On Saturday, April 11th, Britain had lost almost 1000 people to coronavirus within 24 hours. Foreign Secretary Dominic Raab has announced for three weeks extension of the UK lockdown. Most UK newspapers said that BAME (Black, Asian, Minority Ethnic) people are highly vulnerable to this virus and three times more likely to end up in the ICU. Some media organisations even attributed that an absence of “culturally sensitive message” in multi-lingual languages is one of the causes of higher coronavirus infection rates within the BAME community.
“That is not the reason. There is plenty of awareness within the BAME community with regards to coronavirus. The increase in the coronavirus deaths within the BAME community can be attributed to a mix of co-existing health issues and poor socio-economic conditions in which they live.
“The health conditions can vary from diabetes to skin diseases to asthma. Some concern was expressed earlier about certain blood pressure tablets possibly increasing the risk to coronavirus. Please note that is not true. We have strictly advised patients not to change their tablets unless medically specified and prescribed,” said Dr. Adnan Sharif, a consultant transplant nephrologist at Queen Elizabeth Hospital (QEH) Birmingham.
QEH is part of the University Hospitals Birmingham NHS Foundation Trust, and as of April 11th, the hospital had recorded over 400 COVID-19 deaths— the highest toll of any hospital across the UK. According to Dr. Sharif, the hospital had tested over 5,000 patients with over 2,000 of them reportedly positive of Coronavirus.
“We have witnessed that for every 10 patients who are being admitted of coronavirus in our hospital, four of them are from BAME backgrounds. Most of them are predominantly Asians.”
There is no definitive study or research conducted by any health institution within the UK which enumerate the reasons for BAME members being disproportionately affected by the virus. But there are several factors which explain this trend.
First, poverty is the highest in the BAME community, especially among Blacks, Pakistanis, and Bangladeshis. Many of them live in overcrowded houses. Though Indians are comparatively richer, they also live with extended families- elderly parents and grandparents, making them more vulnerable to the illness.
Second, people from ethnic minority backgrounds have more underlying conditions like hypertension, blood pressure, and diabetes. Their food habits are generally spicier with a higher BMI (Body Mass Index) thus, making them more susceptible to the virus. Evidence from doctors so far shows, that most admitted in the ICU from the Asian community are between 45-55 years old.
Third, BAME members tend to live in urban areas. And given the proportion of BAME residents in a certain local borough, there is a likelihood of seeing disproportionately higher patients of BAME background than whites. Channel 4 reported that ICNARC researchers compared the ethnicity of COVID-19 patients with the make-up of the ethnicity of those patients who live there. They found that 65% of COVID-19 patients receiving critical care are of white background from areas that have 74% white residents. The proportion of Asians in that area is around 13% and the patients in ICU are almost the same- around 13%.
“Asian families have multiple generations living in a single household which leads to an increase in their everyday social interaction. What kind of social distancing would be followed by a family of 11 members living in a 3-bedroom house?” asks Dr. Adnan.
Fourth, since colonialism, especially after the second world war, Asians were brought into this country to rebuild the devastated nation. The highest population among ethnic minorities in the UK is that of Indian origin- 1.5million according to the 2011 Census. Many of whom are the frontline staff- mainly doctors and nurses. Since the result of Brexit, BAME doctors have migrated to the UK to fill in the increasing gap in the market.
Councils and local authorities not collating deaths
The NHS has not been filtering and recording the COVID-19 deaths according to their ethnic background. In the meantime, one would expect that these deaths would be registered locally with their council bodies. However, some council bodies have reportedly stopped collating the COVID-19 deaths.
“We are no longer officially notified, as the local authority about any deaths due to COVID-19. The total number of deaths is recorded nationally but not broken down further,” said a council authority of London who did not wish to be identified.
In the meantime, congressional prayers and gatherings within the Asian community has also raised red flags. Whilst the annual Vaisakhi procession in Southall has been cancelled, healthcare professionals are concerned with fellow Muslims gathering for Ramadan prayers and therefore, breaking the chain of social isolation. The epidemic which had first clutched onto Wolverhampton seems to have spread to Dudley and then, throughout Birmingham which remains a densely populated area.
