as a treatment for obsessive-compulsive disorder. But when the coronavirus started spreading, researchers were drawn to the medication because of its ability to reduce inflammation, potentially allowing it to quell the body’s overwhelming response to a coronavirus infection.Several smaller studies of fluvoxamine earlier in the pandemic showed promising results, but none was as large or persuasive as the one published on Wednesday by a group of researchers in Canada, the United States and Brazil, outside scientists said. Among nearly 1,500 Covid patients in Brazil given either fluvoxamine or a placebo, the drug reduced the need for hospitalization or prolonged medical observation by one-third, the study found. It was published in The Lancet Global Health.Some patients struggled to tolerate the drug and stopped taking it, the study said, raising a question among outside scientists about whether they had yet identified the ideal dose. But among those who had largely followed doctors’ orders, the benefits were even more striking. In those patients, the drug reduced the need for hospitalization by two-thirds and slashed the risk of dying: One Covid patient given fluvoxamine died, compared with 12 given a placebo.“That’s really good,” said Dr. David Boulware, an infectious disease scientist at the University of Minnesota who worked on a smaller, real-world study of the drug in Covid patients in California. Plus, he added, “it’s not a shiny new, expensive drug. The nice thing about this is it has a known safety profile.”Beyond proper dosing, the study left other questions unresolved, scientists said. Penny Ward, a visiting professor in pharmaceutical medicine at King’s College London, noted that part of the drug’s benefit appeared to come from reducing the need for extended medical observation, which the study tracked alongside hospital admissions. And most patients in the study were unvaccinated, Professor Ward said, so it’s unclear how well the drug would work in the vaccinated.The new study, coming nearly a year after smaller trials of the drug, was a reminder of the difficulty that many researchers have had running large tests of Covid treatments. The Biden administration has made more funding available for such trials, scientists said, but enrolling enough patients has only gotten more difficult: Most high-risk Americans are vaccinated, and vaccine-averse people may be less likely to participate in trials.Because fluvoxamine is already approved for treating O.C.D., doctors can already prescribe it “off label” for Covid. But Dr. Boulware said that prescriptions of the drug had increased only slightly during the pandemic, unlike other repurposed drugs with far less scientific support, like hydroxychloroquine and ivermectin.“It hasn’t really gotten any cult following,” he said.Federal treatment guidelines say that larger trials are necessary to evaluate the use of fluvoxamine for Covid, and scientists said they expected those recommendations to change on the basis of the new study.The new findings are also expected to boost the popularity of the drug in less wealthy countries: A 10-day course of the drug costs about $4.

Scientists from the Centers for Disease Control and Prevention on Friday took aim at the question of whether the Delta variant of the coronavirus causes more severe disease, finding no significant differences in the course of hospitalized patients’ illnesses during the Delta wave compared to earlier in the pandemic.But larger and more detailed studies from a number of other countries have found that people with Delta infections were considerably more likely to be hospitalized in the first place — a trend that the C.D.C. study was unable to address because of limitations in its data. The C.D.C. study also said that the proportion of older hospitalized patients needing intensive care or dying had shown some signs of increasing during the Delta wave.Delta’s higher level of infectiousness has made it a far greater challenge than earlier versions of the virus, but the question of whether it also causes more serious disease has loomed as it swept around the world. The Alpha variant, an earlier version first detected in Britain, appeared to be linked to a higher risk of death, though scientists have also tried to understand whether factors besides the variant were playing a role.Studies in England, Scotland, Canada and Singapore suggested that the Delta variant was associated with more severe illness, a finding that scientists have said raises the risk that outbreaks of the variant in unvaccinated areas may put a bigger burden on health systems. Unlike the C.D.C. study, those studies drew on genomic sequencing, allowing researchers to distinguish infections with the Delta variant and to track patients from before they enter a hospital.Without access to sequencing data, the C.D.C. researchers could not determine which variants the patients may have been infected with. It also examined patients already admitted to hospitals, making it impossible to determine whether they were at higher risk of needing hospital care in the first place.The study, released on Friday, examined roughly 7,600 Covid hospitalizations, comparing July and August — when Delta dominated — to earlier months this year, and found no significant change in hospitalized patients’ outcomes.The study said that the proportion of hospitalized patients aged 50 and older who died or were admitted to intensive care “generally trended upward in the Delta period,” though the differences were not statistically significant and further work was needed. At the hospitals included in the study, roughly 70 percent of Covid patients were unvaccinated.The researchers said the findings matched those of other C.D.C. studies using similar methods that showed no significant differences in the outcomes of younger people hospitalized before and during the Delta surge.Outside scientists questioned the reliability of the study. Dr. David Fisman, an epidemiologist at the University of Toronto, ran a larger study that found that people infected with the Delta variant had roughly twice the risk of hospitalization as people infected with variants that had not been labeled a concern. He said that such analyses needed to control for the range of factors that affect the course of Covid patients’ illnesses, and that the availability of vaccines, testing and treatments had all been changing during the pandemic.“As this is the U.S. C.D.C., I’m really surprised at the small sample sizes for individuals with more detailed clinical information, as well as the use of such rudimentary statistical methods to deal with these data,” he said.Dr. Fisman’s study, drawing on 200,000 cases and published this month, also showed significantly increased risks of intensive care admission and death among those infected with the Delta variant, after accounting for their age, sex, vaccination status and other factors. Roughly 70 percent of people with Delta infections in the study were unvaccinated, and 28 percent were partially vaccinated. Fully vaccinated people are heavily protected from Covid.Similarly, a study in Scotland from June based on 20,000 Covid cases showed that Delta infections were associated with an 85 percent higher risk of hospitalization, though it allowed for a wide degree of uncertainty about the precise figure.And data from England, drawn from 43,000 cases and published in August, found that people infected with the Delta variant were just over twice as likely to be hospitalized as people with the Alpha variant, though the researchers in that study, too, were unsure of the precise figure.Roughly three-quarters of the patients in that study were unvaccinated, and most of the rest were only partially vaccinated.

