Publisher Health

Federal regulators warned on Thursday they may not have enough data to recommend boosters for anyone except certain recipients of the Pfizer vaccine by late September.WASHINGTON — Top federal health officials have told the White House to scale back a plan to offer coronavirus booster shots to the general public later this month, saying that regulators need more time to collect and review all the necessary data, according to people familiar with the discussion.Dr. Janet Woodcock, the acting commissioner of the Food and Drug Administration, and Dr. Rochelle P. Walensky, who heads the Centers for Disease Control and Prevention, warned the White House on Thursday that their agencies may be able to determine in the coming weeks whether to recommend boosters only for recipients of the Pfizer-BioNTech vaccine — and possibly just some of them to start.The two health leaders made their argument in a meeting with Jeffrey D. Zients, the White House pandemic coordinator. Several people who heard about the session said it was unclear how Mr. Zients responded. But he has insisted for months that the White House will always follow the advice of government scientists, wherever it leads.Asked about the meeting, a White House spokesman on Friday said, “We always said we would follow the science, and this is all part of a process that is now underway,” adding that the administration was awaiting a “full review and approval” of booster shots by the F.D.A. as well as a recommendation from the C.D.C.“When that approval and recommendation are made,” the spokesman, Chris Meagher, said, “we will be ready to implement the plan our nation’s top doctors developed so that we are staying ahead of this virus.”Less than three weeks ago, Mr. Biden said that contingent on F.D.A. approval, the government planned to start offering boosters the week of Sept. 20 to adults who had received their second shot of the Pfizer-BioNTech or Moderna vaccine at least eight months ago. That would include many health care workers and nursing home residents, as well as some people older than 65, who were generally the first to be vaccinated. Administration officials have said that recipients of the single-dose Johnson & Johnson vaccine would probably be offered an additional shot soon as well.Mr. Biden cast the strategy as another tool that the nation needed to battle the highly contagious Delta variant, which has driven up infection rates, swamped hospitals with Covid-19 patients and is now leading to an average of more than 1,500 deaths a day. “The plan is for every adult to get a booster shot eight months after you got your second shot,” he said on Aug. 18, adding, “It will make you safer, and for longer. And it will help us end the pandemic faster.”Like Mr. Biden, members of his pandemic response team have said that the plan depended on the F.D.A. and the C.D.C. authorizing the booster shots. Both Dr. Woodcock and Dr. Walensky publicly endorsed the strategy, as did the nation’s other senior health leaders.Privately, Dr. Woodcock had argued that it was risky to set a firm date for a booster rollout before regulators had a chance to thoroughly review the data, some of which had yet to be submitted by the vaccine manufacturers, and decide whether shots were safe and necessary, according to several people familiar with the discussions.And since the White House announced the booster plan in mid-August, they said, new hurdles appeared.Among the reasons for delaying is that regulators need more time to decide the proper dosage for a possible third Moderna shot. The company’s application asking the F.D.A. to authorize a booster shot contains insufficient data, one federal official familiar with the process said. Other data expected from Johnson & Johnson has not been delivered.Nor has the raw data that the F.D.A. has been seeking from Israel, which is already giving boosters to everyone 12 and older. Israeli officials say their data shows that the potency of Pfizer’s vaccine wanes over time against severe disease and hospitalization, but that a third shot bolsters protection significantly. The F.D.A. wants to see the underlying data, to make sure it backs up summaries that the Israeli government has provided.Dr. Janet Woodcock, the acting commissioner of the Food and Drug Administration, has privately argued that setting a firm date for booster shots to begin was risky.Stefani Reynolds for The New York TimesNarrowing the booster plan could confuse the public and create a perception that federal vaccine policy is in some degree of disarray. But some public health experts will most likely welcome it.They have been arguing strenuously that the administration lacks the data to justify a broad rollout of extra shots and should instead concentrate on vaccinating the roughly 25 percent of Americans who are eligible for shots but remain unprotected. And some have said that Biden aides wrongly cornered regulators by announcing a strategy before they could conduct a full review..