BAPIO (British Association of Physicians of Indian Origin) has recently written to NHS England & Wales about the Covid-19 related high mortality rates amongst the Black and Minority Ethnic (BAME) population.
BMA, BBC, ITV, Sky and various other organisations including Asian Voice have also highlighted the issue and in response the NHS England has instituted an inquiry. A letter was sent to the Chief Executives of all Local Health Boards (LHBs are responsible in Wales for Health & Social Care of each area), First Minister of Wales, Health Minister & Chief Medical Officer because of the concerns of Disproportionate high mortality rates in BAME health professionals.
As a result BAPIO Wales Secretary, Dr Hasmukh Shah BEM and Chair, Prof Keshav Singhal MBE were elected along other colleagues to advice Welsh Government for urgent planning to deal with above issues. Since last week, they have had weekly Skype meetings with the Welsh Government.
The letter sent to the health board in Wales said, that given that the high BAME mortality rate continues unabated (3 senior Indian origin clinicians died on 16 April 2020) BAPIO wishes to raisetheirconcerns with the employing health boards about this disproportionate mortality amongst BAME frontline staff with suggestions to mitigate the same.
“The latest data from ICNARC reveals that 34% of the critically ill ITU admissions are those of BAME which above the national demographic of 14% BAME population.
“According to the Office for National Statistics, the age-specific mortality rate (March 2020) due to the coronavirus (COVID-19) increased significantly in each age group, starting from ages 55 to 59 years in males and ages 65 to 69 years in females. Of the deaths involving COVID-19 that occurred in March 2020, there was at least one pre-existing condition in 91% of cases.
“Data from US shows mortality rates in black population approaching 50 to 70% of all Covid19 deaths.
“An analysis by Sky News found that of the 54 front line health and social care workers in England and Wales that have died because of COVID-19, 70% were black or from an ethnic minority. Our own updated figures as of 17thApril show that 51 out of 71 NHS staff deaths from Covid19 were BAME equating to71%. 15 out of the 15 doctors who have died have been BAME.
“The available figures suggest that being male, BAME and older adult along with at least one co morbid condition puts them at greater risk of mortality,” the letter highlighted.
It is a fact that BAME populations have a higher incidence of known risk factors including visceral obesity, diabetes and metabolic syndrome. According to CDC, these patients probably have 10 times risk of mortality.
South Asian population has diabetic rates around 3-5 times that of white population, hypertension and Ischaemic Heart Disease, chronic lung disease including Asthma, COPD or chronic URTI and Vitamin D deficiency.
It added, “While research is going on and will take time to complete, it is vital that all of us take cognisance of these disturbing trends and take urgent steps to mitigate against any further and unnecessary tragedies.”
Urgent Action Needed
The letter further spoke about how the Management of Health and Safety at Work Regulations (1999 as amended) requires employers to ensure that work environment is, as far as reasonably practicable, safe and without risks to health.
“Alongside that there should also have been an Equality Impact Assessment to determine whether particular groups of staff might be especially at risk and whether particular groups or communities might be at risk such as the poor (greater likelihood of chronic health conditions) or those from particular communities
“The employers therefore have a legal, moral and ethical duty to provide a safe working environment for their employees and to perform a comprehensive risk assessment, given the health risks of COVID-19 pandemic. Unless corroborated evidence is provided to suggest otherwise, existing data suggests that certain demographic characteristics, such as age, sex and race are major determinants of mortality from COVID19 infection. We can find no evidence of any such assessments being carried out.
“Hence, we expect employers to urgently carry out a stratified risk assessment so that those on the frontline of tackling the pandemic are not unnecessarily put in harm’s way. Likewise, the NHS has the legal and ethical obligation to ensure that retired and returning senior doctors and nurses are not given jobs that are front line facing.
“We hope you will take note of our concerns and take immediate action to address the safety of the NHS staff. BAPIO will extend every support and assistance to you while we all deal with this national crisis.
“We will immediately advise our members of the following: They should not feel pressurised into putting themselves at unwarranted risk particularly with inadequate PPE, in view of the enhanced risk of mortality as noted above. They should notify their Line Manager and Occupational Health of their health problems and ask for an urgent risk assessment which needs to be fully documented and must receive appropriate training if redeployed to unfamiliar area.”
