However the Inquiry’s public health organisations will have to address six crucial issues to be credible
By Thomas L Blair 19 April 2020 ©
Black, Asian and minority ethnic people are over-represented in Covid-19 critical care units and among NHS staff who have died. Belatedly, the Conservative government has asked the governing body NHS England and the watch dog agency Public Health England to inquire why they appear to be more affected by the virus.
But critics fear the Inquiry will kick the solutions to the deaths crisis down the road even as the consequences could be lethal.
Here, for the first time, we have sourced and publish the available evidence-based inequality data. We report the warnings from Black and Asian professionals and politicians and the poetic tributes to key frontline workers of immigrant heritage so far ignored.
Myth-busting is the first step
Since the outbreak took hold in the UK, most cases are concentrated in hardscrabble Black, Asian and ethnic communities in the virus epicentres of London and other urban areas. Research by the Intensive Care National Audit & Research Centre shows that Blacks make up 11.9% of critically ill coronavirus patients in England and Wales though they are only 3.3% of the population. Also, when the figures are matched to localities, Black patients are over-represented at a rate of double the local population.
Furthermore, a Guardian analysis “found that of 53 NHS staff known to have died in the pandemic so far, 68% were Black, Asian and minority ethnics (BAME). They include 22 nurses, two porters, a radiology support worker, a patient discharge planner and a hospital bus driver”.
The alarm has been raised
Dr Chaand Nagpaul, chair of the British Medical Association says “there appears to be a manifest disproportionate severity of infection in BAME people and doctors. This has to be addressed – the government must act now.”
This view negates the “equaliser” myth said distinguished clinical practice and policy expert Prof Kamlesh Khunti, of the Black and Minority Ethnic Health Centre in Leicester, one of the most ethnically diverse cities in the UK. The data show a higher number of black and minority ethnic populations being admitted to intensive care units, said the Department of Health advisor on screening, risk assessment, obesity and vascular disease in diabetes.
Black politicians have already sounded the alarm. Marsha de Cordova MP, Labour’s Shadow Women and Equalities Secretary told The Mail Online “The Government must urgently investigate why BAME communities are more vulnerable to this virus.”
The deeply moving multi-voiced poem #You Clap For Me Now has sparked an outpouring of support for the frontline workers who serve despite the coronavirus. These include all staff in NHS health and social care and public service, transport, food provision, delivery drivers, refuse collectors, many of immigrant backgrounds.
But while imperilled frontline workers would readily applaud the NHS, a national treasure even in normal times, the campaigning #CharitySoWhite is an influential online critic. One of their followers tweeted “We’re in their photographs, we fill in surveys. Nothing changes. There’s no action. There’s no roadmap. Honestly, I’m so tired of just talking”. In sum we are watching, in real time, the pandemics of disease and race/class disparities.
Lord Simon Woolley, director of Operation Black Vote, said: “The virus itself doesn’t discriminate, but the system does, and that has left BAME communities extremely vulnerable both on health and economic grounds. Therefore, “There is a debt owed to these communities by the government and the nation and they must not be left behind.”
But are the inquirers up to the task?
|When viewing the most senior ranks of the tasked NHS England and the watch dog agency Public Health England one doubts their abilities to satisfactorily address pass six crucial issues.
One, given their longstanding mission, they have so far failed to provide enough public data for policymakers and the public to understand the virus impact on threatened communities. Thereby, failing to uphold core commitments to tackle “health inequalities and human rights as part of the Health and Social Care Act 2012”.
Two, they have shown no evidence that they have monitored, collected and published relevant data –- before or in the early stages of the Black viral crisis. If they have, they should reveal the data, their evaluation and conclusions for scrutiny.
Three, resolving the controversy over ethnic coding for death certification is likely to be a thorny issue, according to epidemiologists in health care and race equality.
Four, the lack of visible diversity at the highest managerial levels increases every suspicion they will fail to call on the resource pool of minority talent and frontline opinions.
Five, there is no real evidence that they have or will actively “seek to involve patients, staff and communities in equality-related discussions”.
Six, the lack of binding constraints on delivery does not engender confidence in their ability to speedily “improve the access, experiences and health outcomes and quality of care for all who use and deliver health and care services”.
If these flaws are not redressed it is impossible to deny that the inquiry will be anything more than a pantomime of justice.
Clearly, the extraordinary effect of the virus is the de facto disparity between life and death for Black, Asians and minority ethnic people compared with other citizens. However, it is one thing to task the NHS and Public Health England with an inquiry and another for them to promptly assist policy action. Anything less than a timely report back will understandably cause mistrust in minority communities weary after the year’s long Grenfell fire and the Windrush generation still inconclusive inquiries.
These are legitimate concerns and matters for Prime minister Boris Johnson, his stand-in Dominic Raab and the Conservative government to correct.
Read more about the race deficit at April 1, 2020, Covid-19 Virus Lockdown Spotlights Race Deficit
NOTES and SOURCES
The “PPE” artwork by Zita Holbourne is reproduced from zitabaracuk
For further evidence from ICNARC on the disproportionate impact of COVID-19 on people of colour – see https://www.bbc.co.uk/news/uk-52219070 and https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports
Chronicleworld combines cyber-scholarship and social action challenging the status quo