The latest The brutal fourth wave of the pandemic in the United States continues to show signs of slowing. New daily coronavirus cases have fallen nearly 60 percent nationwide since a mid-September peak brought on by the highly transmissible delta variant, according to The Washington Post's tracking. But the progress against delta has been lopsided, with some states struggling to contain their outbreaks, and the nation is still averaging more than 1,400 deaths per day. Most of the conditions that put people at risk for severe illness from covid-19 are physical in nature. But the mind matters, too, according to the Centers for Disease Control and Prevention. This month, the CDC added mental health disorders, such as depression and schizophrenia, to its list of high-risk conditions that make someone more likely to be hospitalized or die from the disease. The move could make millions of people eligible for vaccine booster shots based on mental health diagnosis alone, my colleague Jenna Portnoy reports. The Pfizer-BioNTech vaccine could soon be cleared for use in elementary school-aged kids — perhaps as early as next week. Advisers to the Food and Drug Administration on Tuesday endorsed the shots for children ages 5 to 11, finding after a vigorous debate that the benefits outweighed the risks. The advice isn't binding, but the FDA is all but certain to grant emergency use authorization, extending the shots to some 28 million youngsters. The U.S. pharmaceutical giant Merck has agreed to share its formula for its promising new covid-19 drug, molnupiravir, with a nonprofit so that other companies can make it globally available. Merck says the pill can cut hospitalizations and deaths by half among high-risk patients. Health advocates praised Merck's move, saying it could drive down prices and expand access to the drug in countries where vaccines are hard to come by. The Trump administration could have saved more than 130,000 American lives with swifter action and better messaging on the coronavirus, the White House's former coronavirus response coordinator told congressional investigators this month. Instead, Deborah Birx said, Trump officials were "distracted" by the 2020 election and ignored recommendations to curb infections. My colleague Dan Diamond has more on Birx's interview with the House select subcommittee on the pandemic. Other important news Some immunocompromised people who got the Pfizer-BioNTech or Moderna vaccines can get a fourth shot, the CDC says. Officials recommend that those who qualify wait six months after their third dose to go in for the additional jab. A new feature on the iPhone allows users to add a verifiable coronavirus vaccination card to the Apple Wallet app and store test result records in its Health app. The United States will soon lift pandemic restrictions that barred entry to people from 33 countries. Airlines say they're bracing for an "onslaught" of travelers. Supply-chain gridlock related to the pandemic is getting worse, despite the Biden administration's efforts to get cargo moving again. During the pandemic, companies increasingly used arbitration to resolve grievances. Employees almost never won their cases. |
Your questions, answered Do I understand correctly that the vaccine does not protect you from infection but only reduces the severity of the illness and particularly reduces the likelihood of hospitalization because of your strengthened immune defenses? — Doug in Georgia This is an important question, and it's something that health officials (and reporters like myself) could have done a better job explaining at the beginning of the vaccine rollout. The coronavirus vaccines can protect you from infection to some degree, but their main purpose is to prevent severe illness, as you note. All three of the vaccines available in the United States do this extremely well. There's a misconception that the goal of the shots is to wrap us in a layer of armor that the virus can't penetrate. This is an idea known as "sterilizing immunity" — an immune response that not only prevents disease but annihilates the virus on impact. Most vaccines, including the coronavirus vaccines, don't deliver this protection. In fact, some experts say sterilizing immunity may not be fully attainable at all. My favorite analogy for understanding all this is the bug zapper vs. poison trap comparison. Sten H. Vermund, an infectious-disease epidemiologist and dean of the Yale School of Public Health, described it over the summer to my former colleague Ben Guarino, the longtime anchor of this newsletter. Vaccines don't function like bug zappers, Vermund explained, at least not in the sense that "as soon as [the virus] touches my mucosa or skin or genital tract — boom, zap, it's gone." Rather, vaccines are more like poisoned traps: A pest wanders in, wriggles around, then dies from the insecticide. If a vaccinated person inhales a few virus particles, it's possible for their antibodies to rush in and neutralize them immediately, almost bug zapper-style. But when the viral load is bigger, for example, or when a person's antibodies have waned over time, the virus can slip past that first line of defense. The immune system, primed by the vaccine to recognize the virus, sends antibodies to slow it down while alerting other immune defenders. T cells root out and destroy the infected cells, stopping the virus from proliferating. To keep Vermund's analogy going, the insecticide takes hold and soon the pest is gone. While it's hard to estimate how often such breakthrough infections occur, most are likely to be mild or even asymptomatic, and they rarely require hospitalization. The prospects are far more grim for unvaccinated people, who are are many times more likely to be hospitalized with covid-19 or die of the disease. Vaccines don't always stop infections, but they excel at preventing the worst outcomes. |