Coronavirus: Increased risk of infection behind higher ethnic minority deaths, Sage report suggests

Black and minority ethnic groups are more at risk of being admitted to hospital, with their occupation and other non-medical factors potentially increasing risk

Shaun Lintern
Health Correspondent
Wednesday 03 June 2020 00:49
A report requested by SAGE finds no higher risk of death for ethnic minorities from Covid-19
A report requested by SAGE finds no higher risk of death for ethnic minorities from Covid-19

Black and minority ethnic (Bame) people are not more likely to die from Covid-19 once their characteristics and underlying conditions are taken into account, according to a report requested by the government’s Sage committee last month.

The Scientific Advisory Group for Emergencies ordered the analysis in mid-April after a “signal” that black people had a higher risk of death among coronavirus patients compared with the overall Bame population.

Experts from the University of Liverpool and Edinburgh University used data on hospital coronavirus patients and matched patients from ethnic minorities to white patients using 23 different characteristics including age on admission, sex, obesity, diabetes, cardiac disease, asthma, smoking and deprivation.

They concluded that while black and minority ethnic people were more likely to be admitted to hospital and critical care with Covid-19, once their characteristics were taken into account their risk of admission to intensive care and risk of death were equivalent to white patients.

The study, one of more than 50 documents released at the weekend, appears to show that the increased risk of death from the coronavirus for Bame patients is not due to medical reasons but to their likelihood of initially being infected and may be linked to occupation, housing and other non-medical risks.

The shadow care minister, Liz Kendall, said: “This is a virus that seeks out and kills the poor.”

She said the health inequalities “must be a wake-up call for ministers across government, and the entire health and care system, to fundamentally shift the focus of action towards prevention, early intervention and reducing the gap between rich and poor”.

The analysis looked at 14,228 hospital patients and aimed to match Bame patients to white patients with similar characteristics on a one-to-one or nearest-neighbour basis.

The report, dated 25 April, said that using this method “no difference was seen in risk of death from Covid-19 between ethnic groups”.

It said: “More admissions to hospital are seen in the black and minority ethnic group in this cohort, compared with that expected from the population proportion at a country level. More admissions to [intensive care] are seen in the black, Asian and minority ethnic group, compared to the white ethnic group.

“These are explained by differences in patient characteristics such as co-morbidity. No difference in ICU admission is seen after adjusting for patient characteristics. The white ethnic group has higher mortality than the Bame group.

“In conclusion, black and minority ethnic individuals might be more likely to be admitted to hospital with Covid-19. Bame groups are more likely to be admitted to ICU. When patient characteristics are taken into account, no excess ICU admissions or deaths are seen in the Bame group.”

It comes as Public Health England (PHE) published a report on Tuesday suggesting there was a higher risk of death for some ethnic groups, although the report admitted it “did not account for the effect of occupation, co-morbidities or obesity.”

The PHE report found that the biggest risk factor was being a man and being older, but it also highlighted regional differences and an increased risk to those living in more urban areas.

An analysis by the Office for National Statistics has previously found that men working as security guards, taxi drivers, chauffeurs, bus and coach drivers, chefs, sales and retail assistants, lower skilled workers in construction and processing plants, and men and women working in social care had significantly high rates of death from Covid-19.

The health secretary, Matt Hancock, emphasised at the daily Downing Street press conference that "the wider determinants of health" were what was important and would be considered in future work.

Sally Warren, director of policy at the King’s Fund, said: “The coronavirus pandemic has exposed the stark inequalities that exist throughout our society. People who have been worst affected by the virus are generally those who had worse health outcomes before the pandemic, including people working in lower-paid professions, those from ethnic minority backgrounds and people living in poorer areas.

“We’ve known for many years that these groups typically have worse health outcomes, but there has been disappointingly little effort over the last decade to address inequalities and improve people’s health. The scandal is not that the virus has disproportionately affected certain groups, but that it has taken a global pandemic to shine a light on deeply entrenched health inequalities.”


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