Coronavirus Killing Black Britons at Twice the Rate as Whites - The New York Times

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That gap grows to four times when class and health differences aren’t considered. South Asians have also been dying disproportionately.

Credit...Andrew Testa for The New York Times

LONDON — Black people in England and Wales are twice as likely to die from the coronavirus as white people, even accounting for differences in class and in some underlying health measures, according to official figures released on Thursday, laying bare an extraordinary gap in the toll of the coronavirus.

The analysis, conducted by Britain’s Office of National Statistics, found that longstanding differences in wealth, education, living arrangements and self-reported health could explain a portion of the outsized impact of the virus on racial and ethnic minorities.

But not all of it. The number of black and South Asian people working in public-facing jobs and living with conditions that increase vulnerability to the coronavirus, like obesity, hypertension and diabetes, may account for other parts of the elevated risk, researchers said.

“The underlying health and social disparities that drive inequality in health and life expectancy have been there all along, and this virus has just laid them bare,” said Dr. Riyaz Patel, an associate professor of cardiology at University College London. “This pandemic has not been the great leveler. It’s been the great magnifier, as it were.”

A decade of austerity under successive Conservative-led governments in Britain had already contributed to shrinking life expectancy in deprived communities and to expanding health inequality, according to a major report released in February by the Institute of Health Equity at University College London.

More than 30,000 people in Britain have died from the coronavirus, among the worst death tolls in Europe.

As the outsized toll of the virus on black and South Asian people has emerged in recent weeks, the government of Prime Minister Boris Johnson, a Conservative, has been forced to respond.

Public Health England said it would review how ethnicity, among other factors, figures into people’s risk from the coronavirus.

Responding to the deaths of a number of black, Asian and ethnic minority doctors, the National Health Service issued guidelines telling hospitals to assess the vulnerability of front-line workers and potentially reassign some to other jobs.

Matt Hancock, the health secretary, said on Monday: “We recognize that there has been a disproportionately high number of people from black and ethnic minority backgrounds who have passed away, especially among care workers and those in the N.H.S.”

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Credit...Peter Nicholls/Reuters

Among the major unanswered questions is whether people from racial and ethnic minority groups are catching the virus at higher rates or, once they catch it, are suffering more serious effects, said Keith Neal, an emeritus professor of the epidemiology of infectious diseases at the University of Nottingham.

“If they’re catching it twice as often, that’s a different answer to ‘they’re dying twice as often,’” Professor Neal said.

The analysis from the Office of National Statistics went beyond previous studies in Britain in examining the fate not only of hospital patients, but also of people in nursing homes and elsewhere who died from the virus.

After accounting for limited class and health data, people of Bangladeshi and Pakistani ethnicities were nearly twice as likely to die from the coronavirus as white people.

People of Indian and mixed ethnicities also had an elevated risk of death, the analysis found. The only group with a lower risk of death than their white counterparts, accounting for socio-economic differences, was Chinese women.

The researchers accounted for a range of factors that could be associated with people’s risk from the virus. Among them were crowding in households, urban-rural divides, income and education.

Nearly a third of Bangladeshi households, a sixth of Pakistani households and an eighth of black households experienced overcrowding from 2014 to 2017, a risk factor for spreading the coronavirus. Only 2 percent of white British households experienced the same, according to a study of the English Housing Survey.

Black people and ethnic minorities are also more likely to live in cities, where the virus arrived first in Britain and spread much more quickly.

The researchers also adjusted for a rough measure of self-reported health from the 2011 census and the presence of disability. That helped account for pre-existing health disparities, analysts said, but not necessarily the higher prevalence among minorities of specific conditions that raise the risk from the virus.

Without accounting for class or health differences, black people were four times as likely to die from the coronavirus as white people in England and Wales, the Office of National Statistics found.

Dr. Patel questioned whether successive British governments had done enough over the long term to improve the health of vulnerable groups and help them withstand a pandemic.

“Health inequality has increased over the last decade or more, rather than decreased,” he said. He pointed to the February report about health inequities showing that, for part of the period from 2010 to 2020, “life expectancy actually fell in the most deprived communities outside London for women and in some regions for men.”

Some lawmakers demanded action in response to the analysis on Thursday.

“Appalling,” said David Lammy, a Labour lawmaker. “It is urgent the causes of this disproportionality are investigated. Action must be taken to protect black men and women — as well as people from all backgrounds — from the virus.”

  • Updated April 11, 2020

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.



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