Older Indian-origin males in UK’s COVID-19 high risk category, new report finds

Older Indian-origin men fall within a higher risk category of coronavirus deaths in England, a British government review into the disparities in the impact of the deadly virus indicated on Tuesday. The 'Disparities in the risk and outcomes of COVID-19' report by Public Health England (PHE), tabled before the House of Commons, concluded that age and gender played a major role in the risk factors associated with the disease – with people who were 80 or older 70 times more likely to die than those under 40. And, men falling within that category were at a greater risk, with those in the black, Asian and minority ethnic (BAME) category more vulnerable than white ethnic groups.

"This work underlines that being black or from a minority ethnic background is a major risk factor. This racial disparity holds even after accounting for the effect of age, deprivation, region and sex," UK Health Secretary Matt Hancock told Parliament. "The PHE ethnicity analysis did not adjust for factors such as comorbidities and obesity, so there is much more work to do to understand the key drivers of these disparities, the relationship between the risk factors and what we can do to close the gap," he said.

The Cabinet minister announced a further review into the factors behind the ethnic variations of COVID-19 impact in the country, which will be led by UK Equalities Minister Liz Truss. The PHE report found that in its analysis of survival among confirmed Covid-19 cases, after accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death when compared to people of White British ethnicity.

"People of Chinese, Indian, Pakistani, Other Asian, Caribbean and Other Black ethnicity had between 10 and 50 per cent higher risk of death when compared to White British," the PHE report notes. It adds: "For older age groups, the probability of death was also higher among people of Chinese, Indian and Other Asian ethnic groups.

"Black males were 3.9 times more likely to die than the white group, compared with 2.5 times in Asian males." The report concludes that the relationship between ethnicity and health is "complex" and likely to be the result of a combination of factors. People from ethnic minority communities are at increased risk of acquiring the infection as they are more likely to live in overcrowded households and have jobs that expose them to higher risk. Comorbidities, or underlying health conditions such as diabetes, hypertensive diseases, chronic kidney disease, chronic obstructive pulmonary disease and dementia, are also a likely factor. Diabetes and hypertensive disease, which have a higher instance within South Asian groups in the UK, were among the underlying conditions most commonly found among Covid-19 patients, with obesity likely to be another major factor.

An analysis of 119 deaths of National Health Service (NHS) staff showed a disproportionately high number of BAME staff among those who had died. The British Medical Association (BMA) called for more information to "make sense of why the dreadful virus is impacting the BAME community adversely" and what needs to be done to urgently protect them.

"Given the staggering disproportionate number of deaths among BAME doctors and healthcare workers during the Covid-19 pandemic, the BMA called on government to carry out an investigation to understand why this is happening," said BMA Council Chair Dr Chaand Nagpaul. PHE has said that the results of its "descriptive" review improves the understanding of the pandemic and will help in formulating the future public health response to it. The review had been launched by the government at the end of April to conduct a rapid analysis of the disproportionate impact of Covid-19 on certain sections of the UK's population. The findings have renewed calls for a more in-depth analysis into the factors behind the ethnic variations highlighted in the report.

"This review confirms what we already knew – that racial and health inequalities amplify the risks of Covid-19. Those in the poorest households and people of colour are disproportionately impacted," said Opposition Labour's shadow equalities minister Marsha de Cordova. "But when it comes to the question of how we reduce these disparities, it is notably silent. It presents no recommendations. Having the information is a start – but now is the time for action," she said..

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