By MATTHEW PERRONE

WASHINGTON (AP) — Pfizer Inc. said Friday that its experimental antiviral pill for COVID-19 cut rates of hospitalization and death by nearly 90% in high-risk adults, as the drugmaker joins the race to bring the first easy-to-use medication against the coronavirus to the U.S. market.

Currently all COVID-19 treatments used in the U.S. require an IV or injection. Competitor Merck’s COVID-19 pill is already under review at the Food and Drug Administration after showing strong initial results, and on Thursday the United Kingdom became the first country to OK it.

Pfizer said it will ask the FDA and international regulators to authorize its pill as soon as possible, after independent experts recommended halting the company’s study based on the strength of its results. Once Pfizer applies, the FDA could make a decision within weeks or months. If authorized the company would sell the drug under the brand name Paxlovid.

Researchers worldwide have been racing to find a pill against COVID-19 that can be taken at home to ease symptoms, speed recovery and reduce the crushing burden on hospitals and doctors.

Pfizer released preliminary results Friday of its study of 775 adults. Patients who received the company’s drug along with another antiviral shortly after showing COVID-19 symptoms had an 89% reduction in their combined rate of hospitalization or death after a month, compared to patients taking a dummy pill. Fewer than 1% of patients taking the drug needed to be hospitalized and no one died. In the comparison group, 7% were hospitalized and there were seven deaths.

“We were hoping that we had something extraordinary, but it’s rare that you see great drugs come through with almost 90% efficacy and 100% protection for death,” said Dr. Mikael Dolsten, Pfizer’s chief scientific officer, in an interview.

Study participants were unvaccinated, with mild-to-moderate COVID-19, and were considered high risk for hospitalization due to health problems like obesity, diabetes or heart disease. Treatment began within three to five days of initial symptoms, and lasted for five days. Patients who received the drug earlier showed slightly better results, underscoring the need for speedy testing and treatment.

Pfizer reported few details on side effects but said rates of problems were similar between the groups at about 20%.

An independent group of medical experts monitoring the trial recommended stopping it early, standard procedure when interim results show such a clear benefit. The data have not yet been published for outside review, the normal process for vetting new medical research.

Top U.S. health officials continue to stress that vaccination will remain the best way to protect against infection. But with tens of millions of adults still unvaccinated — and many more globally — effective, easy-to-use treatments will be critical to curbing future waves of infections.

The FDA has set a public meeting later this month to review Merck’s pill, known as molnupiravir. The company reported in September that its drug cut rates of hospitalization and death by 50%. Experts warn against comparing preliminary results because of differences in studies.

Although Merck’s pill is further along in the U.S. regulatory process, Pfizer’s drug could benefit from a safety profile that is more familiar to regulators with fewer red flags. While pregnant women were excluded from the Merck trial due to a potential risk of birth defects, Pfizer’s drug did not have any similar restrictions. The Merck drug works by interfering with the coronavirus’ genetic code, a novel approach to disrupting the virus.

Pfizer’s drug is part of a decades-old family of antiviral drugs known as protease inhibitors, which revolutionized the treatment of HIV and hepatitis C. The drugs block a key enzyme which viruses need to multiply in the human body.

The drug was first identified during the SARS outbreak originating in Asia during 2003. Last year, company researchers decided to revive the medication and study it for COVID-19, given the similarities between the two coronaviruses.

The U.S. has approved one other antiviral drug for COVID-19, remdesivir, and authorized three antibody therapies that help the immune system fight the virus. But they have to be given by IV or injection at hospitals or clinics, and limited supplies were strained by the last surge of the delta variant.

Shares of Pfizer spiked more than 9% before the opening bell Friday.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

By DAVID KOENIG

AP – Tens of millions of Americans who work at companies with 100 or more employees will need to be vaccinated against COVID-19 by Jan. 4 or get tested for the virus weekly under government rules that took effect Thursday.

The Occupational Safety and Health Administration said companies that fail to comply could face penalties of nearly $14,000 per violation.

The new requirements, which were first previewed by President Joe Biden in September, will apply to about 84 million workers at medium and large businesses, although it is not clear how many of those employees are unvaccinated.

Tougher rules will apply to another 17 million people who work in nursing homes, hospitals and other facilities that receive money from Medicare and Medicaid. Those workers will not have an option for testing and will need to be vaccinated.

It was unclear how OSHA planned to enforce the rules. A senior administration official said the agency would target companies if it gets complaints.

Workers will be able to ask for exemptions on medical or religious grounds.

The release of the rules followed weeks of regulatory review and meetings with business groups, labor unions and others. The regulations form the cornerstone of Biden’s most aggressive effort yet to combat the spread of COVID-19, which has killed more than 740,000 people in the U.S.

