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COVID-19 IMPACT ON ETHNIC MINORITIES

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Introduction

The United Kingdom is one of the nations globally, which has recorded the highest number of coronavirus infections (COVID-19). As of June 2020, UK had registered 276,322 confirmed cases accompanied by 39,045 deaths. These cases increase daily to various reasons associated as they continue to claim more lives of minority ethnic societies, including the black and Asian populations.

Ethnic minorities

There is an assumption among scholars whether the minority societies are at increased exposure to succumbing to coronavirus than whites. The Indian subcontinent, which includes several countries, Bangladesh, Sri Lanka, India, and Pakistan, has also been particularly at risk. Hospital deaths concerning the COVID-19 pandemic exceeded expectations for Indians in the United Kingdom by a rate almost double than expected. Simultaneously, the figures speculated for the black community for the Bangladeshi people, specifically the black African. The models exceeded by a margin of 4 times than predicted, while in the black Caribbean, it was double of what was speculated. Other minor populations of the BAME groups were higher by 1.6 times.

Across the UK, the pandemic has spread rapidly, which has led to the admission of patients from minority societies at an increased rate in hospitals. The Public Health England (PHE) compared the Bangladeshi population living in the UK and their white counterparts and reported findings that the Bangladeshi was at the risk of death twice higher than whites. The BAME population’s death rates concerning the disease have been on the rise due to health inequalities, as reported by Wasim Hanif, who works at the University Hospital Birmingham as a professor.1

Health care workforce

As the pandemic continues, the health-care workforce lament on the government’s neglect to routinely publish data on the progress of handling the coronavirus outbreak among them; this is according to the British Medical Association (BMA) based in London, Dr. Chaand Nagpaul. Health care workers from BAME communities who succumbed to the illness are much higher than expected compared to their white counterparts. The figures could be on the rise due to various issues, including health-related complications that worsen the symptoms of COVID-19 infections. Illnesses such as diabetes, coronary heart disease, hypertension are among the top health conditions that have led to increased deaths among BAME NHS staff.

Workplace factors play a role too in contributing to the increased number of deaths. For the successful operation of the NHS, crucial roles regarding patients have to be undertaken by doctors.2 These roles include; specialist, staff grade, and associate specialist, often consisting of many BAME doctors. In high-risk areas, the British Medical Association (BMA) surveys reported that BAME doctors were at an increased risk more than the white population in feeling pressured to check on their patients without adequate personal protective equipment (PPE).3 Despite the considerable role doctors are playing during this pandemic, the government should prioritize concerns over safety issues by doctors. However, through research by the British Medical Association, it was reported by the media that white doctors feel more confident twice than their BAME colleagues in addressing any concern in the workplace. Geographical factors are among the factors to be considered since it has been reported by the UK’s Institute for Fiscal Studies that ethnic minorities mostly occupy areas greatly affected by the coronavirus.

Religious perspectives

In the United Kingdom, an association between different religious groups was on the rise for weeks since the beginning of the pandemic. Unity and cooperation have been focused on religious groups and various communities to mitigate the rates of infections that have claimed thousands of lives globally. During the pandemic, specific behavioral patterns relate to different cultures and traditions that have emerged have emerged. There have been reports of the underestimation of COVID-19. Some of the BAME population members do not adhere to public health protocols such as social distancing due to the perception of optimism bias due to the pandemic’s association with factors such as racism.

There exist speculations towards the COVID-19 vaccine acceptance within the community. It has been noted that BAME groups are more reluctant to be administered the vaccine within the British population due to lower confidence.4 White respondents who would accept the vaccine are at 79 percent, while that of BAME populations is 57 percent. Communities that have disproportionately affected face the risk of lack of vaccines reaching them despite being more at risk and higher chances of death. It is according to the United Kingdom Race Equality Foundation chief executive Jabeer Butt.