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;}Regulators are only beginning to review critical data that will help them determine if and how boosters should be given. Pfizer completed its booster application to the F.D.A. last week, officials said, and Moderna has just initiated its own.This week, two of the F.D.A.’s top vaccine regulators announced that they would be leaving the agency this fall, apparently partly because of frustration with the administration’s booster plan. Dr. Marion Gruber, who directs the agency’s vaccines office, and her deputy, Dr. Philip Krause, have told people there was not nearly enough data to justify offering extra shots to the general population starting in just weeks.More friction may lie ahead. On Sept. 17, the F.D.A.’s outside advisory committee is scheduled to publicly review Pfizer’s data supporting a booster shot. Even though Pfizer has asked the F.D.A. to approve booster doses for people 16 and up, the agency could decide to restrict who gets a booster. The C.D.C. and its outside advisory panel would also have to weigh in.One key member of the F.D.A.’s advisory panel, Dr. Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia, argues boosters are premature. “There is no compelling reason to get a third dose” now, he said in an interview on Thursday.He said the administration had appeared to expect that the F.D.A. and the C.D.C. would rubber-stamp its booster timeline. “Bypassing and marginalizing those agencies led veterans who you need in this pandemic to leave the F.D.A.,” he said, referring to the departures of Dr. Gruber and Dr. Krause.Various studies have shown that the potency of the Pfizer-BioNTech and Moderna vaccines ebbs against infection over time, but suggest that the vaccines continue to offer robust protection against severe illness and hospitalization.But Dr. Vivek Murthy, the surgeon general, said in an interview on Thursday that a few studies have suggested a dip in protection against severe disease over time. “Our feeling was that if we waited several more months we would see protection against hospitalizations and deaths break down,” he said.In an interview published Thursday on WebMD.com, Dr. Woodcock echoed that view, saying that the trend of breakthrough infections has led health officials to believe at some point, “we are going to see hospitalizations and more serious disease” among fully vaccinated people. When that happens, she said, “we want to be ready” with the booster plan.Some Americans are already getting booster shots ahead of F.D.A. approval: more than a million fully vaccinated people have received an additional dose since mid-August.

Just when we thought it was safe to go to the local garden center, researchers from Japan have discovered that fungicide-resistant strains of a nasty pathogen have been getting up to no good among the tulip bulbs.
In a study published in August in Environmental Microbiology researchers from the University of Tsukuba and Chiba University have revealed that plant bulbs harboring a potentially lethal pathogen also make the perfect lab for evolving fungicide-resistant strains.
The risk associated with fungal infections is increasing, with occurrences of pulmonary aspergillosis (PA), a deadly fungal infection caused by the human pathogen Aspergillus fumigatus, rising globally. Of particular concern are influenza-related PA and COVID-19-related PA, the case numbers of which are growing quickly. Azoles — a class of antifungal compounds often used as antifungal drugs to treat aspergillosis — are also widely used as agricultural fungicides. Azole-resistant strains of A. fumigatus are spreading in the environment, potentially promoted by agricultural azole use. Azole resistance is a factor known to affect the treatment of PA, and there is concern that this problem is only worsening.
“Understanding how the genetic variation linked with azole resistance in A. fumigatus strains is distributed and enriched in the environment is necessary for suppressing resistant strains,” says senior author of the study Daisuke Hagiwara. “In this study, we set out to do this by investigating the genetics of those strains.”
Previously, the research team found several azole-resistant A. fumigatus strains attached to imported plant bulbs for sale in Japanese gardening shops. In this study, they investigated eight strains of azole-resistant A. fumigatus isolated from a single tulip bulb bought in Japan. The researchers used genome sequencing and comparative analysis, and compared the strains for sensitivity to agricultural and medical azoles, in addition to other classes of fungicides. The results indicated that there had previously been genetic recombination between the strains, and that some of them exhibited tolerance to other fungicide classes.
“Our results show that plant bulbs provide not just a vehicle for this pathogen, but also an ideal niche for its strains to encounter each other, and to evolve their resistance to drugs,” says Hagiwara.
This study fills gaps in the knowledge of azole-resistant A. fumigatus, providing important information on the genetics behind an urgent global One Health challenge. The research team’s findings will inform a deeper understanding of drug-resistant fungi and help with the development of future solutions to this problem.
This study was supported by a grant from the Institute for Fermentation, Osaka (to DH). HT was partly supported by the National Bioscience Database Center (NBDC) of the Japan Science and Technology Agency (JST), and JSPS KAKENHI Grant Numbers 21K07001 and 16H06279. DH and HT were partly supported by AMED, Grant Number JP19fm0208024.
