A third of coronavirus patients in intensive care are from black, Asian and minority ethnic backgrounds, prompting the head of the British Medical Association to warn that government inaction will be responsible for further disproportionate deaths.
Chaand Nagpaul, the BMA Council chair, was the first public figure to call for an inquiry into whether and why there was a disparity between BAME and white people in Britain in terms of how they were being affected by the pandemic, in April.
Subsequent studies, including a Public Health England (PHE) analysis in early June, confirmed people of certain ethnicities were at greater risk, but Nagpaul said no remedial action had been taken by the government.
The proportion of people in intensive care in England, Wales and Northern Ireland who are not classified as white is 33.9%, very close to the 35% figure in April when the disparity was first identified, Intensive Care National Audit and Research Centre statistics show.
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According to the last census, 14% of the population of England and Wales are BAME, meaning they are significantly over-represented among the sickest coronavirus patients. More than 1,000 people are in hospital with Covid-19 across the UK, with the prime minister warning that a “second wave is coming”.
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Nagpaul told the Guardian: “We are continuing to see BAME people suffering disproportionately in terms of intensive care admissions so not acting means that we’re not protecting our vulnerable communities. Action was needed back in July and it’s certainly needed now more than ever.
“As the infection rate rises, there’s no reason to believe that the BAME population will not suffer again because no action has been taken to protect them. They are still at higher risk of serious ill health and dying.”
After the PHE report was criticised for failing to outline any recommendations to address the increased risk, the health secretary, Matt Hancock, said he had charged the equalities minister, Kemi Badenoch, with examining “what further could be done”. A subsequent PHE report in mid-June contained a series of recommendations:
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Ensure comprehensive ethnicity data collection, including on death certificates.
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Involve BAME communities in research to help understand the social, cultural, structural, economic, religious and commercial determinants of Covid-19
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Improve NHS experiences for BAME people including ensuring good representation of staff from minority ethnic communities at different levels.
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Accelerate development of culturally competent occupational risk assessment tools, particularly for key workers.
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Fund, develop and implement culturally competent Covid-19 education and prevention campaigns.
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Increase culturally competent health promotions promoting healthy weight, physical activity and management of diseases such as diabetes.
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Create long-term sustainable change by tackling ethnic inequalities.
Nagpaul said some of the PHE recommendations could have been immediately implemented, adding: “I am deeply concerned that three months since the publication of the PHE review, we have heard nothing from the government around any specific action or implementation of any of the recommendations.
“We must remind ourselves that the purpose of the review was to protect a sector of our population who have been disproportionately harmed.”
Other organisations, such as Independent Sage, have published their own recommendations. Dr Zubaida Haque, a member of Independent Sage and a former deputy director of the Runnymede Trust, said: “A good point to start is to ask the government: ‘What exactly have you done?’ Because we haven’t seen anything that they’ve done. It does feel like the ball’s been kicked into the long grass with the recommendations because we’ve never seen nor heard anything and we’re on the verge of the second wave.
“Have they set up necessary … accommodation support [for people self-isolating] and have they ensured that the public health messages around social distancing and help for self-isolation is reaching black and ethnic minority people on the ground, including those who may not be fluent [in English]?”
At the weekend, the government announced a £500 lump sum for low-paid workers who need to self-isolate as a result of Covid.
Simon Woolley, the director of Operation Black Vote, who has been campaigning for a Covid-19 race equality strategy, said. “As the rates of Covid increase again, without a clear health plan that will take away those that are most vulnerable, we could be hit again.”
A government spokesperson said: “The equalities minister is taking forward vital work to tackle disparities and protect our most vulnerable communities from the impact of the virus.
“This work will continue throughout 2020 and 2021 and the first of the quarterly updates will be provided to the health secretary and the prime minister in the coming weeks. This will show progress made against the published terms of reference and action taken to tackle Covid-19 disparities.”
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