Urgent response needed to tackle COVID-19 health disparities

An Imperial expert has called for rapid action to tackle the causes of severe COVID-19 illness and death in ethnic minority groups.

Dr Shevanthi Nayagam, MRC Research Fellow within the School of Public Health at Imperial College London and Honorary Consultant Hepatologist at Imperial College Healthcare NHS Trust, led a study which found that Black patients requiring hospitalisation are at increased risk of poorer health outcomes from COVID-19.  She was speaking at the Imperial College Academic Health Science Centre (AHSC) COVID-19 online seminar series which took place earlier this month.

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Reasons for the disparity

A Public Health England inquiry confirmed that people from Black, Asian and other ethnic minority groups are dying disproportionately from COVID-19.  The report also found that people of Bangladeshi background in England are twice as likely as white Britons to die if they contract COVID-19, and other ethnic minority groups face an increased risk of up to 50 per cent.    

Ahead of a second wave of COVID-19 cases, Dr Nayagam explained that more work needs to be done to further understand the reasons for the disparity and to target interventions at those who are at highest of severe COVID-19 illness or death. She said:

“The COVID-19 pandemic has had a devastating impact on many in the UK.  However, those from minority ethnic groups have suffered disproportionality and studies have shown that they have a higher risk of severe illness and death from the virus than people who identify as White.  Now that we have this information it is important for us to dig deeper and find out the causes behind this . The underlying reasons are likely to be due to a complex interplay of factors. Cases of COVID-19 are on the rise again and we need to take immediate action to ensure that communities most at risk are protected.” 

Main risk factors

The research done by Dr Nayagam and her team, which has been published in Clinical Infectious Diseases, analysed the main risk factors associated with deaths for patients admitted for COVID-19 to three hospitals in Imperial College Healthcare NHS Trust earlier this year, evaluating whether outcomes vary by ethnicity.

The findings revealed that over a five-week period, a larger proportion of patients admitted were from ethnic minority groups when compared with last year’s admissions at the same hospital Trust.  In addition, compared to white patients, black patients admitted to hospital with COVID-19 tended to be younger, have fewer pre-existing health conditions, and when other factors are taken into account, tended to have worse health outcomes.

Dr Nayagam explained that the disproportionate impact of COVID19 on ethnic minority communities was seen in other countries around the world.  For example, a large study in Brazil showed that people from a mixed or Black background had a higher risk of mortality compared to white Brazilians.  Similarly, in the USA cases of COVID-19, hospitalisations and deaths were higher in people from African American backgrounds than their white counterparts.