The Pfizer-BioNTech vaccine was 93 percent effective against hospitalization with Covid-19 among 12- to 18-year-olds, the Centers for Disease Control and Prevention reported on Tuesday, the strongest evidence to date of the vaccine’s ability to keep young people out of the hospital.With federal regulators now considering authorizing the vaccine for children ages 5 to 11, the study offered additional signs that extending vaccines to more young people could not only reduce the spread of the virus in the United States, but also protect those children from the rare cases in which they become severely ill.“This evaluation demonstrated that two doses of Pfizer-BioNTech vaccine are highly effective at preventing Covid-19 hospitalization among persons aged 12–18 years,” the agency’s scientists wrote, “and reinforces the importance of vaccination to protect U.S. youths against severe Covid-19.”The agency studied young people who were hospitalized at 19 pediatric hospitals across 16 states from June through September, as the Delta variant spread across the country and exacted a devastating toll in less-vaccinated states in the South and West. It compared the odds of vaccination among children hospitalized with Covid and children hospitalized with other illnesses.Among the 179 patients in the study who had Covid, three percent were vaccinated and 97 percent were unvaccinated. Twenty-nine of the young Covid patients needed life support, and two died; all of those patients were unvaccinated, the agency said. Vaccinated children with Covid also tended to have shorter hospital stays than unvaccinated children.Nearly three-quarters of the Covid patients in the study had at least one underlying health condition, including obesity, diabetes, asthma or respiratory disorders, putting them at higher risk of severe illness.As of Monday, the C.D.C. said, 46 percent of children ages 12 to 15 were fully vaccinated nationwide, as were 54 percent of 16- and 17-year-olds. The Pfizer-BioNTech vaccine is authorized for emergency use in children ages 12 to 15, and fully approved in people ages 16 and over. Booster shots have not been authorized for anyone in the United States under 18 years old.Pediatric hospitalizations rose as the Delta variant spread across the United States, reaching their highest level during the pandemic in September, the C.D.C. said.A clinical trial of the Pfizer-BioNTech vaccine had earlier shown that the shots were highly effective at preventing Covid cases in children, but had not examined effectiveness against hospitalization in that group.

