Why are more people from BAME backgrounds dying of Covid-19? A GP’s take on the new government report

The highly anticipated report from Public Health England has exposed some stark racial disparities in Britain when it comes to Covid-19 - but are we any closer to finding out why?
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  • The report, titled ‘COVID-19: review of disparities in risks and outcomes’, was released 2 June and showed that people from Black, Asian and ethnic groups are up to twice as likely to die with Covid-19 than those from white British backgrounds.

    This statistic is even higher when it comes to those on the front line. Of the 169 front-line health and social workers in England and Wales known to have died from contracting coronavirus, 63.9% were people from BAME backgrounds. Of the 29 British doctors who have died of coronavirus during the pandemic, 27 were from BAME backgrounds, according to reporting by the Washington Post. 

    Last week, the government released the Public Health England report addressing disparities with Covid-19, after initially announcing there would be a delay due to the Black Lives Matter media focus. But, for many, the report has generated more questions than answers. 

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    We spoke to Dr Adwoa Danso, a GP in London and board member of the Ghanaian Doctors and Dentist Association UK. Adwoa works tirelessly using her Instagram @theclinicdiaries to promote health knowledge within her community and was recently awarded Health and Wellbeing Advocate 2019 at the National BAME Health and Social Care Awards.

    Death rates have been reported to be up to 50% higher for those with BAME backgrounds – does the report answer why?

    It is disappointing that the report makes no attempt to explain why there is a disproportionately higher death rate in BAME individuals. As a black doctor, knowing that my risk is much higher but not knowing why is difficult to process. 

    There has been much speculation and numerous theories floating around, but we need recommendations and clarity – not just for ourselves, but for our patients. 

    What are your theories on why this statistic is so high? 

    There has been evidence of discrimination and structural racism within the NHS before the pandemic – we cannot ignore that this would have had an impact on the BAME population. Ongoing distrust and uncertainty of policies will naturally lead to poor outcomes. 

    We also are aware that other medical issues such as diabetes and high blood pressure are more common in this group, which leads to a poorer outcome. 

    What would you have wanted to see more of in the PHE report? 

    We need to understand what is driving these disparities. We need to know how these inequalities can be addressed with specific ethnic groups in mind so they can be safeguarded as necessary. 

    A ‘second wave’ has been widely speculated and details of how to manage this would be necessary for us to be confident that the government is acting to rectify any issues identified initially.

    It took six weeks for the government to release this information – has this longer time frame been detrimental? 

    Absolutely – it has caused a lot of speculation, uncertainty, and the birth of myths.

    Most concerning is that it also went some way to propel the distrust of the health system, which already runs deep within some of the higher-risk communities. 

    Have you been able to glean anything that’s useful from the report when it comes to offering BAME patients advice and support? 

     The report confirms what I and many others already suspected. Without any recommendations provided, inferring from this report can be highly subjective. 

    As medical professionals, our patients are the priority and we want to ensure they continue to be supported during this time.

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    Do you have advice for people from BAME backgrounds on how to protect themselves from Covid-19? 

    It is vital you become aware of your medical problems and any other factors which may affect your risk. If you are unsure or need clarification speak to your GP. 

    Although lockdown appears to be easing, the threat of coronavirus exists, so continue to protect yourself and your family. If you have concerns about workplace safety, do not hesitate to contact your employer or GP for further advice.

    The key question is between genetics and social/environmental factors – are we any closer to an answer? 

    Yes we are, but we need much more.

    What do we need now, in terms of more research and clarity? 

    I think we need further research within the BAME group. Genetics are widely different between Black and Asian people, with even more differences among black people. 

    Grouping numerous ethnicities into one group can be detrimental and we now have evidence how ethnicity affects coronavirus. Many have died, including colleagues and key workers. We need a public inquiry.  

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    What needs to change in the NHS to keep people of BAME backgrounds safe? 

    Clear guidance on how employers can safeguard their staff. We know, for example, that BAME groups are twice as likely less to speak out about an unsafe work environment. 

    We need to encourage them to speak out about their concerns and not be fearful of repercussions. The pandemic has shone a light on health inequalities and structural racism; this is the time to address these very serious issues.

    You can follow Adwoa Danso on Instagram – @theclinicdiaries.

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