Many were eager to read the published report by Public Health England regarding deaths from COVID-19, especially given the high mortality rate amongst the Black, Asian and Minority Ethnic (BAME) community. Disappointingly, there was little guidance on how the government intends to mitigate the risks of BAME healthcare workers contracting Covid-19.
The report contained information already known of the disproportionate impact COVID-19 has had on the BAME community in comparison to their White/British counterparts. In particular, the report mentioned key factors, such as associated health conditions, that would inevitably put BAME people at a higher risk of dying from the coronavirus. For instance, stating that people of Bangladeshi and Pakistani background have a higher rate of cardiovascular disease than people of White/British ethnicity. Furthermore, people of Black Caribbean and Black African ethnicity have higher rates of hypertension when compared with other ethnic groups.
However, it appears other important factors such as occupation were not taken into account as much as possible. Occupation is a vital factor, as it plays a major role in assessing the impact COVID-19 has had on BAME communities. The report, however, shifted its focus onto other factors, such as death rates in deprived areas. These factors have been thoroughly discussed since the outset of the pandemic, especially in the context of the disproportionately high BAME mortality rate.
In particular, deaths of BAME health workers have grown substantially in the public consciousness, leading to Dr Chaand Nagpaul, Chair of the Council of the British Medical Association, urging for an investigation into why Black, Asian and Minority groups are more at risk of COVID-19. Despite this, significant improvement and shift on this issue is yet to be seen, especially as the report failed to provide a solution.
I believe the government should provide guidance on how they will address the structural inequalities that exist within our society, which have led to people from the BAME community to be disproportionately affected by COVID-19.
For instance, those who come from poorer backgrounds have little choice but to go to work and put themselves at risk of contracting COVID-19, as opposed to being able to self isolate and work remotely. This stems back to the link of health and racial inequality present within society. Consequently, individuals from BAME communities sometimes live in fear, a direct result of the Government’s failure to provide a solution that prioritises and fully protects those at high risk.
Rebecca Hilsenrath, chief executive of the Equality and Human Rights Commission, said: “People are more than statistics, and we cannot afford to ignore the broader context of entrenched race inequality across all areas of life. Only a comprehensive race equality strategy will address these issues.”
The report also failed to fully acknowledge and provide guidance on BAME health workers who work for the NHS, and as a result are in direct contact with patients diagnosed with COVID-19.
It is true that the NHS has provided recommendations and risk assessments in order to help reduce the risk of BAME health workers from contracting COVID-19. However, this has not appeared to have had any significant impact on their mortality rate.
Despite the fact that the COVID-19 pandemic has now been ongoing for a number of months, NHS BAME health workers are still expressing their concerns over the lack of PPE and insufficient training on its use. They have also expressed fear of contracting the virus and spreading this to vulnerable household members.
There has also been talk of ‘systematic discrimination’ as health workers in the NHS have reported that people from BAME backgrounds are more likely to be chosen to work in the front line to treat patients with COVID-19.
The Royal College of Physicians (RCP) found that 48% of all doctors who responded to its survey were either concerned or very concerned for their health, a figure that rose to 76% among BAME doctors.
Dr Chaand Nagpaul has said, “The BMA and the wider community were hoping for a clear action plan to tackle the issues, not a re-iteration of what we already know. We need practical guidance”.
Whilst the Health Secretary Matt Hancock acknowledged that the pandemic has revealed the “injustice” in our healthcare system, he disappointingly failed to provide a form of solution as to how the government intends to resolve these issues.
Discussion of disproportionate deaths within the BAME community is certainly not new. As time progresses, we grow more familiar with the idea of living with COVID-19. The pandemic, however, has revealed that public health can so easily be undermined by various factors, such as marginalisation, poverty, and perhaps even through racial discrimination. This does not necessarily mean that the pandemic discriminates; it is our society and our healthcare system that is not innocent and perhaps even prone to discrimination.
We must not be silent on this issue. As well as prioritising and safeguarding the public’s health, we must urge the government to provide a cohesive solution that helps to protect the BAME community.