United States

The United States of America comprises minority ethnic societies, including Hispanics, blacks, and Asian populations. There have also been reports of the infection disproportionately affecting the minority groups. In research conducted among 14 US states, African-Americans represented 18% of the whole population sample, out of which hospitalized cases represent 33% of the total patients. In New York City, out of a population of 100,000, African-Americans faced death rates at 92.3. The Hispanic population stands at 74.3 while whites and Asians stand at 45.2 and 34.5, respectively. Health conditions play a vital role in the pandemic, including diseases such as kidney disease, obesity, asthma, and hypertension. 5Through research, it has been noted that the mentioned chronic conditions are expected in blacks than in white populations. Due to economic conditions, BAME groups have been reported to be more willing to go to work, which increases infection risks due to factors experienced such as minimum wage rates, which exclude sick pay and public transport. It is also a common occurrence to see the population that resides in congested areas are the minority societies, which increases the risk of increased infections.

Africa and Asia

Despite the coronavirus pandemic being present for more than a year, prosperous and developed countries continue to top the tables for the highest records of infections and deaths globally. 6However, the African and Asian continents, which comprise underdeveloped and developing nations, continue to record lower rates of infections and deaths. The pandemic’s efficient handling in such areas has led to increased criticism of how the United Kingdom handles the pandemic. At the same time, misconceptions and mistakes are also factors to the expanded complaint. However, these statistics may be based on various factors, including different methodologies in recording infections and deaths, protective antibodies due to the exposure of other diseases present in the region, Africa’s demographic profile, a young, and more efficient use of outdoor spaces. These developing and underdeveloped nations paid more attention to the most effective ways to handle the pandemic to ensure creativity and preparedness. Some countries had succeeded so far due to their earlier response and effective, responsive measures when the virus became a global problem.

African countries are not new to the ideology of infectious diseases. As of September, the World Health Organization (WHO) reports that sub-Saharan African countries managed 116 infectious diseases, 12 humanitarian emergencies, and 104 disease outbreaks. The previous encounters in handling simultaneous infections alongside the coronavirus have enabled these nations to be more effective in preparing and managing the pandemic; this allows African countries to appropriately use scarce resources to limit outbreaks before they become widespread. Early screening by nations such as Mauritius had long and short term effects as it contributed to their successful handling of the pandemic. They instituted policies that required mandatory testing at airports and putting visitors from high-risk nations in quarantine designated areas for several weeks to limit the spread. Countries also closed their borders to limit the spread while also demonstrating political support to determine to handle and eradicating the virus.

African and Asian leaders’ responsiveness has contributed to the better management of the pandemic by African and Asian countries. For example, when the first case was announced in Nigeria, it took only ten days for the President Muhammadu Buhari to create a task force response team responsible for communicating daily information to him and the country.7 The situation isn’t similar to the United Kingdom, which showed delays in responsiveness by a margin of months since its first case was reported. Within that period, Boris Johnson, the United Kingdom’s prime minister, has been absent from five emergency meetings about the virus.8 Due to the previous Ebola outbreak in Africa, African nations saw the need for practical cooperation and activities about handling pandemics, which have no regard for geographical jurisdiction. It led to the establishment of institutions responsible for managing infectious diseases. To accelerate COVID-19 testing capacity by providing laboratory equipment, this institution launched its partnership in April, which has enabled the deployment of health care workers to areas most affected in the continent.

Vietnam

Despite Vietnam being a developing nation, it is among the countries that recorded the lowest COVID-19 related deaths. This fact has been contributed and accelerated Vietnam’s experience with Sars, which shaped the leadership strategies in handling such situations. Its containment strategies differ from that of the United Kingdom in which its quarantine measures were based on symptoms rather than exposure risk strategies employed by Vietnam. The nation has also been in the spotlight in participating in public health campaigns, which have increased unity among citizens. Governments made heavy investments in health infrastructure after the Sars outbreak in 2003, which has increased Vietnam’s preparedness in dealing with infectious outbreaks.

