The steady pace of highly pathogenic avian influenza outbreaks at commercial poultry farms and in backyard flocks continues, with the virus striking 11 more commercial farms across seven states, according to updates over the past few days from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).

Affected premises include two broiler farms in Arkansas; more turkey farms in Ohio, Minnesota, and South Dakota; and a duck farm and a layer farm in California. Colorado and North Dakota also reported more outbreaks at commercial farms. Also, the virus hit backyard poultry in seven states, including Colorado, Idaho, Iowa, Kansas, Michigan, Montana, and South Dakota.

Since H5N1 first turned up in US poultry in early 2022, the outbreaks have led to the loss of a record 68.4 million poultry across 47 states. In the past 30 days alone, the virus has fueled outbreaks in 24 states.

A new retrospective analysis of the California State Inpatient Database during 2020 shows Hispanic residents were disproportionately affected by the pandemic, with both the highest mortality rates and intensive care unit (ICU) admissions throughout the state.

The study, published in Scientific Reports, and adds to the growing body of literature showing significant racial disparities during the COVID-19 pandemic in the United States.

All hospitalizations for adults ages 18 and older were included in the final analysis. Among a total of 87,934 COVID-19 hospitalizations, Hispanics accounted for 56.5% of patients, followed by White (27.3%), Asian, Pacific Islander, Native American (9.9%), and Black (6.3%) residents of California.

When compared with White counterparts, Hispanic patients had a higher mortality risk, with a hazard ratio (HR) of  0.91 (95% confidence interval [CI], 0.87 to 0.96).

Hispanics most affected in California

Both Hispanic and Black patients had significantly greater odds of ICU admission compared to Whites (odds ratio [OR], 1.70; 95% CI, 1.67 to 1.74 for Hispanics and OR, 1.70; 95% CI, 1.64 to 1.78 for Blacks).

The risk of all-cause in-hospital mortality was significantly higher among Hispanics and associated with older age, male sex, and comorbidities.

Compared with other races and ethnicities, hospitalized Hispanics were also significantly younger, with 43.9% in the age group 45 to 64 years, while among Whites (46.5%) and Asian, Pacific Islander, Native Americans (40.0%), most hospitalized patients were in the age group 65 to 84 years.

The authors of the study said the proportion of comorbidities, such as diabetes mellitus, obesity, and liver disease, were highest among Hispanics.

"In this study of COVID-19 hospitalizations in California, the risk of all-cause in-hospital mortality was significantly higher among Hispanics and associated with older age, male sex, and comorbidities," the authors concluded.

If the United States had rolled out COVID-19 booster doses with the same speed and consistent public health messaging as Israel, another 29,000 US lives could have been saved by June 2022, estimates a new study published in Health Affairs.

The Northwestern University-led study team mined COVID-19 death and vaccination data for Milwaukee County, Wisconsin, for 2017 to 2022 to estimate vaccine effectiveness against death among people ages 55 years and older. They then extrapolated the estimates to national death and vaccination data.

The study authors also estimated the number of lives that could have been saved had the US booster campaign started later than Israel's but with the same uptake speed and coverage, as well as the potential number of additional lives lost had the US rollout been slower but with the same uptake.

On July 29, 2021, Israel became the first country to roll out COVID-19 boosters for adults ages 60 and older, expanding quickly to all adults who completed the primary vaccine series at least 5 months before. US authorization lagged Israel's by 2 months, starting on September 18, 2021, and only for older and high-risk people 6 months after primary vaccination; authorization was expanded to all adults on November 29.

US rollout still may have averted 42,000 deaths

Of 300,791 COVID-19 deaths among people 55 and older, 56,566 occurred among vaccinated people eligible for boosters, and an estimated 29,418 (52%) of those deaths could have been prevented had the United States followed Israel's lead with the booster rollout.

Moving more slowly to approve boosters, as some advocated, would have cost many additional lives.

"However, FDA [US Food and Drug Administration] scientists and others questioned whether boosters were needed at all and how soon they might be needed, and they wanted to prioritize initial vaccination and save vaccine doses for poor countries," the researchers wrote.

But while US regulatory caution amid a pandemic had a large, avoidable cost, "the US booster rollout still avoided 42,000 deaths," they added. "Moving more slowly to approve boosters, as some advocated, would have cost many additional lives."