As the British government carries out an official investigation into deaths among ethnic minorities from COVID-19, Duncan Bartlett considers the risks facing Asian people living in the UK
On instructions from the Minister of Health, Public Health England is urgently trying to establish why non-white people appear to be disproportionately affected by the COVID-19 outbreak.
Reports from intensive care wards in hospitals suggest more than a third of critically ill patients come from ethnic minority groups, despite only making up around 14 per cent of the overall population.
Most scientists believe that black and Asian people are at greater risk of catching the disease not because of their race, but because of social and cultural factors.
Duncan Young, professor of intensive care medicine at the University of Oxford, says: ‘There is a possibility of a genetic cause for the disproportionate number of ICU admissions in Asian and black patients, but as it is occurring across two different ethnic groups, this is not likely.’
People with underlying health conditions are particularly hard hit by the virus. The British Medical Association says that some chronic problems, which affect all ethnicities, are especially common in minority groups. It says there are higher rates of hypertension (high blood pressure), coronary heart disease and diabetes among ethnic minority communities than within the general population.
The poet and writer Shamim Azad, who was born in Bangladesh but has lived in the UK for the past 30 years, believes that diet and lifestyle factors, which could be linked to poverty and deprivation, may increase the risk for the Bangladeshi community.
‘People often buy food which is high in carbohydrates, such as rice, because it’s their staple diet and also because it is cheaper than fresh produce. But eating mainly rice only three times a day is not healthy and it can make people prone to high blood pressure. In some cases, families are forced to prioritise food rather than sanitation, so we need to encourage our people to think about health issues in a more balanced way.’
Ms Azad also notes that many British Bangladeshi people do jobs where their physical presence is essential, such as working in small shops or on the transport network. She says this makes them more likely to catch the virus from outside than people who are working from home.
In London and other cities in the UK, many Asians live in extended families, sometimes in cramped conditions. A survey by the government in 2018 found that around 2% of White British households experience overcrowding, compared with 30% of Bangladeshi households – the highest percentage.
Overcrowding has also been identified as a problem for about 7% of Indian and Chinese families in Britain.
For Shamim Azad, ‘one of the good things about our community is the way people take care of each other. You won’t find Bangladeshi people sleeping on the street or dying alone. Even unemployed people are brought under the family roof. But in such environments, social distancing is a problem, especially in poorer families, where women are in the kitchen all day and some people might even end up sleeping on the floor.’
Doctors in danger
Another concern is the effect of the virus on people working in the healthcare sector.
The first 12 doctors to die from the virus in the UK were all from ethnic minority groups. The British Medical Association’s chair, Dr Chaand Nagpaul, described the data as ‘stark and disturbing’.
‘Many of these doctors came from abroad to save other people and it is absolutely tragic that they lost their own lives in the process,’ said Dr Nagpaul. ‘It is imperative that the government looks into this and takes the necessary action to mitigate the discriminatory impact of this disease on certain groups of people.’
The British Association of Physicians of Indian Origin (BAPIO) has urged authorities to deploy senior and retired medics away from frontline duties until more evidence can be collected on the ethnic variables for COVID-19 risks.
Dr Ramesh Mehta, the BAPIO president, said: ‘We need a better understanding of the issues of ethnic mortality in the context of the general population – particularly if it helps us to manage sick and vulnerable groups – so that we can be accurate in our messaging.’
Asian community leaders are also asking for culturally sensitive messages to be delivered in a variety of languages on issues such as handwashing and social distancing.
Preparing for prayer
In Britain, Asian communities often have a relatively young average age, whereas COVID-19 tends to have a bigger impact on the older generation. Furthermore, only about one in three Muslim women go out to work, and this could reduce the risk of the virus being transported back into their homes.
Muslim culture also encourages believers to wash their hands up to 15 times a day before regular prayer, which is in accordance with the hygiene recommendations to combat coronavirus.
Nevertheless, people of all religions remain deeply concerned about the impact on Britain’s Asian community.
Shamim Azad says: ‘Whenever there’s a war or disaster, people from ethnic minorities suffer the most, because we are on the frontline. But the government should recognise how much we contribute to society. It’s especially sad when a doctor or a nurse dies. These people are so valuable to us, we’ve invested so much in them, and now we are losing them.’