For the first time in known history, Alabama in 2020 had more deaths than births in a single year.

The state’s population shrinkage, which Alabama Health Officer Scott Harris attributed to deaths from covid-19, comes as officials in states across the South and West are tallying grim hospitalization and death numbers amid a fourth wave of infection due to the delta variant of the coronavirus.

On Friday expert advisers to the Food and Drug Administration voted unanimously to recommend that the agency authorize a booster shot of the Pfizer-BioNTech coronavirus vaccine for people 65 years and older or who are at risk for serious disease.

Here’s what to know

  • Rationing medical care, one of the most feared scenarios of the pandemic, is becoming a reality in a few parts of the United States as coronavirus infections remain at surge levels.
  • The Biden administration is buying hundreds of millions more doses of the Pfizer-BioNTech coronavirus vaccine to donate to the world, according to two people familiar with the deal.
  • Federal employees can be fired for refusing to be vaccinated against the coronavirus, but as their disciplinary cases wind through the system, they will report to work alongside vaccinated colleagues, according to Biden administration guidance issued this week.
  • Researchers have found that the Moderna vaccine is the most effective against covid-19 hospitalization.