Dr Sarath Obeysekera
In the UK, people from BAME (Black, Asian, and Minority Ethnic) backgrounds are disproportionately affected by Coronavirus. For instance, the first 10 doctors named as having died from Covid-19 in the UK were all from BAME communities. Nobody can give a good enough reason for this yet and the UK government has already launched an investigation/inquiry to find out why.
Attached below are two newspaper articles on the subject, one
from Guardian (left wing) and another from Telegraph (right wing) for your
info.
Is there a similar trend/ finding in Canada, US and Why are
people from BAME groups dying disproportionately of Covid-19?
Last month the Institute of Health Equity-produced a
report reviewing Marmot’s Fair Society, Healthy Lives.
The report highlighted two key findings; a growth in the health gap between
wealthy and deprived areas and an increase in the number of people who will
spend more of their lives in poor health.
The review also found that the health of a population was not entirely based on the strength, resilience, or functionality of the healthcare system but rather on the conditions in which people are born, grow, work and eventually age. Marmot coined this as the social determinants of health and the implications of this are evident more than ever when you look at the case prevalence, mortality rate and hospitalisation statistics by demographic in relation to Covid-19.
A recent report by the Intensive Care National Audit and Research Centre has found that the patients from black and ethnic minority backgrounds have shown more severe complications of the disease. The study looked at 2,249 patients in the critical care units participating in the Case Mix Programme. Individuals who identified as non-white makeup around 13 percent of the UK population but accounted for a third of the patients that were admitted to critical care.
theguardian.com/world/2020/apr/22/why-are-people-from-bame-groups-dying-disproportionately-of-
covid-19
Hannah Devlin April 22, 2020
One explanation for why people from black and minority ethnic
(BAME) backgrounds are dying in disproportionately high numbers is demography.
The virus hit London first and hit it hardest. But even when you take these
regional differences into account there is a mismatch. In particular, if you
take into account that ethnic minorities are generally younger – particularly
important for Covid-19 where 90% of deaths are in people over 60 – the ethnic
differences become even more stark.
Co-morbidities could certainly play a role. The black
population, where the discrepancy appears to be greatest, is particularly
afflicted with hypertension. Diabetes is three-fold higher in this ethnic
group. Both of those conditions will increase your risk of death once you’ve
got Covid. The added problem is that these conditions occur at a younger age in
people of black descent. However, in mitigation against that, certainly older
people of black African descent don’t smoke as much, so have less respiratory
disease, have lower rates of cancers and coronary disease.
With Asian populations, the story is a bit different, but again
there is a four-fold excess in diabetes and blood pressure rises higher with
age in South Asians compared to Europeans.
Genetics sounds like an easy get-out clause, but it isn’t.
Ethnicity is a complex socio- cultural construct, it’s not a biology construct.
There’s no gene for being Asian. There’s no gene for being black. People of
ethnic group membership can change over time and with age, it’s not an
immutable thing and it very poorly maps on to any biology you can think of.
People have looked to see if there’s a genetic explanation for these ethnic
differences in chronic disease and have been unable to find one, despite having
looked quite hard in large numbers. So there’s no evidence that genes explain
the excess risk of Covid susceptibility. It’s important to put a nail in that
one because it feels as if we can abdicate any responsibility for sorting this
out and this
Ethnic minorities are over-represented in high-risk occupations,
including health workers, in the transport sector and essential shop work.
Clearly, there’s a huge amount of heterogeneity, but overall ethnic minorities
are more likely to live in deprived, dense, over-crowded urban areas and are
more likely to be disadvantaged. In some cases, household composition could
play a role, particularly in Asian households where you have multi-generational
households living together.
So both through occupation and residential reasons,
they’re less able to socially isolate effectively and much more likely to be
exposed to high doses of the virus. There’s some suggestion that the greater
the dose you’re exposed to the more likely the disease is to prove fatal.
That’s perhaps one reason why even quite young healthcare workers are
succumbing to the disease.
The evidence on ethnic differences in healthcare-seeking behavior is quite messy, and we need to remember that these are quite heterogeneous groups. For instance, people of black ancestry have been found to be less likely to consult for chronic diseases like diabetes, but that doesn’t mean to say that if it’s an acute condition they won’t come forward. One study of people accessing antiviral flu treatments in the flu pandemic of 2009 found that ethnic minorities were less likely to ask and less likely to collect these. But whether this was due to reluctance, differences in access to healthcare, the way the message was put across or racism – it is difficult to pick apart because the healthcare-seeking process is so complicated.
Ultimately, this is about health inequalities, about deprivation
and affluence and how important socio-economic status is in determining health
outcomes. This isn’t just an ethnicity story, it affects all of us. Britain has
a long history of health inequalities. It’s critically important to understand
and I’m relieved that the government is taking this seriously.
Prof Chaturvedi is director of the MRC Unit for Lifelong
health
Why are so many black and ethnic minority people dying from
coronavirus?
telegraph.co.uk/news/0/why-bame-people-dying-coronavirus-black-ethnic-minority/
By Gabriella Swerling, Dominic
A review into why people from ethnic minorities are
disturbingly” and disproportionately affected by coronavirus has been launched
by the Government.In UK
The inquiry comes after weeks of pressure on ministers to launch
an investigation into the issue. 50 BAME front-line health staff have now died
of coronavirus.