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In a new study by Yale Cancer Center, researchers show stem-like T cells within certain lymph nodes could be natural cancer fighters. Targeting these T cells, which are a type of white blood cells, with immunotherapy drugs could increase the number of cancer patients that respond to treatment. The findings were reported online today in the journal Science Immunology.
“Therapies that use the immune system to destroy cancer have been a game changer for patients with lung and other cancers,” said Nikhil Joshi, PhD, Assistant Professor of Immunobiology, a member of the Center of Immuno-Oncology at Yale Cancer Center, and senior author of the study. “But not all people respond to immunotherapy drugs, so it was important for us to discover the role of these special T cells in tumor growth.”
In this study, researchers first developed a new animal model where they could look at the stem-like T cells in tumors over the course of several months of tumor growth, and determine how the stem-like T cells survive. They discovered the stem-like T cells do not persist in the tumor for very long, which meant they are resupplied from somewhere else in the body. Nearby lymph nodes, an immune organ containing many of these stem-like T cells, were replenishing the supply. Every so often, a few stem-like T cells leave the lymph node and travel to the tumor. This keeps the tumor supplied with fresh cancer fighting T cells. Researchers believe this is important for slowing the growth of cancer. An analysis of immune cells isolated from patients with lung cancer confirmed that stem-like T cells are in lymph nodes near the lung.
“T cells in tumors become exhausted, but our study results show the stem-like T cells within the nearby lymph nodes do not experience exhaustion during the course of disease,” said Kelli A. Connolly, a post-doctoral fellow at Yale Cancer Center and lead author of the study. “This could be an important treatment advance as the potential to respond to immunotherapy is preserved.”
“We are focused on developing therapies that will activate the stem-like T cells in the nearby lymph node and bring them into the fight against cancer,” adds Joshi. “We plan to continue this work and focus on how to improve these therapeutic responses to help patients.”
Funding for the study was supported by the American Lung Association, the National Cancer Institute, the Lung Cancer Research Foundation, and the Yale SPORE in Lung Cancer.
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Chronic back pain affects upwards of 15 million adults in the US, racking up billions in healthcare costs and lost work days. Degeneration of the discs that cushion and support vertebrae, a common occurrence of aging, is a major contributor to low back pain. Although a widespread condition, few treatments are available. Now Jefferson’s Makarand Risbud, PhD, James J. Maguire Jr. Professor of Spine Research in orthopedic surgery, division director of orthopedic research and co-director of the cell biology and regenerative medicine graduate program, and colleagues have shown that treating mice with a drug cocktail that removes aging cells reduces disc degeneration. The findings, reported in Nature Communications on September 3rd, show how a novel approach to preventing age-related disc degeneration may pave the way for treating chronic back pain.
“Once intervertebral discs start to degenerate, there is very little regeneration that happens,” says Dr. Risbud. “But our results show that it is possible to mitigate the disc degeneration that happens with aging.”
Surgery or steroid injections are options to treat low back pain from disc degeneration, but the vast majority of patients do not meet criteria for surgery and epidural steroid injections do not work well most of the time. Prolonged use of strong painkillers prescribed for back pain, such as opioids, carry the risk of addiction.
In collaboration with Brian Diekman, PhD, an assistant professor of biomedical engineering at the University of North Carolina in Chapel Hill, Dr. Risbud and his team were looking for an effective and noninvasive way to treat back pain from disc degeneration that did not involve painkillers like opioids. Instead, they turned to a class of small molecules known as senolytics. These drugs target cells in the body that are in a process of age-related deterioration called senescence.
With age, every tissue in the body accumulates senescent cells. Senescent cells secrete destructive enzymes and inflammatory proteins that affect nearby healthy cells. Senolytic drugs remove these deteriorating cells, leaving room for new cells to replace them. The idea is that removing senescent cells from a tissue will improve the tissue’s function.
Recent research has shown that to be the case. Two senolytic drugs, dasatinib and quercetin, have shown enough promise to treat scarring in lung tissue that they are now in clinical trials. But the lungs are very different than discs in the spine.