“This new group can do all the fancy footwork it wants, but China’s not going to cooperate,” one expert said.The position is unpaid. The world’s scientists and internet sleuths will scrutinize every move. Completing the first assignment with the available tools, and to everyone’s satisfaction, will be nearly impossible.Despite those considerable obstacles, more than 700 people have applied for spots on a new committee charged with breathing life into the World Health Organization’s stalled inquiry into the origins of the coronavirus pandemic.The committee, expected to be announced this week, represents an attempt by the embattled global health body to reset its approach to determining how the pandemic began. Nine months after sending a team of international experts to China, only for its findings to become entangled in geopolitics and trailed by concerns over Beijing’s influence, the W.H.O. is trying to inoculate its latest efforts from the slightest hints of undue deference toward China.Its new advisory team will include specialists in fields like laboratory safety and biosecurity, a step that analysts say may help placate Western governments pressing for consideration of whether the virus emerged from a lab. And, crucially, the committee will have a mandate to weigh in on the emergence of any new pathogens beyond this novel coronavirus, giving it a permanence that could help insulate it from political squabbling and strengthen the W.H.O.’s hand for future outbreaks.Maria Van Kerkhove, the W.H.O.’s Covid-19 technical lead, said the group — comprising some two dozen virologists, geneticists, animal experts and safety and security specialists — would help the organization return to its roots amid the rancor and partisanship of the coronavirus origins debate.“Especially in light of the politicization of this particular aspect,” she said in an interview, “we want to take this back to the science, take this back to our mandate as an organization to bring together the world’s best minds to outline what needs to be done.”What most needs doing in the hunt for Covid’s origins, many scientists believe, is something that the new advisory group will be powerless to achieve: persuading China to release evidence about the first infections and to let researchers inspect virology labs, bat caves and wildlife farms within its borders.China has reacted angrily to the idea that the virus may have emerged from a lab, pushing instead for investigations into early cases in other countries, like Italy, or into American research facilities.“This new group can do all the fancy footwork it wants, but China’s not going to cooperate,” said David Fidler, a senior fellow for global health at the Council on Foreign Relations, a research institute. “For them, all of this continues to look like an attack on China’s response to the pandemic, and there it’s a zero-sum game.”Maria Van Kerkhove, the W.H.O.’s Covid-19 technical lead. “We want to take this back to the science,” she said of the new team.Martial Trezzini/Keystone, via Associated PressSince the beginning of the pandemic, the W.H.O. has been caught in the middle of a tug of war between China and the United States — first over China’s response in the early days of the pandemic, and more recently over the question of how the virus emerged.Even as China has resisted deeper studies of the virus’s origins, the Biden administration has pressed the W.H.O. for a renewed investigation. The State Department pointedly questioned the results of a joint study by the W.H.O.-chosen scientists and Chinese researchers from March that said a leak of the coronavirus from a lab, while possible, was “extremely unlikely.”That W.H.O. team, too, struggled to coax the data it needed from Chinese scientists. Members of the team, which has been disbanded, warned in August that time was running out to recover crucial evidence about the beginning of the pandemic. But it is unclear whether China has taken up the team’s recommendations for future studies, including analyzing blood banks for evidence of early coronavirus infections, testing workers on wildlife farms and assessing wild bats and farmed animals for signs of exposure.Some scientists have said that studies of Chinese animal markets, and of bats harboring close relatives of the virus behind Covid-19, have strengthened their belief that the coronavirus spilled naturally from animals into humans.The W.H.O. has said that Chinese researchers were conducting new studies but that it had not been kept abreast of any findings. “I don’t have any detail on what was done, or is being done,” Dr. Van Kerkhove said of the Chinese research.President Xi Jinping said last month that China would support “science-based origins tracing,” but would oppose “political maneuvering in whatever form.”The Wuhan Institute of Virology during the W.H.O.’s investigation team’s visit last winter.Thomas Peter/ReutersThe new committee, known as the Scientific Advisory Group for the Origins of Novel Pathogens, will differ in several respects from the team that the W.H.O. sent to China. Because that team visited Wuhan, China had considerable influence over its membership. That is not the case for the new committee, a permanent panel that Dr. Van Kerkhove said would begin with frequent, closed-door meetings on the coronavirus.In soliciting applications, the W.H.O. asked potential committee members for a statement about any conflicts of interest, in addition to a cover letter and résumé. That appeared to be an attempt to head off critics who complained that a member of the previous team, Peter Daszak, an animal disease specialist, was too closely tied to a Wuhan virology institute at the center of lab leak theories to offer a dispassionate assessment. Dr. Daszak has said that his expertise on China and coronaviruses made him well-suited to participate in the earlier trip.“Conflicts of interest of members of the last group put a huge cloud over the head of the World Health Organization,” said Lawrence Gostin, who directs the O’Neill Institute for National and Global Health Law at Georgetown University. Of the new advisory group, he added: “It’s a committee with a proper charge, and a proper global mandate — none of that happened before.”For the W.H.O., Professor Gostin said, the new committee serves several purposes. In choosing a larger group reflecting a wider range of expertise and geographic regions, the organization can try to amass widespread international support for its work and underscore China’s intransigence, he said.Crucially, forming the new group could also help shore up the W.H.O.’s standing with its key Western backers, none more important than the United States. Despite the agency’s attempt to act deferentially toward China during the pandemic, Professor Gostin said, China had repeatedly stonewalled the organization and concealed crucial information.Now, he said, the organization needed to pay heed to the desires of Europe and the United States — not least because Tedros Adhanom Ghebreyesus, the W.H.O. director-general, is counting on their support as he seeks re-election in May. Tedros Adhanom Ghebreyesus, the W.H.O. director-general, will be seeking re-election next May.Christopher Black/World Health Organization, via Agence France-Presse — Getty Images“It was one thing to lose America under Donald Trump, where there was a great deal of sympathy for the W.H.O.,” Professor Gostin said. “It’s quite another thing to do it with President Biden, who is an internationalist and who does support the W.H.O.”Despite the eventual avalanche of applications, recruiting for the new committee was no simple task. In some cases, scientists rebuffed the W.H.O.’s pleas to apply.“We did have some people say to us, ‘No, we really don’t want to get engaged, because it’s just too politicized,’” Dr. Van Kerkhove said.The composition of the committee remains under tight wraps. Members of the W.H.O. team that traveled to Wuhan were allowed to apply. Dr. Van Kerkhove declined to say whether any Chinese scientists would be selected. She said that some countries had nominated participants, but that the internal W.H.O. selection group had not taken countries’ backing into account.She said the new committee would meet for the first time roughly two weeks after it is named, following a public comment period that is standard for the global health body’s advisory groups.“It will be a relief to have the first couple of meetings,” Dr. Van Kerkhove said. “But, you know, any time I feel like I’ve reached some kind of finish line, it’s really just a start.”