Recently 10 doctors who passed away due to coronavirus, were of BAME background, with ancestry from regions such as Asia including India, Pakistan and Bangladesh, the Middle East and Africa. The head of the British Medical Association Dr. Chaand Nagpaul has called on the government to investigate if and why BAME people are more likely to die from coronavirus.
Although BAME staff make up 44% of medical personnel in the NHS, Dr Nagpaul said that the fact that those who have died were all from ethnic minority backgrounds is 'extremely disturbing'. Besides the 10 doctors, three out of six nurses who died from the virus were from the BAME community, as was a hospital pharmacist and at least one healthcare assistant.
The Labour party has acted on Dr. Nagpaul’s concern with Shadow equalities minister Marsha de Cordova insisting that "the Government must urgently investigate why BAME communities are more vulnerable to this virus."
Some of the British media have been busy ridiculing India for how the country’s poor have been suffering. It’s not wrong to be critical of a nation, where class disparity has always been a stark reality, but frankly, Britain criticising India on coronavirus effect is more like the ‘pot calling the kettle black’!
When thousands have died in a day in the UK (a death rate/day higher than Italy so far), the media has been focussing on Prime Minister Boris Johnson’s recovery or on the herculean effort of the government to procure 3000 PPEs. With all that blasé logic of ‘herd immunity’, the reality remains that, our Prime Minister Mr. Johnson, was a month late to take necessary actions.
A member of BAPIO, Dr. Parijat Bhattacharjee, is a consultant across North-west London hospitals including Northwick Park, Central Middlesex, and Ealing. Speaking exclusively to Asian Voice, he said, “Deaths among ethnic minority doctors and nurses are indeed disproportionate. But are we more susceptible to coronavirus related deaths? I can’t say. Hypertension, diabetes and higher BMI among South Asians in the UK are prevalent. These could be contributing risk factors. On top of this cultural factors may add to the absence of social isolation, especially in families with elderly members.”
He added, “There is no concrete evidence that medics from ethnic minority backgrounds are being discriminated against or forcefully being exposed to coronavirus more than others. Doctors who have died have been senior consultants in various hospitals. It shows that as a community, we are very hardworking and highly committed to our jobs. There is, in fact, a possibility, that there is a cultural implication here- gratefulness towards this country as migrants, leading to certain ethics, values, professionalism, and dedication towards our jobs. And there is a strong possibility that these are causing higher deaths among ethnic minority medics.”
Dr. Arjun Ghosh is a Consultant Cardiologist at Barts Heart Centre (BHC), St. Bartholomew’s Hospital, London and at University College London Hospital (UCLH). His normal duty has now changed into a covid duty. Speaking to Asian Voice, he said, “It is difficult to say whether the BAME community is more susceptible to the virus. But among BAME medics, there is a possibility, because we make up more of front line acute staff.”
Vaccination and the future
Researching on the progress of the vaccination to fight the deadly virus, Dr. Parijat said, “The first human trial of a vaccine has started in the USA (by Modern) on 16 March 2020. This is an extremely rapid progress (unprecedented in the history of vaccine development). The genetic sequence of the virus was published by China on 11 January 2020. There are 115 different developers, 78 of which are open/ public - out of which 73 are still in a preliminary developing stage in Lab. 72% are private companies including Glaxo and Janssen. 28% are government or academic institutions. 46% in the USA, 18% each in China, Asia, Europe.
“The aim is to release it in early 2021 under 'Emergency Protocol'. Traditionally, vaccines take an average of 10 years to be released for public use. Even the deadly Ebola vaccine was released after 5 years as 'urgent'.
“90% of all vaccines developed on average for a particular disease are rejected Therefore, gross modifications of development, regulatory & manufacturing processes will be needed. Most importantly there may be gross concerns about the safety & effectiveness of the vaccine when it is released.
“Finally just finding a vaccine is not the endpoint. Funding will become paramount to ensure wide, rapid and most importantly for government agencies and health organisations for equitable uptake, particularly in poorer countries, else it will be pointless for a disease like this.”