SharecloseShare pageCopy linkAbout sharingimage sourceReutersThe EU and UK-Swedish drug-maker AstraZeneca have settled a row over a shortfall in coronavirus vaccines that affected the European rollout earlier this year.AstraZeneca has agreed to deliver 200 million doses of its vaccine, which had been promised under a contract, to the EU by the end of March 2022.The deal puts an end to the EU’s pending action in the Belgian courts.The EU said this week that 70% of adults had been double vaccinated.Earlier this year AstraZeneca angered European Commission officials when it said it could only deliver a fraction of the doses agreed for the first three months of 2021. The bitter dispute overshadowed the initial weeks of the vaccine rollout across the EU’s 27 countries. The Commission accused the company of breaking an August 2020 advanced purchase deal while AstraZeneca hit back arguing that the contract only required its “best effort” to deliver millions of vaccine doses on time.Covid vaccines still effective against Delta variantMerkel gets Moderna jab after AstraZenecaAstraZeneca’s Covid vaccine, now known as Vaxzevria, has also been hit by age restrictions imposed by several EU countries because of very rare side effects. The EU’s medicines agency made clear that the benefits outweighed the risks for all adult groups.The delivery row was set to reach the Brussels courts at the end of September and Rudd Dobber of AstraZeneca said he was “very pleased that we have been able to reach a common understanding” with the Commission.EU Health Commissioner Stella Kyriakides said there were still “significant differences in vaccination rates between our member states, and the continued availability of vaccines, including AstraZeneca’s, remains crucial”.Under the settlement the two sides agreed that another 60 million doses would be delivered by the end of this month, a further 75 million by the end of December and a final 65 million by the end of March 2022.

SharecloseShare pageCopy linkAbout sharingimage sourceGetty ImagesExposure to high levels of air pollution can make children obese and put them at greater risk of asthma, a new study has found.The study said obese children had a 79% greater chance of having asthma. This association was highest seen in Delhi, which experiences hazardous air quality every year.And while there could be many causes for obesity in children, “ambient air pollution could be an important contributing factor”, it said.The study by the Lung Care Foundation and Pulmocare Research and Education is the first in India to establish a link between overweight children, asthma and air pollution. Experts have long warned that prolonged exposure to unclean air could lead to respiratory illnesses, especially among children. They say urgent action is required to protect them.Lung Care Foundation looked at 3,157 children in 12 schools – selected at random – from Delhi, and southern Indian cities of Kottayam and Mysuru – both of which have relatively cleaner air. It found that 39.8% children from Delhi were overweight as compared to 16.4% in Kottayam and Mysuru. This correlates “very well” with the reported particulate matter (PM2.5) – dangerous tiny pollutants in the air – levels found in these cities, the study said. Delhi is among the most polluted cities in the world. Every year, air pollution there climbs to levels around nine times more than what the World Health Organization (WHO) considers safe, as a thick blanket of smog – fed by agriculture fires and festive fireworks – engulfs the city. ‘India must cut pollution to avoid Covid disaster’The fight against air pollution in three global cities Dr Sundeep Salvi, director of Pulmocare Research and Education (PURE) Foundation in the western city of Pune, said the research confirms that breathing such unclean air can make children fat. He said that pollutants in the air contain certain chemicals, known as obesogens, that can alter a person’s metabolism. “When a person breathes polluted air, these obesogens enter the body. This messes up the endocrine system and leads to obesity,” Dr Salvi told the BBC.image sourceGetty ImagesDr Salvi said that children are especially vulnerable because their intake of air is higher as they are more active than adults. “This makes them more susceptible to inhaling these obesogenic pollutants.”The study also found that school children in Delhi have “significantly higher prevalence” of asthma and allergy symptoms – such as itchy watery eyes, cough and rash – as compared to those in Kottayam and Mysuru. At least 29.3% children from Delhi were found to have airflow obstruction or asthma during a breathing test as compared to 22.6% children in Kottayam and Mysuru. This difference was despite the fact that the two main factors associated with childhood asthma – family history of the disease and a smoker in the family – were more prevalent in the southern cities, researchers said. Dr Arvind Kumar, the founder trustee of Lung Care Foundation, called the study “eye-opener”. “It has shown an unacceptably high prevalence of respiratory and allergic symptoms, spirometry-defined asthma, and obesity in Delhi children,” he said. And air pollution is “the probable link with all three”. “It is high time that the air pollution issue in Delhi and other cities is settled in a systematic manner to save the future of our children,” he said.

