How virus discriminates against our BAME communities – Dr Mohammed Ali

It soon became obvious that older people are the most vulnerable, men are more likely to be hit than women and over 90 per cent of victims have one or more underlying health conditions.

More recently the shocking death toll among BAME communities hit the headlines when figures released by the Intensive Care National Audit and Research Centre showed that 34 per cent of critically ill patients identified as minority ethnic, even though these groups make up just 14 per cent of the population.

Nearly twice as many Asians and four times as many black people are critically ill than would be expected if the virus really did have the same impact on everyone.

The risks are even greater for medical staff. Of course, we should expect ethnic minorities to be overrepresented among the victims when around 40 per cent of doctors and 20 per cent of nurses are BAME – but not to the extent that they account for the vast majority of health or social care workers who have died so far.

The Government and the Opposition have now set up task groups to find out why this is the case. I am relieved that they are taking this issue so seriously, but sorry that it has taken a worldwide health crisis to raise awareness that people’s ethnicity affects not only their quality of life but how long they have on Earth.

It should not have come as a surprise that those people most vulnerable to coronavirus come from communities where people have always died before their time. The single most important factor affecting your life expectancy isn’t the genes that you have inherited from your parents. It isn’t anything you can control such as switching to a healthy diet or taking more exercise. It’s how much you earn. This is an inconvenient truth that’s usually brushed under the carpet, but wander around many of our inner-city cemeteries and you cannot help but be struck by the number of premature deaths recorded on the gravestones.

Many of these will belong to someone from an ethnic minority background. Half of the UK’s eight million-strong BAME population lives in the 10 per cent most deprived local authority wards. Members are more likely to be out of work, under-employed or in insecure contracts, and live in overcrowded households. These now provide ideal conditions for the virus to spread and make self-isolation well-nigh impossible.

Unable to afford the luxury of a healthy lifestyle, some ethnic minority groups are prone to conditions like high blood pressure and heart disease. South Asians are six times as likely to develop type 2 diabetes as people of European descent.

But income levels alone can’t explain why Covid-19 seems to target people from minority backgrounds. The grim reality is that a disproportionate number of those in frontline jobs who are now exposing themselves to the virus every day as they struggle to keep us alive are BAME. Many of these – such as public transport workers, taxi drivers, delivery staff and shelf stackers – are over-worked and underpaid. Nurses and care workers provide more collateral damage.

Yet not everyone in the firing line is on a low income. Almost all the doctors who have died so far are from an ethnic minority background but in the NHS, as in so many large public sector organisations, there are stark differences.

Like the above average number of BAME medical practitioners working in ‘Cinderella’ disciplines like geriatrics and A&E, where they come into close contact with the public. They are less likely to rock the boat by protesting about lack of PPE equipment than their white colleagues. And several of the first victims seem to have been encouraged to come out of retirement in response to the threat of Covid-19.

I look forward to reading the findings of the Government and Labour party reviews, but I doubt they will tell us anything that we don’t know already. Action is more important than words – and that is well overdue. Yet something positive can come out of this pandemic if it forces us to address the fundamental economic and social inequalities afflicting the ethnic minority communities.

Immigrants have often been reviled as burdens on the NHS. Now they, and their descendants, are paying the ultimate price as they put their lives on the line to fight this deadly virus. Let us hope their sacrifice is not forgotten when this battle is won.

Dr Mohammed Ali OBE is a former non-executive director of Bradford and Airedale Teaching Primary Care Trust and founder of QED Foundation which promotes the social and economic advancement of disadvantaged communities.

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