The arrival of vaccines and declining Covid-19 cases in the first half of 2021 coincided with an easing of symptoms of anxiety and depression across the United States, according to survey data released on Tuesday by the Centers for Disease Control and Prevention.But symptoms remained much more common in June 2021, the end of the survey period, than before the pandemic, and could be on the rise again because of the summer surge in cases of the Delta variant, C.D.C. scientists said.The agency relied on a biweekly online survey conducted from August 2020 to June 2021. Researchers analyzed 1.5 million responses over that period about the severity of symptoms of anxiety or depression.From August to December 2020, symptoms of anxiety rose by 13 percent and symptoms of depression by 15 percent, the surveys found. But from December to June 2021, that trend reversed: Symptoms of anxiety decreased by 27 percent and of depression by 25 percent.The C.D.C. said that there was a strong correlation between the average number of daily Covid-19 cases and the severity of respondents’ anxiety and depression.Noting that some parts of the population had been harder hit by the virus than others, the agency said those same groups may be at higher risk for psychological ill effects from Covid-19 and that good access to mental health services was critical. Other research has indicated that people with low incomes were at higher risk of depression during the pandemic.The national trends were mirrored in most states, with anxiety and depression peaking in December 2020 or January 2021, when U.S. cases, hospitalizations and deaths all peaked. States that experienced steeper increases in symptoms last year also showed larger reductions in the first half of 2021.Mississippi was among the states with the largest increases in anxiety and depression scores by percentage in the second half of 2020. New York, on the other hand, experienced both the smallest rise in anxiety scores in late 2020 and the smallest drop in the first half of this year.

Americans with a disability were more likely to want coronavirus vaccines but were having a harder time getting them than other people, according to data released on Thursday by the Centers for Disease Control and Prevention, a stark signal of what the agency’s scientists said was a need for health officials to remove barriers to access.In a survey of nearly 57,000 people from May to June, unvaccinated people with a disability such as serious difficulty seeing, hearing or walking were nearly twice as likely as their unvaccinated counterparts without a disability to say that they would definitely get vaccinated. (The survey only included people outside of nursing homes and other institutions.)And yet, people with a disability were less likely to be vaccinated: Among 50- to 64-year-olds, 63 percent of people with a disability had received coronavirus shots, compared with 72 percent of other people. Among people older than 75, the gap was smaller but still evident: Eighty-eight percent of people with a disability were vaccinated, compared with 90 percent of people without one.“Covid-19 vaccination coverage was lower among U.S. adults with a disability than among those without a disability, even though adults with a disability reported less hesitancy to getting vaccinated,” the study’s authors wrote.The study noted that state-run vaccine registration websites were not all compliant with basic accessibility recommendations. It suggested that online scheduling systems offer call lines for people who needed help booking vaccinations.It also said that not all vaccination sites had American Sign Language interpreters or workers trained in helping people with developmental disabilities, and that getting to those sites in the first place was often difficult for people with a disability.“These efforts would be relevant to the reduction of health disparities related to disability beyond the Covid-19 pandemic,” the study said.

Americans who received a third dose of a coronavirus vaccine in recent weeks reported side effects at roughly the same rates as they had after their second shots, the Centers for Disease Control and Prevention said on Tuesday, a reassuring sign about the safety of additional doses.At the time of the C.D.C. study, which stretched from mid-August to mid-September, additional vaccine doses were only authorized for people with compromised immune systems who had gotten two doses of the Pfizer-BioNTech or Moderna vaccine. Last week, though, federal regulators authorized Pfizer booster shots for broad swaths of the general population, making the safety of the additional doses an issue of intense interest for health officials, doctors and ordinary Americans.The C.D.C. analyzed how commonly people reported side effects after a third dose compared with a second among 12,600 recipients who had filled out surveys as part of a voluntary safety monitoring system.Reactions at the injection site, like pain or swelling, were reported by 79.4 percent of recipients after a third vaccine dose, compared with 77.6 percent after a second dose. Slightly smaller numbers of people experienced systemic reactions, like a fever or headache: 74.1 percent of people reported those side effects after dose three, compared with 76.5 percent after dose two.“Most reported local and systemic reactions were mild to moderate, transient, and most frequently reported the day after vaccination,” the study’s authors said.The study focused on people who had received a third dose of the same vaccine that they had originally received, either from Pfizer-BioNTech or Moderna. The C.D.C. said that too few people had reported receiving an additional dose of the Johnson & Johnson vaccine, or an additional dose from a different vaccine maker than they had originally received, to study those side effects.The results reinforced findings from a small clinical trial of third shots of the Pfizer vaccine that the company’s scientists outlined to federal medical advisers last week. That trial, too, found that adverse reactions after a third dose were similar to those after a second.While the C.D.C. study covered only a period when people with immune problems were eligible for additional doses, the data likely also included people without such conditions who had nevertheless received a third shot, the study’s authors wrote. In all, the study said, about 2.2 million people had received additional doses by Sept. 19, the end of the C.D.C. study period.

