Doctor’s Note: Is coronavirus risk higher for some ethnic groups?

In the US and UK Black people and other ethnic minority groups are being hit disproportionately hard by the coronavirus.

Doctor''s note - ethnic groups are being disproportionately affected by coronavirus
There are reports of some ethnic groups being disproportionately affected by the coronavirus [Getty Images]

We know that nobody is immune to becoming infected with the coronavirus, and that is why countries have introduced such stringent measures of social distancing and self-isolation.

New York’s Governor, Andrew Cuomo, once called the coronavirus a “great equaliser,” but if everybody is at equal risk, why are there reports of some ethnic groups being disproportionally affected by the virus?

In the United States city of Chicago, where Black people make up 29 percent of the population, they account for some 70 percent of deaths from the coronavirus so far. Other cities in the US are reporting similar trends – including New York, Louisiana, New Orleans, Detroit and Milwaukee.

This trend is not restricted to the US. A similar picture is being reported in the United Kingdom.

According to The Intensive Care National Research and Audit Centre, of the 3,300 British coronavirus patients it has studied, 35 percent were non-white, while only 13 percent of the UK population is non-white.

Health inequalities carved along racial lines are nothing new. The coronavirus pandemic has merely shone a light on what we already knew.

Several studies have shown well before the coronavirus pandemic that ethnic minorities in countries like the US and the UK have worse overall health outcomes than their white counterparts, so is it any wonder that these populations would show higher rates of infection when the coronavirus hit?

Experts are still grappling with the total numbers of people affected by the COVID-19 virus and searching for reasons why they are higher in certain communities. However, one message is cutting through the noise and that is one of socioeconomic class.

In the US, Black Americans are twice as likely to lack health insurance as their white counterparts, and are more likely to live in areas where medical services have been cut or restricted.

They are also more likely to work in lower-paid jobs that do not offer sick pay, so there is increased pressure on them to get to work even if they should be self-isolating.

Last month, Congressional Democrats including Elizabeth Warren sent a letter to the Centers for Disease Control (CDC) asking why the data it had released on the coronavirus was not being broken down along racial lines.

In it, the Democrats stated: “Although COVID-19 does not discriminate along racial or ethnic lines, existing racial disparities and inequities in health outcomes and health care access may mean that the nation’s response to preventing and mitigating its harms will not be felt equally in every community.”

As well as these socioeconomic disparities, however, people from Black and South Asian backgrounds are more likely to suffer from chronic diseases that increase their risk of the complications of coronavirus.

Conditions such as type 2 diabetes, heart disease, kidney disease and high blood pressure are all more prevalent in these communities.

The reasons for this are not fully understood, but experts believe it is a mix of dietary, lifestyle and genetic differences in the way these groups store body fat that increases their risk.

So, although socioeconomic factors play a large part in determining health outcomes for these populations, genetic makeup and predisposition for diseases that have been linked to poorer outcomes when combined with a coronavirus infection also play a part.

When coronavirus infects people with these conditions, their immune systems can respond more slowly, increasing their chances of developing life-threatening complications such as pneumonia and respiratory distress.

This might be part of the reason we are seeing higher numbers of patients in intensive care with the coronavirus from these populations.

Certain ethnic groups also tend to be more likely to live in multi-generational housing. According to UK government statistics, 30 percent of people from a Bangladeshi background were likely to live in overcrowded homes. This drops to 16 percent for those from a Pakistani background and 15 percent for those from a Black African background.

These are all markedly higher than the 2 percent of white British people who are said to be living in overcrowded housing, which makes social distancing and self isolation much harder.

In the UK, people who work in transport services and for the National Health Service are disproportionately from ethnic backgrounds.

The chairman of the British Medical Association (BMA), Dr Chaand Nagpaul, has urged the British government to investigate if and why people from ethnic groups are more vulnerable to COVID-19, after the first 10 doctors in the UK to have died from the virus were all from these populations.

Even allowing for the over-representation of ethnic-minority staff in the NHS (44 percent of medical staff compared with 14 percent of the population in England and Wales), this trend in deaths was described as “extremely disturbing and worrying”, by the BMA chair.

While essential services remain open in the UK, there are higher numbers of people from these populations being exposed to the virus and, subsequently, infected.

Although the factors are multiple, the statistics are becoming clearer. People from ethnic backgrounds are at greater risk of dying from the coronavirus.

This pandemic has highlighted what was already an obvious health inequality for many. When the time is right, serious questions need to be asked.

Source: Al Jazeera