PHE review a ‘missed opportunity’

by Peter Blackburn

A delayed Public Health England review looking into the effect of COVID-19 on BAME (black, Asian and minority ethnic) communities has failed to deliver a ‘clear action plan’.

Location: UK
Published: Thursday 4 June 2020

That was the message from BMA council chair Chaand Nagpaul who said the statistical analysis ‘gets us no closer toward taking action that avoids harm to BAME communities’.

The BMA first called for the review in April in a bid to understand why there were such disproportionate deaths and serious illnesses in BAME healthcare workers and in the community – so action could be taken to protect them – but Dr Nagpaul called the published document a ‘missed opportunity’.

He added: ‘The report fails to mention the staggering higher proportion of BAME healthcare workers who have tragically died from COVID-19 – with more than 90 per cent of doctors being from BAME backgrounds. The report has also missed the opportunity for looking at occupational factors; the BMA was clear we needed to understand how job roles, exposure to the virus and availability of PPE [personal protective equipment] were risk factors.’

Amplified effects

The BMA’s submission to PHE outlined the evidence surrounding the effect of COVID-19 on people from BAME backgrounds – highlighting that BAME people are more likely to have higher rates of severe illness and admission to critical care, as well as mortality from COVID-19.

Data covering clinical care units in England, Wales and Northern Ireland has shown that BAME people make up 33.2 per cent of admissions – significantly higher than the 14 per cent of BAME people in the England and Wales population.

NHS England data on daily deaths in hospital from COVID-19 shows that 16 per cent are BAME people (as at 26 May). But the age profile of the BAME population in England and Wales, however, is considerably younger than the White population, with around half of the hospital deaths recorded from COVID-19 are among the 80 plus age group but only around 3 per cent of the over 80s are BAME.

‘Clear action’

Analysis from the Office of National Statistics shows that, after accounting for different age profiles, black men and women are four times more likely to die from COVID-19 than white men and women. The analysis also shows that there were significantly increased risks compared with the white population for people of Bangladeshi, Pakistani, Indian and mixed ethnicities too. After accounting for sociodemographic factors and self-reported health, people of black, Bangladeshi and Pakistani ethnicities were still almost twice as likely to die from COVID-19.

Dr Nagpaul 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, particularly in relation to how healthcare workers and others working in public-facing roles will be protected.

‘With the global conversation so focused on inequalities and discrimination it is for the Government to instil confidence that all people will be protected equally. We need action, and we need action now.’

Reaching out

The BMA submission to PHE said: ‘The review should consider what needs to be done to improve the reach of health services to BAME communities at the moment, including to migrants and their families, and to mitigate the impacts of the lockdown so that existing health inequalities are not widened. Over the longer term there must be a determined public health focus on interventions to narrow the longstanding inequalities that COVID-19 has brought to the fore.'