OSHA drafted the rules under emergency authority meant to protect workers from an imminent health hazard. Senior administration officials said the rules preempt conflicting state laws or orders, including those that ban employers from requiring vaccinations, testing or the wearing of face masks.

The administration will face an immediate challenge from Republican state officials who are eager to fight Biden in court. More than two dozen Republicans serving as state attorneys general have indicated they plan to sue, arguing that only Congress can enact such sweeping requirements under emergency authority.

Last week, 19 states sued to stop Biden’s narrower mandate that employees of federal contractors be vaccinated. That requirement was scheduled to take effect Dec. 8, but the administration said Thursday it will be delayed until Jan. 4 to match the requirements on other large employers and health care providers.

Workers will need to receive either two doses of the Pfizer or Moderna vaccine or one dose of the Johnson & Johnson vaccine by Jan. 4. Unvaccinated employees must submit a verified negative test to the company at least once a week and wear face masks on the job.

Employees who test positive must be removed from the workplace.

OSHA will require businesses to provide paid time off for employees to get vaccines and sick leave to recover from side effects that prevent them from working. The requirements for masks and paid time off for shots will take effect Dec. 5.

Because vaccines are free, OSHA said, companies do not have to provide or pay for tests.

The Centers for Medicare & Medicaid Services issued a rule requiring vaccination for workers in 76,000 health facilities and home health care providers that get funding from the government health programs. A senior administration official said that several large private health care organizations imposed their own mandates and achieved high vaccination rates — 96% or higher — without widespread resignations.

The White House sees the new requirements as a potent tool to winnow down the ranks of the tens of millions of Americans who have thus far refused to get a shot.

For weeks, Biden has encouraged businesses not to wait for the OSHA rule to take effect. He has touted businesses that have already announced their own vaccine mandates and urged other companies to follow their lead.

Administration officials say those efforts are paying off, with about 70% of the nation’s adults now fully vaccinated.

However, some companies have expressed fear that some vaccine-hesitant workers might quit, leaving their workforces even thinner in what is already a tight labor market.

Several large business groups complained about the timing of the mandate. Retail groups worried that the requirement could disrupt their operations during the critical Christmas shopping period. Retailers and others also said it could worsen supply chain disruptions.

The mandate on federal contractors led to demonstrations by opponents, including workers at a NASA rocket engine test site in Mississippi. Some said they are immune because they contracted COVID-19. Others said vaccines violated their religious beliefs and constitutional rights.

“No one should be forced to take a medical treatment just to keep their job,” said Nyla Trumbach, an engineer at the site. “There’s years and years of experience and skill out here, and I just want anyone who’s watching to see what we stand to lose here if these people don’t keep their jobs.”

Dozens of groups sought meetings with administration officials to air their concerns and objections to likely provisions of the OSHA rule, including the U.S. Chamber of Commerce, the National Association of Manufacturers, the AFL-CIO and anti-vaccine organizations.

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Associated Press Writer Stacey Plaisance-Jenkins in Picayune, Mississippi, contributed to this report.

By NICHOLAS RICCARDI

The off-year elections for governor in Virginia and New Jersey tend to receive outsize attention, and the results are mined for deeper meaning about what they portend for the midterm elections the following year that determine which party controls Congress.

Here are some key takeaways from Tuesday’s elections:

DEMOCRATS SEE WORST FEARS IN VIRGINIA

Democrats’ worst fears are that they’re on course for a 2010-like drubbing in next year’s midterm elections and that they can’t use the specter of former President Donald Trump to stop it.

Those fears got a lot stronger after Republican Glenn Youngkin won the governor’s race in Virginia.

President Joe Biden won Virginia by 10 percentage points just a year ago, and if Democrats cannot generate more enthusiasm than their gubernatorial candidate Terry McAuliffe did, they’ll likely be swept out of power in Congress.

In Virginia, governors are limited to a single term and elections are held in odd-numbered years, making it the go-to gauge of voter sentiment before midterms. It usually is a warning for the party in power in Washington and this year was no different.

McAuliffe, elected Virginia governor in 2013, was unable to excite voters amid significant headwinds facing Democrats, including Biden’s drooping poll numbers, the congressional stalemate over the president’s economic agenda and the persistence of the pandemic.

Democrats have only a five-vote margin in the House and a single-vote margin in the Senate. Historically, the party in power almost always loses seats in Congress. But if 2022 nationally is anything like Virginia 2021, Democrats will lose a lot more than normal.

YOUNGKIN SHOWS THE GOP THE WAY

Diversifying states with a large share of college graduates like Virginia have been an unsolvable puzzle for the GOP during the political era dominated by Trump. But Youngkin seems to have cracked the code.