When President Biden announced in June that the United States would buy 500 million Pfizer-BioNTech coronavirus vaccine doses for poorer nations, there was a gaping hole in his plan: To fund it, the administration quietly diverted hundreds of millions of dollars that had already been promised to countries for helping to get shots into people’s arms.Mr. Biden did not make the same mistake a second time.His announcement on Wednesday that the United States was donating an additional 500 million Pfizer doses came paired with a promise of an additional $750 million for vaccine distribution, roughly half of it through a nonprofit involved in global vaccinations. That reflected a growing awareness on the part of global leaders that turning vaccines into actual vaccinations represents one of the most significant challenges of this phase of the pandemic.Even so, the Biden administration’s schedule for shipping the newly announced Pfizer doses frustrated activists: Of the 1.1 billion doses that the United States has committed to donations, only 300 million are expected to be shipped this year. The longer the virus circulates around the world, the more dangerous it can become, even for vaccinated people in wealthy countries, scientists have warned.“Purchasing doses for donation sometime next year is helpful, but it does not meaningfully expand the global supply, and it is not justice,” said Peter Maybarduk, the director of the Access to Medicines program at Public Citizen, an advocacy organization.Some experts pleaded for more aggressive action by Mr. Biden to pressure American vaccine makers to share their formulas with nations that desperately need more shots.“Where is the monthly calendar of what each wealthy country is going to deliver?” said Kate Elder, senior vaccines policy adviser for Doctors Without Borders’ Access Campaign. She added, “Where are the announcements about meeting the calls of regions and middle-income countries that are begging to be self-sufficient?”It was not immediately clear how the administration was planning to allocate the new money for vaccine distributions. Some countries have been struggling to train and pay vaccinators and to transport doses. Pfizer doses present especially steep challenges: They must be stored at ultralow temperatures, requiring the installation of freezers and, in many cases, backup generators.Early this year, supply shortages represented the most pressing problem for global vaccinations. Rich nations had raced to secure doses while slow-walking pledges of money and supplies to Covax, the United Nations-backed program to immunize the world.But as those manufacturing difficulties have eased, different problems emerged. One was blatant inequality: More than 5.9 billion shots have been given globally, but overwhelmingly in wealthier nations. Another was that poorer countries had been left without the money needed to move shots from airport tarmacs into people’s arms.Although the Biden administration’s pledges have outpaced those of most Western nations, analysts said other wealthy countries were setting an extraordinarily low bar..css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:’Collapse’;}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:”;background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}And even as countries have promised to donate more doses, they have been slow to follow through, with the World Health Organization saying that only 15 percent of promised donations have been delivered. The W.H.O. has set a target of vaccinating 40 percent of every country’s population this year, requiring wealthy nations to share doses significantly more quickly.There remains considerable excess supply: Wealthy nations will have 1 billion more vaccines than they need by the end of 2021, even if they administer booster shots, according to Airfinity, a science analytics company.Global health officials have urged wealthy nations to let go of those supplies before they expire. Some countries have donated vaccines so close to their expiration dates, and in such small quantities, that poorer countries have struggled to use them.Some 11 billion doses are needed globally, and activists said on Wednesday that the wealthy world’s response remained far too piecemeal. The new Pfizer doses purchased by the U.S. will be shipped through Covax starting in January.

