Coronavirus: Risk of death is higher for ethnic minorities

People from ethnic minorities are at a higher risk of dying from coronavirus, a report by Public Health England says.

It shows age remains the biggest risk factor, while being male is another.

The impact of Covid-19 is also "disproportionate" for other Asian, Caribbean and black ethnicities. But it remains unclear why.

A trade union for doctors said the report was a "missed opportunity" for "action" to be taken to protect health workers who are from ethnic minorities.

The health secretary said the "troubling" report was "timely" because "right across the world people are angry about racial injustice".

On Monday night, the Department of Health and Social Care denied reports the delay was down to official concerns of potential civil unrest linked to global anger over the death of African-American George Floyd.

Health Secretary Matt Hancock told the House of Commons the public was "understandably angry about injustices" and that he felt a "deep responsibility because this pandemic has exposed huge disparities in the health of our nation".

"Black lives matter, as do those of the poorest areas of our country which have worse health outcomes and we need to make sure all of these considerations are taken into account, and action is taken to level-up the health outcomes of people across this country," he said.

Speaking at the daily coronavirus briefing in Downing Street, Mr Hancock said "much more work" needed to be done to understand "what's driving these disparities".

"We are absolutely determined to get to the bottom of this and find ways of closing this gap," he said, adding that he has asked equalities minister Kemi Badenoch to continue working on the issue alongside Public Health England (PHE).

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The BBC's Rianna Croxford pressed Mr Hancock on whether there were any specific recommendations for people from ethnic minority backgrounds.

He said everyone in "the different high risk categories" highlighted in the report should follow social distancing guidelines "very stringently".

'I can't change my colour'

Prof John Newton said although the virus was having a worse impact on black and minority ethnic people, "that is not necessarily because of their ethnicity" and could instead be related to their job, for example.

He said the report's findings needed to be "widely discussed before deciding exactly what needs to be done".

"The report if nothing else emphasises the complexity of what we're seeing, so really we're urging people not to jump to conclusions and institute measures which are not really justified by the data," he added.

London Mayor Sadiq Khan said "lives depend on" finding out why the virus disproportionately impacts black and minority ethnic people, and what actions the government was taking to stop it.

Davida Wilkins, a 38-year-old district nurse in the West Midlands, told the BBC she felt "even more anxious" about doing her job following the report's publication.

She said she felt "obligated" to continue her front-line role but added she cannot minimise the risks posed to her by the virus because "it's the colour that I am and I can't change it".

A large proportion of NHS doctors are from an ethnic minority background

The rapid review was launched when it became clear that some people were getting more sick with coronavirus than others.

PHE reviewed thousands of existing health records and other virus data to look at disparities by:

• age and sex

• geography

• deprivation

• ethnicity

• pre-existing health problems or co-morbidities

It is not possible to combine all of these factors together to judge an individual's risk because of the way the source data is recorded, but the data does reveal clear inequalities.

The analysis on ethnicity and risk did not consider a person's occupation or obesity, even though both are known risk factors for getting seriously ill with coronavirus.

The report also found:

• If you strip out age and sex, people of Bangladeshi ethnicity have twice the risk of death than people of white British ethnicity

• People aged 80 or older are 70 times more likely to die than those under 40

• Working-age men diagnosed with Covid-19 are twice as likely to die as women

• The risk of dying with the virus is higher among those living in more deprived parts of the UK

• Certain occupations - security guards, taxi or bus drivers and construction workers and social care staff - are at higher risk

• Virus death rates were highest among people of Black and Asian ethnic groups when compared to white British ethnicity

• People of Chinese, Indian, Pakistani, other Asian, Caribbean and other Black ethnicity had between a 10% and 50% higher risk of death when compared to white British people

Analysis: Report has important flaw

The government had been under pressure to publish the findings of this inquiry. It was due to be released by the end of May.

Now it's here, it's not clear why there was a delay. The main findings reinforce what we already know - that belonging to an ethnic minority group is a major risk factor.

It doesn't move us forward in answering why, though.

The report acknowledges an important flaw in the analysis - it couldn't factor in important risks, such as a person's job and underlying health conditions, that increase the chance of dying with coronavirus. Where you live and how much you earn are important considerations too.

Death rates for people living in the most deprived areas of England were more than double the least deprived areas.

The report says coronavirus has replicated and in some cases increased existing health inequalities. It doesn't mention how to address those to save more lives.

It acknowledges that more work is needed to understand and advise people about the risks.

Labour leader Sir Keir Starmer criticised the report for not providing recommendations for at-risk groups, adding that the virus "thrives on inequality" and "inequality thrives on inaction".

Labour MP for Battersea Marsha de Cordova said the report was "notably silent" on how risks amplified by "racial and health inequalities" could be reduced.

She said the government "must act immediately" to mitigate the risks "so that no more lives are lost".

While Labour MP for Tottenham David Lammy said families "are living in fear" and the government "must take urgent action to protect at-risk groups".

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Gill Walton, chief executive of the Royal College of Midwives, said while the report's conclusions were "helpful... it does nothing to protect people". She said "clear guidance and support" from the government should be given to help the NHS tackle the risk to workers.

The Royal College of Nursing pointed out that health care staff from black and ethnic minority groups faced an increased risk from the virus and that "swift and comprehensive action" was needed to protect workers.

While the council chair of the BMA, the doctors' trade union, said the report was a "missed opportunity".

"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," Dr Chaand Nagpaul said.

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The equality watchdog says the government should produce a "comprehensive race equality strategy" in response to the report.

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."

Latest government figures show 39,369 people with coronavirus have died in the UK, across all settings, with an increase of 324 deaths on Monday's figures. There were 1,613 new positive cases recorded in the past day.