NEW YORK - A growing number of US governors from both political parties and other officials are circumventing a federal guidance to offer boosters to anyone over 18 in hopes of staving off a spike in cases over the holidays, while the Joe Biden administration is purchasing more vaccines and pills in preparation for future pandemics, especially a potential surge of the coronavirus this winter.

California made the first move to expand access when public health officials quietly sent a letter to local health jurisdictions and vaccine providers on Nov. 9 instructing them to trust patients to decide whether a booster is appropriate. Within days, officials in Colorado, New Mexico, Arkansas, West Virginia and New York City endorsed boosters for all adults.

"More states and jurisdictions are expected to follow," reported The Washington Post (WP) on Tuesday. "If you're in doubt and you meet the waiting period, just get a booster. Choose the side of greater protection," Democratic New Jersey Governor Phil Murphy was quoted as saying on Monday. "With the holidays coming up, we need as many people boosted as possible. It's that simple."

The Food and Drug Administration (FDA) is aiming to authorize booster doses of Pfizer-BioNTech's coronavirus vaccine for all adults as early as Thursday, "a move that would expand the number of Americans eligible for additional shots by tens of millions," The New York Times (NYT) on Tuesday quoted official sources as saying.

The Centers for Disease Control and Prevention's (CDC) independent committee of vaccine experts has scheduled a meeting for Friday to discuss data on the booster dose's efficacy and safety. If both the FDA and the CDC sign off this week, they will have acted strikingly quickly, a little more than a week after Pfizer asked for authorization of boosters for everyone 18 and older.

Under that scenario, any adult who received a second dose of the vaccine at least six months earlier would be officially eligible to get a booster as soon as this weekend. The FDA is reportedly expected to rule without consulting its own expert panel, which has met frequently during the pandemic to review vaccine data and make a recommendation ahead of a regulatory decision.

CONCERN AND CAUTION

Anthony Fauci, the United States' top infectious-disease expert, said at a Reuters summit on Tuesday that COVID-19 could be reduced to an endemic illness in the country by next year, but only if more unvaccinated people get vaccinated and more fully vaccinated people get booster doses.

"I think it's conceivable" that could happen by next year, said Fauci. "I hope we do, and it might even be likely, if we implement a good vaccination of the unvaccinated and a really good uptake of boosting those who are fully vaccinated."

Fauci said reaching endemic level, to him, means the virus may not be eliminated but "that infection is not dominating your life." He added that "people will still get infected. People might still get hospitalized, but the level would be so low that we don't think about it all the time and it doesn't influence what we do."

Also on Tuesday, Fauci said during an interview that COVID-19 cases in the United States need to fall "well below 10,000" per day for the country to achieve some semblance of pre-pandemic life, and as low as 3,300 per day for the nation to gain control over the virus.

"I think if we can get well below 10,000, I think that would be a level that I think would be acceptable to us to get back to a degree of normality," Fauci said. "But again, I have to warn the listeners, these are not definitive statements -- these are just estimates."

US COVID-19 cases plateaued at between 70,000 and 75,000 per day for almost three weeks before starting to rise again toward the end of last week. Fauci said that cases stabilizing at that high a level was a sign that the nation had "really bad control" over the pandemic, noting that the United States could be "in for some trouble" heading into the winter without taking proper public health precautions.

VACCINES AND PILLS

The White House is prepared to invest billions of dollars to expand US manufacturing capacity, with the goal of producing at least one billion doses a year beginning in the second half of 2022, NYT quoted two top advisers to US President Joe Biden as saying on Tuesday.

The investment is the first step in a new plan for the government to partner with industry to address immediate vaccine needs overseas and domestically and to prepare for future pandemics, said David Kessler, who oversees vaccine distribution for the administration, and Jeff Zients, Biden's coronavirus response coordinator.

The idea for the new public-private partnership is still in its early stages, and the price tag is uncertain. Kessler, who has been working on the proposal for months, estimated it at "several billion." The money has been set aside as part of the American Rescue Plan, the $1.9 trillion pandemic relief package that Biden signed into law in March.

Meanwhile, the Biden administration is planning to purchase 10 million courses of Pfizer's COVID-19 pill, a $5 billion investment in a treatment that "officials think will help change the trajectory of the coronavirus pandemic by reducing severe illness and deaths," reported WP on Tuesday.

As the administration and Pfizer hammered out the final details, the company asked federal regulators to authorize the five-day antiviral pill regimen called Paxlovid. The medication is the second easy-to-take treatment aimed at keeping newly infected people out of the hospital to go before the Food and Drug Administration. The other is by Merck and Ridgeback Biotherapeutics.

"Biden aides see both treatments as potential game-changers to help restore a sense of normalcy heading toward the pandemic's second anniversary" and are eager to add them to a still-small collection of treatments for Americans who contract the coronavirus, according to the report.