SharecloseShare pageCopy linkAbout sharingimage sourceEPAAustralia says it has secured an extra four million doses of the Pfizer vaccine from the UK in a swap deal.Prime Minister Scott Morrison said the extra vaccines would help his country come out of its lockdowns sooner.About half of Australia’s population is currently in lockdown due to outbreaks in the cities of Sydney, Melbourne and Canberra.Under the deal, Australia will send the same amount of doses back to the UK later in the year.Australia has ramped up vaccination rates in recent weeks, after drawing criticism for a slow rollout.Mr Morrison said the Pfizer doses would leave for Australia on Saturday. “This will enable us to bring forward significantly the opportunity for Australia to open up again,” he told reporters on Friday.Mr Morrison’s government has drawn criticism for failing to secure more Pfizer doses early on, and for not better addressing public concerns about rare clotting from the AstraZeneca vaccine.How AstraZeneca became ‘rejected’ in AustraliaThe Australian millennials desperate for vaccinesCurrently, 36% of the eligible population is fully vaccinated – a level among the lowest of OECD nations. But Australia is now administering doses at a rate higher than peaks seen in the UK and US.The UK – which opened up in July – is now nearing 80% coverage for over-16s.Australia has also secured vaccine swap deals from Poland and Singapore.It is aiming to ease out of lockdowns when adult coverage targets hit 70%, with plans to re-open schools, businesses and state borders.Based on current rates, that could occur around mid-October. When vaccine levels reach 80%, Australia also plans to re-open to vaccinated travellers from designated safe nations, including the UK.New South Wales Premier Gladys Berejiklian says she is aiming for Sydney to welcome travellers by November.But plans to re-open have also drawn controversy, particularly among the majority of Australian states with no current Covid cases.Queensland and Western Australia have indicated they are unwilling to re-open their borders amid current case rates in Sydney. Sydney reported over 1,400 new cases and 12 deaths on Friday.

The country is holding fast to a lockdown to contain an outbreak that began in mid-August. But it’s also acknowledging that lockdowns can’t go on forever.AUCKLAND, New Zealand — When New Zealand, for the first time in months, reported a case of community spread of the coronavirus on Aug. 17, residents sprang into action. They stripped supermarket shelves of pasta and toilet paper, dug masks out of drawers and fled to vacation homes in the mountains or at the beach.Hours later came the expected announcement: The country, after a single case of the Delta variant, would plunge into a highly restrictive three-day lockdown. New Zealand, one of the last countries to still pursue “Covid zero,” would aim to eliminate the virus once again, Prime Minister Jacinda Ardern said at a news conference that day.“While we know that Delta is a more dangerous enemy to combat,” she said, “the same actions that overcame the virus last year can be applied to beat it.”Two weeks later, New Zealand is still in lockdown, one that will last at least another 14 days. One case has become nearly 700, with almost three dozen requiring hospitalization. And the familiar playbook that has made New Zealand an envied model throughout the pandemic is struggling to contain a much more contagious variant of the virus.“The challenge is eliminating Delta,” said Rodney Jones, an adviser to the New Zealand government on the pandemic. “No country has eliminated Delta.”For now, New Zealand appears nearly unified behind the effort to try, with lockdown compliance high and faith in public health officials strong. But Ms. Ardern and other leaders have begun to acknowledge that New Zealand may eventually have to change course as the virus continues to spread — 75 new cases were reported on Wednesday, up from around 50 each of the two previous days — and its vaccination campaign lags.That would mean tolerating some spread of the virus to keep society more open, a strategy pursued to varying degrees in almost every developed country.Dr. Ashley Bloomfield, New Zealand’s top health official, with Prime Minister Jacinda Ardern last week.Pool photo by Robert KitchinWhile China has signaled a long-term commitment to a Covid-zero approach, the Delta variant has already felled such virus elimination blueprints in Singapore, Hong Kong and several other places in the Asia-Pacific region. New Zealand’s leaders are most intently watching neighboring Australia, where, after almost two months of lockdown, the state of New South Wales is now reporting more than 1,000 cases a day.Until July, Australia had not recorded a single Covid death in 2021, and it had snuffed out every small flare-up in infections. Now, its prime minister, Scott Morrison, has disavowed the virus elimination approach altogether.