Agencies

The UNHCR (United Nations High Commissioner for Human Rights) is reported to address concerns relating to how the outbreak of the virus affects individual races of the world population. Michelle Bachelet advocates for prioritizing health testing and monitoring to ensure accurate data and statistics, enabling a nation to efficiently allocate resources to deal with the pandemic. Access to health-care by minority ethnic groups is also advocated to mitigate the increased number of infections and deaths within the groups while also providing adequate information by the International Human Rights. The World Health Organization (WHO) has been tasked to expand its knowledge towards the virus to enable nations to manage the disease to end it effectively. It has associated itself with global governments and experts to monitor the condition and ensure current health protocols and regulations adhere. The United Nations has shifted its efforts and focuses more on refugees and migrants at a higher risk of infections due to the crowded camps’ densely populated nature. Due to travel restrictions imposed by most nations, these refugees and migrants tend to be stranded, worsening their health conditions while also being targeted by criminal gangs.9

The virus has played a vital role in exposing existing inequalities that have gone unnoticed for decades. In the United States, George Floyd’s killing triggered nationwide unrest against brutal police violence and the existing disparities present in employment opportunities, health, and education. 10The Black Lives Matter protests emerged as a result of the killing to address discrimination in criminal justice. However, such unrest has led to ignorance of health protocols, including social distancing, thereby increasing the number of cases. 11Ms. Bachelet reports that efforts to eradicate the disease will only be possible if governments prioritize the management of ethnic communities by the appropriate collection of data. It will enable identifying inequalities and addressing these issues, including discrimination, which has been among the factors that have contributed to poor health outcomes.

Belly Mujinga case analysis

Belly Mujinga was a 49-year-old woman who worked in London as a ticket collector. However, the coronavirus pandemic claimed her life after an alleged reckless man intentionally coughed and spat on her. It led to the demand for justice from her family members, friends, and thousands of supporters after the Crown Prosecution Service reviewed the evidence and claimed it was not enough to press charges. Despite there being CCTV footage and witness evidence, Suzanne Llewellyn claimed they were insufficient on the grounds of assault. Her case clearly illustrates how minority ethnic groups suffer from discrimination in criminal justice as authorities are reluctant to charge the man responsible for Belly’s death.

Conclusion

In conclusion, the minority societies in the United Kingdom are affected by the coronavirus pandemic’s higher impact due to multiple reasons: discrimination and health care inequalities. To combat and mitigate the disease’s risks, governments should closely associate the ethnic communities with reducing the number of infections and deaths.

Bibliography

Table of cases

Belly Mujinga v British Transport Police

Table of statutes

Statutes

Human Rights Act of 1998

Books

Covid-19 and ethnic minorities: an urgent agenda for overdue action. Kamlesh Khunti, Lucinda Platt, Ash Routen, Kamran Abbasibmj 369, 2020

Covid-19: NHS bosses told to assess the risk to ethnic minority staff who may be at greater risk, Gareth Iacobucci. BMJ 369, 2020

COVID-19 Pandemic: Exacerbating Racial/Ethnic Disparities in Long-Term Services and Supports, Tetyana P Shippee, Odichinma Akosionu, Weiwen Ng, Mark Woodhouse, Yinfei Duan, Mai See Thao, John R Bowblis, Journal of Aging & Social Policy, 1-11, 2020

The impact of the risk of COVID-19 on Black, Asian, and Minority Ethnic (BAME) members of the UK dental profession.Chet Trivedy, Ian Mills, Onkar Dhanoya, British dental journal 228 (12), 919-922, 2020

Evidence mounts on the disproportionate effect of COVID-19 on ethnic minorities, Tony KirbyThe Lancet Respiratory Medicine 8 (6), 547-548, 2020

Journal Articles

Association of ethnicity with survival rates among patients with COVID-19 at an urban medical center in New York, Rafi Kabarriti, N Patrik Brodin, Maxim I Maron, Chandan Guha, Shalom, Kalnicki, Madhur K Garg, Andrew D Racine JAMA network open 3 (9),e2019795-e2019795, 2020

Black Lives Matter protests, social distancing, and COVID-19, Dhaval M Dave, Andrew I Friedson, Kyutaro Matsuzawa, Joseph J Sabia, Samuel Safford, National Bureau of Economic Research Working Paper Series, 2020

Burchard EG, Ziv E, Coyle N, Gomez SL, Tang H, Karter AJ, et al. The importance of race and ethnic background in biomedical research and clinical practice. N Engl J Med. 2003;348(12):1170–5.

Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioral factors, or by 25 (OH)-vitamin …Zahra Raisi-Estabragh, Celeste McCracken, Mae S Bethell, Jackie Cooper, Cyrus Cooper, Mark J Caulfield, Patricia B Munroe, Nicholas C Harvey, Steffen E Petersen. Journal of Public Health 42 (3), 451-460, 2020

Rimmer A. Covid-19: The government will explore the disproportionate impact on ethnic minority health-care workers. BMJ2020;369:m1562. doi:10.1136/BMJ.m1562 pmid:32303494

Rimmer A. Covid-19: Two-thirds of health-care workers who have died were from ethnic minorities. BMJ2020;369:m1621. doi:10.1136/BMJ.m1621 pmid:32327412

The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States, Don Bambino Geno Tai, Aditya Shah, Chyke A Doubeni, Irene G Sia, Mark L Wieland, Clinical Infectious Diseases, 2020

Websites

Abuelgasim E, Saw LJ, Shirke M, Zeanah M, Harky A. COVID-19: unique public health issues facing Black, Asian, and minority ethnic communities. Curr Probl Cardiol. 2020;45(8):100621. https://doi.org/10.1016/j.cpcardiol.2020.100621.

Ali P. Places of worship can be health promotion spaces for faith-based black, Asian, and minority ethnic (BAME) communities Evid Based Nurs. 2019-2019-103140. https://doi.org/10.1136/ebnurs-2019-103140.

Barajas CB, Jones SCT, Milam AJ, Thorpe RJ Jr, Gaskin DJ, LaVeist TA, et al. Coping, discrimination, and physical health conditions among predominantly poor, urban African Americans: implications for community-level health services. J Community Health. 2019;44(5):954–62. https://doi.org/10.1007/s10900-019-00650-9

Bavel JJV, Baicker K, Boggio PS, Capraro V, Cichocka A, Cikara M, et al. Using social and behavioral science to support COVID-19 pandemic response. Nat Hum Behav. 2020;4(5):460–71. https://doi.org/10.1038/s41562-020-0884-z.

British Dental Association. Live updates: Coronavirus and dentistry. 2020. Available online at https://bda.org/advice/Coronavirus/Pages/latest-updates.aspx (accessed June 2020).

Cook T, Kursumovic E, Simon L. Exclusive: deaths of NHS staff from covid-19 analyzed. 2020. Available at https://www.hsj.co.uk/exclusive-deaths-of-nhs-staff-from-covid-19-analysed/7027471.article (accessed May 2020).

GOV.UK Ethnicity Facts and Figures. People Living in Deprived Neighbourhoods

https://www.ethnicity-facts-figures.service.gov.uk/uk-population-by-ethnicity (

May 24, 2020, date last accessed.)

Haroon SM, Barbosa GP, Saunders PJ. The determinants of health-seeking behavior during the A/H1N1 influenza pandemic: an ecological study. J Public Health (Oxf). 2011;33(4):503–10. https://doi.org/10.1093/pubmed/fdr029

https://www.theguardian.com/world/2020/apr/22/racial-inequality-in-britain-found-a-risk-factor-for-covid-19

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/updatingethniccontrastsindeathsinvolvingthecoronaviruscovid19englandandwales/deathsoccurring2marchto28july2020

Moorthy A, Sankar TK. Emerging public health challenge in the UK: perception and belief on increased COVID19 death among BAME health-care workers [published online ahead of print, 2020 Jul 3]. J Public Health (Oxf). 2020;fdaa096. https://doi.org/10.1093/pubmed/fdaa096

NHS England. Coronavirus: second phase of NHS response to COVID-19. Apr 29, 2020. https://www.england.nhs.uk/coronavirus/publication/second-phase-of-nhs-response-to-covid-19-letter-from-simon-stevens-and-amanda-pritchard.