The Centers for Disease Control and Prevention released data on Friday indicating that the level of protection against Covid hospitalizations afforded by the Pfizer-BioNTech vaccine dropped significantly in the four months after full inoculation.The data was released hours before a scientific advisory committee to the Food and Drug Administration recommended authorizing booster shots for recipients of the Pfizer coronavirus vaccine who are 65 or older or are at high risk of severe Covid-19, at least six months after the second shot.The new study found that from two weeks after recipients got their second dose — a point at which they are normally considered fully vaccinated — to four months later, the Pfizer vaccine was 91 percent effective in preventing hospitalization. Beyond 120 days, though, its effectiveness fell to 77 percent.The Moderna vaccine showed no comparable decrease in protection over the same time frame: It was 92 percent effective against hospitalizations four months after recipients’ vaccination, a level virtually identical to its 93 percent effectiveness before then.The study said that not enough participants had received the one-shot Johnson & Johnson vaccine to compare its performance. Overall, though, the Johnson & Johnson shot has been 71 percent effective in preventing hospitalizations.The C.D.C. study released on Friday supported some others that suggested the Pfizer vaccine may offer less protection from hospitalization over time. But the available data is far from unanimous. Other studies have shown that Pfizer’s effectiveness against hospitalization has remained above 90 percent, despite the spread of the Delta variant and the lengthening time since people received their second shots. Pfizer has said that data from Israel suggest a falling effectiveness against severe disease, though it appears that Israel and the United States define “severe disease” differently.The latest C.D.C. study was based on an analysis of roughly 3,700 adults hospitalized across the United States from March to August.People with compromised immune systems, who typically don’t respond as well to vaccines, were excluded from the study. Nevertheless, the vaccinated patients tended to be older people — the Pfizer cohort had a median age of 68 — and it was unclear whether vaccine effectiveness had changed much in younger age groups. Previous studies have shown lower levels of protection in older people.The authors of the study said that the gap in the performance of the Moderna and Pfizer vaccines could stem from higher doses of mRNA in the Moderna shots or the four-week space between doses of the Moderna vaccine. (Pfizer vaccines were given three weeks apart.) It’s also possible, they said, that other, unnoticed differences in the study participants receiving either shot could have also influenced the results.

Championed by doctors and conservative radio hosts alike, monoclonal antibodies for Covid are in high demand — even from those who don’t want a vaccine.Lanson Jones did not think that the coronavirus would come for him. An avid tennis player in Houston who had not caught so much as a cold during the pandemic, he had refused a vaccine because he worried that it would spoil his streak of good health.But contracting Covid shattered his faith in his body’s defenses — so much so that Mr. Jones, nose clogged and appetite vanished, began hunting for anything to spare himself a nightmarish illness.The answer turned out to be monoclonal antibodies, a year-old, laboratory-created drug no less experimental than the vaccine. In a glass-walled enclosure at Houston Methodist Hospital this month, Mr. Jones, 65, became one of more than a million patients, including Donald J. Trump and Joe Rogan, to receive an antibody infusion as the virus has battered the United States.Vaccine-resistant Americans are turning to the treatment with a zeal that has, at times, mystified their doctors, chasing down lengthy infusions after rejecting vaccines that cost one-hundredth as much. Orders have exploded so quickly this summer — to 168,000 doses per week in late August, up from 27,000 in July — that the Biden administration warned states this week of a dwindling national supply.The federal government, which was already covering the cost of the treatment — currently about $2,100 per dose — has now taken over its distribution as well. For the coming weeks, the government has told states to expect scaled-back shipments because of the looming shortages.With seven Southern states accounting for 70 percent of orders, the new process has unsettled some of their governors, who have made the antibody treatment central to their strategy for enduring a catastrophic wave of the Delta variant.More supplies are on the way. The federal government bought 1.8 million more doses this week, expected to arrive in the fall and winter. But for now, some hospitals are uncertain of supplies, state health officials said, even as patients keep searching for doses.“We have providers struggling to get the necessary product,” Kody Kinsley, who leads operations for North Carolina’s Covid-19 response, said in an interview. “I think what has happened is a classic logistics issue, where all of a sudden there’s much more demand.”Amid a din of antivaccine falsehoods, monoclonal antibodies have become the rare coronavirus medicine to achieve near-universal acceptance. Championed by mainstream doctors and conservative radio hosts alike, the infusions have kept the country’s death toll — 2,000 per day and climbing — from soaring even higher.And after months of work by President Biden and Southern governors to promote the treatments, they have won the affection of vaccine refusers who said that the terrors and uncertainties of actually getting Covid had made them desperate for an antidote.