“Any state and territory that thinks that somehow they can protect themselves from Covid with the Delta strain forever, that’s just absurd,” he said last week. “New Zealand can’t do that. They were following an elimination strategy. They’re in lockdown.”Australia is seeking to vaccinate its way to relative safety, focusing on areas hit hard by the Delta variant. That option is unavailable to New Zealand, which has administered the fewest doses per capita of any developed nation.The country did not place its first vaccine order until the end of January, when it purchased 65,520 doses of the Pfizer-BioNTech shot, the only inoculation it is using. By that point, the United States had administered about 50 million vaccine doses.New Zealand, a country of nearly five million people, has given first shots to about 45 percent of the population; fewer than 25 percent of residents are fully vaccinated. The country has increased vaccine distribution since the new outbreak began, but Ms. Ardern warned this week that the effort might have to be slowed once again without more supplies from Pfizer.The government has said it did not have to rush the vaccine approval and procurement process because of its success in containing the virus. With a combination of closed borders and quick lockdowns, it has kept the total caseload to fewer than 3,500, and the death toll to 26. And for most of the past 18 months, residents have lived with few restrictions.But members of the political opposition argued that the government had left the population vulnerable as the Delta variant started to circulate around the world. New Zealand had been at risk of an outbreak for some time, with Delta making up a majority of cases in its border-hotel quarantine facilities for months. The current outbreak has been linked to a New Zealander who flew from Sydney, Australia, and was put in isolation after testing positive for the variant.New Zealanders have lived without restrictions for most of the pandemic. In April, the New Zealand band Six60 performed in Auckland.David Rowland/Associated Press“We have been sitting ducks for Delta,” said Christopher Bishop, a lawmaker for the National Party who speaks for the opposition on Covid-19 policy. “We knew it was going to turn up here and it would cause havoc when it eventually made its way into the community, and that’s exactly what’s happened.”.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;}Still, critical voices like Mr. Bishop’s remain a minority in New Zealand. Ms. Ardern’s Labour government is among the most popular ever in the country, winning a huge majority in the general election last year. New Zealand’s top health official, Dr. Ashley Bloomfield, has attained rock star status and been widely credited with keeping “the team of five million” safe.Although New Zealand is earlier in its lockdown, it has yet to experience the confinement fatigue that has troubled lawmakers in the states of New South Wales or Victoria in Australia. That is in part a reflection of the public’s faith in Dr. Bloomfield as the expert who can get New Zealand out of its Covid trouble.“He has not just a public profile, but a cultlike following,” said Ben Thomas, a New Zealand political commentator and former National Party staff member. “The country has a huge kind of parasocial devotion to him, which is very new to New Zealand.”Despite the high costs of the lockdown, which has closed most businesses and confined all but essential workers to their homes, it is worthwhile to push for elimination of the virus for as long as possible, said Prof. Michael Baker, an epidemiologist at the University of Otago in New Zealand.“I’m very confident we will stamp out this outbreak and return to elimination status,” said Professor Baker, who encouraged the government early on to adopt the Covid-zero approach. Debate on the next steps can come later, he added. “I’ve often framed it as New Zealand keeping its options open,” he said.Not among those options, Ms. Ardern vowed, is lurching in and out of lockdown in perpetuity.“Delta has changed the rules of the game, and that’s why we changed our game plan,” she said at a news conference last week. “No one wants to use lockdowns forever. And I can tell you now, that is not our intention.”Lining up for Covid-19 testing in Auckland last month.Jason Oxenham/New Zealand Herald, via Associated Press

The Supreme Court’s decision not to block a Texas law banning most abortions left Republicans eager to replicate it. Democrats reeled, but sensed a winning issue in coming elections.WASHINGTON — The Supreme Court’s decision not to block a Texas law sharply curtailing abortions abruptly vaulted the issue to the forefront of American politics on Thursday, reshaping the dynamics of elections in California this month, in Virginia in November and in midterms next year that will determine control of Congress and statehouses.Republicans hailed the court’s 5-to-4 decision, explained in a one-paragraph middle-of-the-night ruling, as a tremendous victory, allowing a nearly complete ban on abortions to stand in the nation’s second-largest state.For Democrats, it was a nightmare come true: A conservative Supreme Court, led by three appointees of former President Donald J. Trump, had allowed a highly gerrymandered, Republican-controlled state legislature to circumvent Roe v. Wade, the half-century-old decision that enshrined abortion as a constitutional right.Suddenly, supporters of abortion rights found themselves grappling not only with the political and policy failures that had led to this point, but also with the prospect that other Republican-controlled legislatures could quickly enact copycat legislation. On Thursday, G.O.P. lawmakers in Arkansas, Florida and South Dakota promised to do so in their next legislative sessions.Yet Democrats also embraced the opportunity to force an issue they believe is a political winner for them to the center of the national debate. After years of playing defense, Democrats say the Texas law will test whether the reality of a practical ban on abortions can motivate voters to support them.Senator Catherine Cortez Masto of Nevada, a Democrat up