Downing Street confirmed the NHS and Public Health England will
lead the review of evidence concerning the impact on people black, Asian and
minority ethnic (BAME) backgrounds.
How many BAME people have died?
Despite only accounting for 13 per cent of the population in
England and Wales, 44 per cent of all NHS doctors and 24 per cent of nurses are
from a BAME background. Of the 82 front-line health and social care workers in
England and Wales that have died because of Covid-19, 61 per cent of them were
black or from an ethnic minority.
Among them was Abdul Mabud Chowdhury, a 53-year-old consultant
who warned the Prime Minister about the need for more personal protective
equipment (PPE) to support NHS staff during the pandemic.
In a Facebook post last month, he warned Boris Johnson to
ensure urgently personal protective equipment for each and every NHS worker”.
Mr Chowdhury, who worked as a consultant urologist at Homerton
Hospital in east London, said in his post: People appreciate us and salute us
for our rewarding job which are very inspirational but I would like to say we
have to protect ourselves and our families/kids in this global disaster/crisis
by using appropriate PPE and remedies.”
Manjeet Singh Riyat, who was the United Kingdom’s first Sikh
A&E consultant, died on April 20. Mr Riyat was described as
“instrumental” in building emergency services in Derbyshire over the
last two decades, and was widely respected across the NHS.
Bhai Amrik Singh, the Chair of the Sikh Federation (UK) said:
Manjeet had spent most of his life helping others as an A&E consultant,
from treating the sick to training junior doctors. Something very much in line
with his faith principles of being a devout Sikh.
This is a true tragedy, as another frontline NHS worker
falls victim to this deadly virus. His death comes as a huge loss to the Derby
& Burton hospital, wider NHS family and to the whole Sikh community.”
The limited data available and images of those who have passed
away suggests Covid- 19 is disproportionally impacting on Sikhs and wider BAME
communities.”
Dr Chaand Nagpaul, British Medical Association (BMA) council
chair, welcomed the review into BAME deaths, but stressed it must be informed
by real-time data to understand why the virus appears to be disproportionately
affecting BAME communities and healthcare workers.
This must include daily updates on ethnicity, circumstance and
all protected characteristics of all patients in hospital as well as levels of
illness in the community which is not currently recorded,” Dr Nagpaul said.
The government must send a directive to every hospital telling
them to record the ethnicity of patients who are admitted and succumb to COVID
immediately.”
Why are there more BAME coronavirus patients?
Black, Asian and minority ethnic patients are shown by new data
to face a disproportionately high risk of death from coronavirus. Of the 13,918
victims who tested positive in hospital up to April 17, 16.2 per cent of these
were of BAME background. BAME communities make up around 13 per cent of the
total population.
Last week, data on patients with confirmed Covid-19 from the
Intensive Care National Audit and Research Centre (ICNARC) also suggested
ethnic minorities are over- represented compared with the general population.
Around 7.5 per cent of the population were Asian and 3.3 per
cent black in the 2011 UK census.
The first 10 doctors named as having died from Covid-19 in the
UK were from BAME communities – a figure that the Labour Party described as
“deeply disturbing”.
Some analysts have suggested that the burden of coronavirus falls
on poorer communities, in which BAME people are over-represented.
Are BAME communities more vulnerable?
Marsha de Cordova, the shadow equalities secretary, called for
the Government to “urgently investigate why BAME communities are more
vulnerable to this virus”.
Her call came after the chairman of the BMA, Dr Nagpaul, said it
could not be random that the first 10 doctors named as having died from the
virus were all from BAME communities.
Those doctors have ancestry in regions including Asia, the
Middle East and
Africa. However, the BMA chair said that even allowing for the
over-representation of BAME staff in the NHS the fact that they were all from
ethnic minorities was extremely disturbing and worrying”.
England’s Chief Medical Officer, Prof Chris Whitty, said it was
critical to find out which groups are most at risk. He said it remains unclear
why some ethnic groups appear to be more vulnerable. “I’ve had discussions
with scientists about this in terms of trying to tease this apart today,”
he said.
What about BAME patients outside of the UK?
It is not just in the UK that the number of BAME people affected
by coronavirus has caused alarm.
In the United States, there has been growing concern over the rising number of coronavirus deaths among African-American communities.
The latest data suggests that people who are black or Hispanic in the US are twice as likely to die from Covid-19.
In states reporting fatalities by race, 34 percent of American victims were black, according to research from John Hopkins University, and black Americans also represent
Note
It is essential that Sri Lankan research organizations ponder
into the fact that the rate of infection of high portion of a certain minority
may be due to their life style
One said that moor community attends the prayers and keep touching the floor by placing the temple on the ground and also place both unprotected hands on their face thus increasing the danger of getting infected ?
Dr Sarath Obeysekera
Dr Sarath Obeysekera
CEO Walkers Colombo Shipyard
Colombo
Sri Lanka