“The people you love, you trust, nobody said anything negative about it,” Mr. Jones said of the antibody treatment. “And I’ve heard nothing but negative things about the side effects of the vaccine and how quickly it was developed.”Lanson Jones, a landscape architect in Houston, recovered quickly from Covid after receiving monoclonal antibodies.Brandon Thibodeaux for The New York TimesSome Republican governors have set up antibody clinics while opposing vaccine mandates, frustrating even some of the drugs’ strongest proponents. Raising vaccination rates, scientists said, would obviate the need for many of the costly antibody treatments in the first place. The infusions take about an hour and a half, including monitoring afterward, and require constant attention from nurses whom hard-hit states often cannot spare.“It’s clogging up resources, it’s hard to give, and a vaccine is $20 and could prevent almost all of that,” said Dr. Christian Ramers, an infectious disease specialist and the chief of population health at Family Health Centers of San Diego, a community-based provider. Pushing antibodies while playing down vaccines, he said, was “like investing in car insurance without investing in brakes.”The government-supplied monoclonal antibodies, made by Regeneron and Eli Lilly, have been shown to significantly shorten patients’ symptoms and reduce their risk of being hospitalized — by 70 percent, in the case of Regeneron’s antibody cocktail. The treatments, given in a single sitting, use lab-made copies of the antibodies that people generate naturally when fighting an infection.Patients and doctors alike overlooked the treatments during the wintertime surge of infections. But hospitals and health centers have now ramped up their offerings, transforming dental clinics, mobile units and auditoriums into infusion centers. In states like Texas, where elective surgeries have been postponed to make room for Covid-19 patients, operating room nurses have been enlisted to give infusions.One factor driving the demand is that many patients, including vaccine skeptics, have been spreading the word about their seemingly miraculous recoveries.“They’re like, ‘I have Covid, I want this treatment, my friend or family told me about this,’” said Jennifer Berry, the Houston Methodist nursing director of infusion services. “Now the word is out.”At Houston Methodist, nurses administered nearly 1,100 treatments across eight sites in the first week of September, well more than twice as many as any week last winter. The hospital reduced the average time between orders and infusions to two days this month from three days in early August, giving patients a better chance of fighting off infections.Juggling the infusions with more seriously ill Covid patients this summer forced the hospital, in one case, to move a monoclonal antibody clinic to a strip mall storefront.But the Texas health department has helped, providing 19 nurses for a different Houston Methodist infusion clinic, said Vicki Brownewell, the lead administrator for the hospital’s program. The Biden administration has also invested $150 million in expanding access to monoclonal antibodies, and Houston Methodist has used federal money to arrange medical taxis for patients struggling with transportation.Antibody infusions at Houston Methodist earlier this week. Of the 2.4 million monoclonal antibody doses shipped nationally, at least 1.1 million have been used.Brandon Thibodeaux for The New York TimesEven so, the infusions remain inaccessible to many. Given the heavy demands on staff and the need to create separate infusion rooms for infectious patients, certain communities, especially in rural areas, do not have clinics.In San Diego, Dr. Ramers said, some large, for-profit hospitals have decided not to administer the antibodies at all because of the logistical hassles, leaving wealthier, well-insured patients to hunt down doses at his publicly funded clinic. Some nurses that he hired for infusions left for short, better-paying assignments in hard-hit intensive care units.“The natural, capitalist incentives for health care organizations that are for profit don’t really favor doing this,” Dr. Ramers said. “It’s a lot of work.”.css-1xzcza9{list-style-type:disc;padding-inline-start:1em;}.css-3btd0c{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:1rem;line-height:1.375rem;color:#333;margin-bottom:0.78125rem;}@media (min-width:740px){.css-3btd0c{font-size:1.0625rem;line-height:1.5rem;margin-bottom:0.9375rem;}}.css-3btd0c strong{font-weight:600;}.css-3btd0c em{font-style:italic;}.css-w739ur{margin:0 auto 5px;font-family:nyt-franklin,helvetica,arial,sans-serif;font-weight:700;font-size:1.125rem;line-height:1.3125rem;color:#121212;}#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-family:nyt-cheltenham,georgia,’times new roman’,times,serif;font-weight:700;font-size:1.375rem;line-height:1.625rem;}@media (min-width:740px){#NYT_BELOW_MAIN_CONTENT_REGION .css-w739ur{font-size:1.6875rem;line-height:1.875rem;}}@media (min-width:740px){.css-w739ur{font-size:1.25rem;line-height:1.4375rem;}}.css-9s9ecg{margin-bottom:15px;}.css-16ed7iq{width:100%;display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;-webkit-box-pack:center;-webkit-justify-content:center;-ms-flex-pack:center;justify-content:center;padding:10px 0;background-color:white;}.css-pmm6ed{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-align-items:center;-webkit-box-align:center;-ms-flex-align:center;align-items:center;}.css-pmm6ed > :not(:first-child){margin-left:5px;}.css-5gimkt{font-family:nyt-franklin,helvetica,arial,sans-serif;font-size:0.8125rem;font-weight:700;-webkit-letter-spacing:0.03em;-moz-letter-spacing:0.03em;-ms-letter-spacing:0.03em;letter-spacing:0.03em;text-transform:uppercase;color:#333;}.css-5gimkt:after{content:’Collapse’;}.css-rdoyk0{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;-webkit-transform:rotate(180deg);-ms-transform:rotate(180deg);transform:rotate(180deg);}.css-eb027h{max-height:5000px;-webkit-transition:max-height 0.5s ease;transition:max-height 0.5s ease;}.css-6mllg9{-webkit-transition:all 0.5s ease;transition:all 0.5s ease;position:relative;opacity:0;}.css-6mllg9:before{content:”;background-image:linear-gradient(180deg,transparent,#ffffff);background-image:-webkit-linear-gradient(270deg,rgba(255,255,255,0),#ffffff);height:80px;width:100%;position:absolute;bottom:0px;pointer-events:none;}.css-uf1ume{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-box-pack:justify;-webkit-justify-content:space-between;-ms-flex-pack:justify;justify-content:space-between;}.css-wxi1cx{display:-webkit-box;display:-webkit-flex;display:-ms-flexbox;display:flex;-webkit-flex-direction:column;-ms-flex-direction:column;flex-direction:column;-webkit-align-self:flex-end;-ms-flex-item-align:end;align-self:flex-end;}.css-12vbvwq{background-color:white;border:1px solid #e2e2e2;width:calc(100% – 40px);max-width:600px;margin:1.5rem auto 1.9rem;padding:15px;box-sizing:border-box;}@media (min-width:740px){.css-12vbvwq{padding:20px;width:100%;}}.css-12vbvwq:focus{outline:1px solid #e2e2e2;}#NYT_BELOW_MAIN_CONTENT_REGION .css-12vbvwq{border:none;padding:10px 0 0;border-top:2px solid #121212;}.css-12vbvwq[data-truncated] .css-rdoyk0{-webkit-transform:rotate(0deg);-ms-transform:rotate(0deg);transform:rotate(0deg);}.css-12vbvwq[data-truncated] .css-eb027h{max-height:300px;overflow:hidden;-webkit-transition:none;transition:none;}.css-12vbvwq[data-truncated] .css-5gimkt:after{content:’See more’;}.css-12vbvwq[data-truncated] .css-6mllg9{opacity:1;}.css-qjk116{margin:0 auto;overflow:hidden;}.css-qjk116 strong{font-weight:700;}.css-qjk116 em{font-style:italic;}.css-qjk116 a{color:#326891;-webkit-text-decoration:underline;text-decoration:underline;text-underline-offset:1px;-webkit-text-decoration-thickness:1px;text-decoration-thickness:1px;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:visited{color:#326891;-webkit-text-decoration-color:#326891;text-decoration-color:#326891;}.css-qjk116 a:hover{-webkit-text-decoration:none;text-decoration:none;}Of the 2.4 million monoclonal antibody doses shipped nationally, at least 1.1 million have been used. Precisely how many are still sitting on shelves is hard to determine because of reporting gaps. Still, waning federal supplies and soaring demand from less-vaccinated Southern states have caused what several states have described as large shortfalls in deliveries.North Carolina providers have requested 15,000 weekly doses, the health department there said, more than double what the federal government has allocated. Florida said its latest weekly allotment left clinics there 41,000 doses short of what they wanted.Hospitals had previously been able to order the drugs themselves. But the Department of Health and Human Services will now decide how many doses each state receives based on case rates and use of the treatment. State governments, in turn, will decide on doses for individual sites.The new ordering process, which the Biden administration said would ensure “equitable distribution,” has unsettled some backers of the drug. Gov. Ron DeSantis of Florida, a Republican, warned on Thursday that state officials were unprepared for the new responsibility of parceling out doses.And in heavily vaccinated states, like New York, people coordinating treatments fear that shipments will plummet because of low case rates, leaving hospitals with so few doses that they shutter their programs. Some hospitals recently reported growing numbers of vaccinated patients receiving infusions.Diana Berrent, the founder of Survivor Corps, which has worked to help patients find monoclonal antibody treatments, said that involving state governments would create delays: “You’re layering in 50 new layers of bureaucracy,” she said.Dr. Howard Huang, Houston Methodist’s medical leader for the infusion program.Brandon Thibodeaux for The New York TimesDoctors have warned that antibody treatments alone cannot keep pace with ballooning outbreaks. Whereas any one vaccination protects untold others from exposure, a single infusion only helps a single patient. Infusions must be given within 10 days of symptoms; they are unhelpful to most hospitalized patients. And receiving the antibodies once does not keep people from becoming seriously ill if they catch the virus again later.“Something like that just doesn’t scale,” said Dr. Howard Huang, the medical leader for Houston Methodist’s infusion program.As a result, health officials have warned that vaccine skeptics may become so enamored of monoclonal antibodies that they become even more resistant to getting a protective shot.Within days of his infusion, Mr. Jones, the patient in Houston, had left the bedroom where he had been quarantined and returned to his work as a landscape architect. But he was still weighing whether to be vaccinated.His doctor was pushing for the shot, he said. But the monoclonal antibodies had worked so well that he was tempted to simply return for another infusion if he caught Covid-19 again.“If I can go get an infusion and feel as good as I do right now, man, I’d rather not take a vaccine that has just been developed,” he said. “That makes me nervous, still.”Rebecca Robbins contributed reporting.