for re-election in 2022, said people in her state had fought to protect women’s reproductive freedom and would vote accordingly. “If a Republican is going to go to Washington to roll those freedoms back, I will make it an issue,” she said in an interview. “I don’t think you should underestimate the impact that this issue has to Nevadans.”Republicans held up the Texas law as an example for the country to follow. “This law will save the lives of thousands of unborn babies in Texas and become a national model,” said Lt. Gov. Dan Patrick of Texas. “I pray that every other state will follow our lead in defense of life.”Gov. Kristi Noem of South Dakota, who is considered a potential Republican candidate for president in 2024, said she had directed her office to “make sure we have the strongest pro-life laws on the books.”Senate Democrats’ campaign arm has signaled that it will use abortion rights as a cudgel against Republicans running in key states like Nevada, where Senator Catherine Cortez Masto faces re-election in 2022.Sarahbeth Maney/The New York TimesThe court’s decision, which did not address the substance of the Texas law, creates new urgency for President Biden and congressional Democrats to do more than issue public statements vowing to defend women’s reproductive rights.“The temperature just got a lot hotter on this issue, and I certainly now expect Congress to join in these fights,” said Gov. Michelle Lujan Grisham of New Mexico, the chairwoman of the Democratic Governors Association. “Our voters expect us all to do more.”Yet Senate Democrats do not have the votes to eliminate the filibuster, which would be necessary to change federal abortion law in the evenly divided chamber.In Washington on Thursday, Democratic leaders dutifully scrambled to show their determination to push back against the possibility that the Texas law could be replicated elsewhere — or to respond if the Supreme Court rolls back abortion rights when it rules on a Mississippi law that seeks to ban most abortions after 15 weeks of pregnancy, two months earlier than Roe and subsequent decisions allow.Speaker Nancy Pelosi promised to bring a vote on the Women’s Health Protection Act, which would effectively codify abortion rights into federal law.And Mr. Biden pledged “a whole-of-government effort” in response to the Texas law, directing the Department of Health and Human Services and the Justice Department to identify possible federal measures to help ensure that women in the state have access to safe and legal abortions.“The highest court of our land will allow millions of women in Texas in need of critical reproductive care to suffer while courts sift through procedural complexities,” Mr. Biden said. “The impact of last night’s decision will be immediate and requires an immediate response.”Vice President Kamala Harris added, “We will not stand by and allow our nation to go back to the days of back-alley abortions.”The first election that could test Democrats’ capacity to energize voters over abortion rights comes on Sept. 14 in California, where voters will determine the fate of Gov. Gavin Newsom, who faces a recall effort. Mr. Newsom warned on Twitter that the Texas abortion ban “could be the future of CA” if the recall were successful.In Virginia, Democratic candidates for the state’s three statewide offices and House of Delegates pounced on the issue on Thursday. Former Gov. Terry McAuliffe, who is running to recapture the office in November, said the fight for abortion rights would help motivate Democratic voters who might be complacent after the party captured full control of state government in 2019 and helped Mr. Biden win the state last year.“We are a Democratic state. There are more Democrats,” Mr. McAuliffe said. “But this is an off-off-year, and getting Democrats motivated to come out, that’s always the big challenge.”Eyeing 2022, the Democrats’ Senate campaign arm has signaled it will use abortion rights as a cudgel against Republicans running in states like Florida, New Hampshire, Nevada and North Carolina. Democrats planning campaigns for governor next year are preparing to brand themselves as the last line of defense on abortion rights, particularly in states with Republican-controlled legislatures.“People are now waking up to the fact that the battle will now be in the states, and they recognize that the only thing, literally the only thing standing in the way of Pennsylvania passing the same ban that Texas just passed, is the veto pen of our Democratic governor,” said Josh Shapiro, the Pennsylvania attorney general, a Democrat who has said he expects to enter the race to succeed Gov. Tom Wolf. “I’ve given up on the politicians in Washington. I don’t think we can count on them anymore.”Former Gov. Terry McAuliffe of Virginia, who is running for his old post this year, believes abortion access will be a motivating factor for voters.Pete Marovich for The New York TimesThough Republicans have long made overturning Roe a central political goal — as a candidate in 2016, Mr. Trump predicted that his eventual Supreme Court appointees would do so — there was still a palpable sense of shock among Democrats. Despite the court’s 6-to-3 conservative majority, many Democrats seemed mentally unprepared for Wednesday’s ruling.“You can’t plan for a blatantly false or unconstitutional court ruling like this,” said Representative Conor Lamb of Pennsylvania, a Democrat who is running for his state’s open Senate seat next year.Understand the Texas Abortion LawCard 1 of 4The most restrictive in the country.

