Photographed by Flora Maclean
As the coronavirus death toll continues to rise, it shows that no one is safe. As of 23rd April, over 19,500 people have died in hospitals in the UK and there are over 143,000 confirmed cases. While everyone is at risk of catching COVID-19, new statistics have shown that people from black, Asian or minority ethnic (BAME) backgrounds are disproportionately more likely to die from the virus.
NHS England on Monday revealed the ethnic breakdown of people who have died from the virus thus far and a Guardian analysis revealed that of the 12,593 patients who died in hospital up to 19th April, 19% were of BAME origin, despite these communities making up only 15% of the total population in England. A Times analysis found that Black Britons are dying at twice the rate as white Britons, and those of a Caribbean heritage are hugely disproportionate.
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This shocking news comes after the UK government ordered a review into why ethnic minority patients appear to be disproportionately impacted as it was revealed the first 10 frontline doctors to die from the virus were of BAME origin. On Friday it was announced that Baroness Doreen Lawrence, campaigner and mother of the murdered teenager Stephen Lawrence, will lead a Labour Party review into the impact of coronavirus on BAME communities, while Trevor Phillips, the former chairman of the Equalities and Human Rights Commission, was appointed by Public Health England to provide support with the government's inquiry.
While the exact reasons are yet to be officially determined, experts have suggested a multitude of factors, including pre-existing health conditions, socioeconomic status, cultural beliefs and racial bias within the medical industry.
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19% of the 12,593 hospital patients who died up until 19th April were black, Asian and minority ethnic.
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"I fear that I could lose my life and I will be forgotten about," says Dr Adwoa Danso, a British-Ghanaian frontline GP. "I love my job but my job is not my life. With all the complexities and inequalities that exist within the NHS, I worry that my family and I could pay the ultimate price and lose our lives."
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"You learn very early on as a doctor to manage the dark times you can face at any time. These statistics and the news makes everything that much more real."
While official figures show that BAME people make up 44% of NHS medical staff, a recent Sky News analysis found that nearly three quarters (72%) of all NHS and social care staff who have died from coronavirus are from a BAME background. Quite understandably, this worries Dr Danso. "The rise in BAME cases concerns me a lot. It disappoints and upsets me because people who are very unwell or have died are people I've worked with." She points to evidence from the British Medical Association which suggested that BAME doctors are twice as likely not to complain about safety in the workplace, and in this context, the issue of PPE. "They won't speak up and will just get on with the job."
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I fear that I could lose my life and I will be forgotten about.
Dr Adwoa Danso
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However, Dr Danso admits that the statistics don't surprise her. "Obesity, diabetes and high blood pressure are more common in these communities and they can make your condition worse," she says. "But what we are seeing isn't necessarily surprising because it has somewhat been a trend in other aspects of medicine such as childbirth, where black women are five times more likely to die than white women. The reasons may be quite similar in COVID-19."
Dr Julie Hammond, a British-African London A&E doctor, is also worried. "To be frank these numbers terrify me. Working frontline in A&E, I am exposed to suspected and confirmed cases of COVID-19 patients on a daily basis, which many other BAME NHS workers can relate to. This in combination with high levels of stress due to strain of the current pandemic on the NHS services and its workers, and the long, unsociable working hours, I believe has taken a considerable toll on BAME NHS workers."
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Some people feel that their symptoms are not being taken seriously. These are elements we can't ignore and it's a difficult pill to swallow.
Dr Danso
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"Self-isolating and working from home is a privilege that many people from the BAME community are not privy to due to higher levels of poverty and social housing overcrowding," she says. "Many of the essential work and key services that continue to be compulsory during this time are occupied by BAME members who are unfortunately more likely to come into contact with carriers of COVID-19, thus increasing their risk."
Dr Danso says that racial bias could play a part in the high number of BAME lives being lost, including the death of 36-year-old Kayla Williams from Peckham, who had suspected COVID-19. Kayla's husband reported being told by a paramedic who attended their residence that she wasn't a priority. "Some people feel that their symptoms are not being taken seriously and are subsequently dismissed, unintentionally for the most part. These are elements we can't ignore and it's a difficult pill to swallow."
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Many of the essential work and key services are occupied by BAME members who are more likely to come into contact with carriers of COVID-19, thus increasing their risk.
Dr Julie Hammond
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"People want to describe us [NHS workers] as war heroes and soldiers fighting on the front line. Even soldiers are trained, prepped and given the right uniform and equipment. Why is it that we’re so far into this pandemic and people are still dithering about PPE?"
Dr Hammond adds that many BAME key workers continue to work because they may not be entitled to some of the government's benefit schemes due to the status of their citizenship and therefore have no choice but to go out to work if they want to provide for themselves and their families. "I believe these are crucial factors in why we are seeing more serious cases of COVID-19 infections among younger BAME patients."
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An Asian doctor working on a COVID ward at King's College Hospital in London, who wishes to remain anonymous, told R29 that it has been very difficult to predict the demise of patients. "Some patients turn around very quickly but others deteriorate just as quickly," she says. "The hardest thing is not allowing visitors or loved ones on the wards as people are often frightened and alone."
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Once this is over we need to scrutinise the data further to work out why there are disparities in healthcare and work actively with communities to try and address them.
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The doctor said she was shocked to hear that ethnicity wasn't being recorded on death/public health data at first, as it would help to point out why inequalities in health exist.
"BAME individuals are more likely to have hypertension and diabetes, both factors we know predispose to the virus," she adds. "Disparities in education and access to healthcare are already known about; and perhaps retrospectively we need to go back and look at factors such as how long it took to present to hospital, existing co-morbidities and understanding of the disease."
"ITU is still full to capacity and it is going to take months to recover – our worry at the moment is where all our non-COVID patients are with strokes and heart attacks, (particularly BAME patients) – they just aren’t coming to hospital."
"Once this is over we need to scrutinise the data further to work out why there are disparities in healthcare and work actively with communities to try and address them."
The World Health Organization has declared COVID-19 a global pandemic. It says you can protect yourself by washing your hands, covering your mouth when sneezing or coughing (ideally with a tissue), avoid touching your eyes, nose and mouth and don't get too close to people who are coughing, sneezing or with a fever.