A former private equity executive, Youngkin presented himself as a nonthreatening suburban dad in a fleece vest. He embraced Trump just enough to win the GOP primary and rev up the party base but was also able to target more moderate voters by talking about fiscal management and investing in schools and campaigning without the former president at his side.

According to AP VoteCast, a survey of voters, it paid off. While a majority of voters held an unfavorable view of Trump, about half had a favorable view of Youngkin.

Youngkin’s arm’s-length approach to Trump didn’t seem to hurt him with GOP voters. Most Youngkin voters, about 8 in 10, said the candidate supports Trump the right amount. About 1 in 10 said he supports the former president too much, and about that many said Youngkin supports Trump too little.

Look for more Republicans next year try to model themselves after Youngkin in swing areas — refusing to disavow Trump but not hugging him too closely, and tailoring their messages to both the former president’s most hardcore voters and persuadable suburbanites.

TARGETING EDUCATION ON RACE

Youngkin’s signature issue was an unexpected one — education. He prevailed on the issue by both pledging to boost education funding and hammering public schools on hot-button social issues like race and transgender rights.

He said he would ban the teaching of critical race theory in Virginia classrooms even though it is not a part of the secondary school curriculum.

Critical race theory is an academic framework that centers on the idea that racism is systemic in the nation’s institutions and that they function to maintain the dominance of white people. In recent months, it has become a catch-all political buzzword for any teaching in schools about race and American history.

The focus comes after lengthy school closures during the coronavirus pandemic infuriated some traditionally Democratic voting groups and conservatives targeted school board races nationwide over masking rules and teaching racial justice issues. In Virginia, 14% of voters listed education as a top issue, and about 7 of 10 of those voted for Youngkin.

McAuliffe didn’t help himself when, during a debate, he said, “I don’t believe parents should be telling schools what they should teach,” providing Youngkin a pivotal opening to hammer his opponent.

Youngkin also highlighted a controversial high school bathroom rape case in affluent Loudoun County, in Northern Virginia, to argue against allowing transgender students into their chosen restrooms.

LIBERAL VOTING LAWS AREN’T BAD FOR GOP

Democrats took control of all parts of Virginia’s government in 2019 and steadily started liberalizing the state’s voting laws. They made mail voting accessible to all and required a 45-day window for early voting, among the longest in the country. This year they passed a voting rights act that made it easier to sue for blocking ballot access.

Trump in 2020 attacked efforts to expand ballot access during the pandemic, spreading baseless claims of fraud.

Republican-controlled states have rushed to tighten voting laws, cutting early voting hours, restricting mail balloting and arguing that liberalizing elections invites fraud and helps Democrats. The latter claim contradicts repeated studies that have found that mail voting does not favor either political party.

Now Virginia’s election is another example of how liberal voting laws don’t hurt conservatives. Likewise, New Jersey Democrats greatly expanded access to mail voting in recent years but were struggling to hold onto the governor’s mansion in the solidly blue state.

NEW JERSEY ALSO SCARES DEMOCRATS

The other big governor’s race Tuesday was in New Jersey. Democratic Gov. Phil Murphy was favored in his race against Republican Jack Ciattarelli, but the race was too early to call Wednesday morning.

Democrats were looking to the Garden State for hopeful signs, but were quickly disappointed as what should have been a relatively easy race turned into a nail-biter.

Murphy has been able to deliver on many liberal priorities, like expanding government funding for widespread prekindergarten and community college, and has the advantage of incumbency that McAuliffe lacks. As such, he may offer more of a model of the position Democrats could be in next year should they manage to pass Biden’s agenda. He also avoided McAuliffe’s errors on education.

Still, the race remained tight well after midnight in a state Biden won by 16 percentage points, another sign of the grim national environment for the Democrats.

DON’T OVERINTERPRET

It’s still 12 months before Election Day 2022. While Tuesday’s results hold some clues as to what might happen, they are merely clues.

The two biggest drags on Democrats currently are the persistence of the coronavirus pandemic and supply chain problems that have pushed up prices. Both could improve over the next 12 months, potentially bolstering the incumbent party — or they could worsen.

There are signs Democrats could pass Biden’s infrastructure and social safety net legislation soon. Most Wall Street forecasts call for robust growth next year.

The U.S. Supreme Court is scheduled to issue an opinion on an abortion case next June that will determine whether the conservative majority upholds or overturns Roe v. Wade, the landmark case that affirmed abortion rights.

That could make debates over masking and racial justice lessons in schools seem like quaint relics of Election Day 2021.

So dig into the results of tonight, but they are in no way definitive. A lot can happen in the next year, and probably will.