A next-generation brain implant currently in clinical use for treating refractory epilepsy — to help prevent symptoms including seizures — does not induce changes to patients’ personalities or self-perceptions, a new study of patient experiences shows.
The findings, published in the peer-reviewed journal AJOB Neuroscience,will help alleviate some ethical concerns that have been raised around closed-loop brain stimulation devices which could, in theory, have unintended effects on a person’s sense of self or personality.
“Next-generation brain stimulation devices can modulate brain activity without human intervention, which raises new ethical and policy questions. But while there is a great deal of speculation about the potential consequences of these innovative treatments, very little is currently known about patients’ experiences of any device approved for clinical use,” said lead author Tobias Haeusermann of the University of California.
“This issue is becoming even more pressing, as several similar treatments are currently under development for several common neurological and psychiatric conditions, including depression, anxiety chronic pain, Alzheimer’s disease and ischemic stroke — offering the promise of effective new treatments for these debilitating illnesses.”
Closed-loop brain stimulation systems can monitor and decode brain activity and automatically adjust treatment — delivered through electrical pulses — based on internal software algorithms. These implantable devices may provide more precise and personalized treatment than ‘open loop’ systems, which have been used for decades to treat Parkinson’s disease and other conditions by applying consistent pre-programmed stimulation to targeted brain areas.
Epilepsy is a brain disorder that causes seizures and affects around three million US adults. Around one-third of people with the condition will eventually develop refractory epilepsy — which means that current medications don’t work well, or at all, at controlling their seizures. While brain surgery can be helpful, it isn’t suitable for all patients.
In 2013, the US Food and Drug Administration (FDA) approved a closed-loop brain stimulation system for treating refractory epilepsy. This study followed 12 patients, and their family caregivers, over two years to find out about their experiences of this implant, which is the first clinically approved and commercially available closed-loop brain stimulation device.
“We found that the brain implants did not transform patients’ sense of self or personality. Neither the long-term implantation of the electronic device in their brain, nor the electrical stimulation to modulate their brain function, led to changes in their self-perceptions — or the perceptions of the patient by family members and others around them,” said Haeusermann. “This is reassuring news for more than 3,000 patients with refractory epilepsy implanted with this device to date — as well as the many others who may consider this treatment as a way to prevent their seizures in the future.”
The results also highlighted the importance of evaluating the potential effects of brain stimulation in relation to patients’ previous neurological conditions and medications, which were recognized by both patients and family members as having a profound impact on their personality and self-perception.
The ability of next-generation brain stimulation devices to record, store and display brain data could also offer patients new ways of understanding and making sense of their illness. But the results of the study also indicated that if a patient’s experiences are not corroborated by the technology, they and others around them can begin to question their understanding of their illness.
“While patients generally valued the opportunity to view data collected by these devices, the process could also create uncertainties. Generating what appeared to be objective records of their illness might be interpreted as discrediting a patient’s own reports,” said Haeusermann. “Researchers may need to more carefully consider how patients will make meaning from data that are collected, stored and interpreted by these devices. Design choices such as user interface, options for data use and portability, and the degree of anticipated interaction with clinicians, may have unintended effects on how patients understand their brains and brain conditions.”
However, the authors noted that the brain implant used for these epilepsy patients does not have many of the more advanced functions that are envisioned for future devices. For example, these systems might be designed to exert effects specifically through programmed alterations to patients’ personalities and behaviors for treating psychiatric disorders.