O’Dowd A. NHS health checks should start at age 25 for BAME patients, MPs hear. BMJ. 2020;369:m2462. Published 2020 Jun 18. https://doi.org/10.1136/bmj.m2462.

Pareek M, Bangash MN, Pareek N, Pan D, Sze S, Minhas JS, et al. Ethnicity and COVID-19: an urgent public health research priority. Lancet. 2020;395(10234):1421–2. https://doi.org/10.1016/S0140-6736(20)30922-3

Public Health England. COVID-19: a review of disparities in risks and outcomes. 2020. Available online at https://www.gov.uk/government/publications/covid-19-review-of-disparities-in-risks-and-outcomes (accessed May 2020).

Trivedy C, Mills I, Dhanoya O. The impact of the risk of COVID-19 on Black, Asian and Minority Ethnic (BAME) members of the UK dental profession. Br Dent J. 2020;228(12):919–22. https://doi.org/10.1038/s41415-020-1781-6.

Razaq A, Harrison D, Karunanithi S, Barr B, Asaria M, Khunti K. BAME COVID-19 Deaths – What do we know? Rapid Data & Evidence Review: ‘Hidden in Plain Sight’. 2020. Available at https://www.cebm.net/wp-content/uploads/2020/05/BAME-COVID-Rapid-Data-Evidence-Review-Final-Hidden-in-Plain-Sight-compressed.pdf (accessed May 2020).

UK government. Overcrowded households. Available from:https://www.ethnicity-facts-figures.service.gov.uk/housing/housing-conditions/overcrowded-households/2.2. Accessed 26.07.2020.

Williams DR, Lawrence JA, Davis BA. Racism and health: evidence and needed research. Annu Rev Public Health. 2019;40:105–25. https://doi.org/10.1146/annurev-publhealth-040218-043750.

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World Health Organization (WHO). Coronavirus Disease (COVID-19) Situation Report-134

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  1. Covid-19 and ethnic minorities: agenda for urgent action Khunti K., BMJ 369, 2020.↩︎

  2. Covid-19: NHS assesses the risk to ethnic minority staff, higher, Iacobucci G. BMJ 369, 2020.↩︎

  3. The impact of coronavirus on minority societies dentists, Trivedy C, Mills I, Dhanoya O, 228 (12), 919-922, 2020.↩︎

  4. Ethnicity linked to outcomes of coronavirus? Khunti K, Kumar S, Pareek M, Hanif W, Bmj 369, 2020.↩︎

  5. The disproportionate effect of COVID-19 on ethnic minorities, Tony Kirby 8 (6), 547-548, 2020.↩︎

  6. Risk of severe COVID-19 in ethnic minority societies not explained by socioeconomic or behavior, E. Steffen. ( 42 (3), 451-460) 2020.↩︎

  7. Association of ethnicity with survival chances among patients with COVID-19 in New York. Chandan, Garg K Madhur, Racine D. Andrew, JAMA network open, 2020.↩︎

  8. COVID-19 Pandemic: Exacerbating Ethnic Disparities in Long-Term Services and Supports, Duan Y M, Shippee P, Thao S, Bowles R,, 1-11) 2020.↩︎

  9. https://www.theguardian.com/world/2020/apr/22/racial-inequality-in-britain-found-a-risk-factor-for-covid-19.↩︎

  10. The disproportionate impact of COVID-19 on ethnic societies in the United States of America, Geno B. Shah A. Doubeni A. Sia I. Wieland M. (Clinical Infectious Diseases) 2020.↩︎

  11. Black Lives Matter protests, COVID-19, Dave M, Friedson A. Matsuzawa K, Sabia J, Samuel Safford,( National Bureau of Economic Research Working Paper Series)2020.↩︎


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