When the Prime Minister left hospital before Easter he referred to this national crisis as ‘a fight we didn’t pick, against an enemy we still don’t entirely understand.’ He’s right. Our understanding of Covid-19 is developing fast, but is incomplete. Scientists are working on a cure for the virus, but that might be months away. In the meantime, we need to understand how and why the virus spreads, because this will not be the last time we confront such a threat.
One aspect of the crisis is just starting to get the investigation it deserves: the impact of Covid-19 on the UK’s BAME communities. As Emily Maitlis recently pointed out, the disease is not a ‘great leveller’. Poorer people are more likely to suffer the impact of quarantine and the disease itself than richer people.
In the UK that means there is a strong correlation between being BAME and being at risk. Black and Minority Ethnic people are more likely to be poorer, unable to ‘work from home’, more likely to be forced to work out of immediate economic necessity, and more likely to be living in densely populated urban areas.
The East End is renowned for its rich mix of cultures and diversity, and my constituency has one of the largest ethnic minority populations in the UK. It has a significant Bangladeshi community, and constituents from all over the world - Africa, Asia, Europe and every compass point. Local families in East London are suffering the effects of the virus as severely as anyone in the country.
The Intensive Care National Audit and Research Centre conducted a snapshot survey of the nation’s ICUs in early April and found that more than a third of critically ill coronavirus patients were non-white, despite BAME communities only making up 14% of the UK population.
Yet the Government is failing to properly capture the data, and to analyse its meaning. As a priority, ministers should gather the evidence of the impact of the virus on different BAME communities, including the disproportionately high death rate, and swiftly devise strategies to mitigate the worst effects. They should also be looking at the death rates in disadvantaged white communities and the extent to which health inequalities and socio-economic circumstances put them at greater risk.
Our starting point, as Omar Khan, Director of the Runneymede Trust has stated, is not that people from different races react differently to the virus. The differences are anchored in a blend of socio-economic and cultural factors, especially poverty and disadvantage.
The first is that it is a sad fact that many NHS workers are contracting the virus, and they are more likely to be from BAME backgrounds. The first four doctors to die of Covid-19 were from ethnic minorities: Dr Alfa Saadu, Amged el-Hawrani, Adil El Tayar and GP Dr Habib Zaidi. Of the heroic nurses and other NHS frontline staff who have died, a high proportion were BAME - on 16 April, over two-thirds of NHS deaths were of those from BAME backgrounds.
Housing is a huge factor. Overcrowding disproportionately affects BAME communities. In the UK 30% of Bangladeshis, 15% of Black Africans and 16% of the Pakistani populations live in overcrowded housing. This compares with 2% of the white population of the UK. Overcrowding has a negative effect on mental wellbeing at the best of times. In times of illness and quarantine, it is much worse. This is not just true in London, but in every city where significant BAME communities live in crowded urban conditions, such as the disproportionate impact of Covid-19 in New York and other UK cities. In the USA, the authorities gather data on the ethnicity of victims and can prove the greater impact on ethnic groups.
In the UK we must keep parks and open spaces available for people to use safely. I am pleased that my local authority Tower Hamlets has reopened Victoria Park for safe use by local people. Victoria Park – known as the People’s Park by the Victorians – was designed as an opportunity for East Enders to escape their crowded and polluted environment, to bathe, breath clean air and see grass and trees. This public health function remains as vital today.
Another factor is intergenerational living. Many BAME communities have a strong culture of living with grandparents, parents and children under the same roof. In normal times, this is great for family cohesion and support with care at either end of the age spectrum, but a real problem when vulnerable people need to be isolated. London is filled with blocks of luxury flats, budget hotels and university halls of residence whose rooms are currently empty. Surely ministers can create spaces where older, vulnerable people can live away from their families but remain in touch, safe and cared for?
Why are so few of the important public health messages available in languages other than English? Public Health England must enhance its efforts to communicate with diverse communities. A group of prominent British-Asian celebrities have created a new video targeting the British Asian community with an urgent health message.
In response to pressure from Labour MPs, the Government has agreed to launch an inquiry into the disproportionate impact of coronavirus on BAME communities. Our understanding of the virus, and our investigation into the decision-making process after we have beaten it, must be based on solid evidence, not anecdote. We need to understand the risk factors and barriers. We need to fix the underlying problems of overcrowding, public health inequalities, and access to quality physical and mental health services. The legacy of this terrible disease must not just be memorials, but a collective desire to create a more equal, healthier, resilient society.
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