The review by Public Health England (PHE) published on 2 June was commissioned to examine why people from black, Asian and minority ethnic (BAME) communities were more likely to contract and die from Covid-19.
There were six objectives for the review – among them analysing all current literature and disparities, and, more importantly, suggesting ‘recommendations for future action that should be taken to reduce disparities in risk and outcomes from Covid-19 on the population’.
This 89-page report contains all the evidence required to substantiate what is already known, that the risk of mortality among the BAME community is twice that of the white population. What was unexpected and a huge surprise was that the report made no recommendations at all, and in this regard it not only failed to meet with its objectives, but caused anger and consternation among the BAME community, some calling it a ‘damp squib’ and a ‘half-baked job’.
The fact that PHE’s analysis excluded the reasons that were likely to be contributory factors to the disproportionate effect on ethnic minorities, such as comorbidity and occupation, rendered the report totally unacceptable. However, yesterday the amputated part of the report was leaked to reveal that in fact the following recommendations were made by Professor Kevin Fenton, the lead author:
Coronavirus isn’t racist, but it has exposed racism in the system
1. Collection and recording of ethnicity data as part of routine collection systems, including at death certification
2. Support community participatory research. To understand social, cultural, structural, economic, religious and commercial detriments of Covid-19 in the BAME community. This will help ‘reduce risk and improve health outcomes’
3. Improve representation of BAME communities among staff at all levels in NHS, local Government, and integrated care systems
4. Accelerate the development of culturally competent occupational risk assessment tools that can be employed in a variety of occupational settings and used to reduce the risk of employees exposure to Covid-19. Especially for key for line workers
5. Fund and implement culturally competent Covid-19 education and prevention campaigns
6. Accelerate efforts to target culturally competent health promotion and disease prevention programmes
7. Rebuild trust with the community.
Only an incompetent, confused health secretary would withhold or delay these pragmatic and sensible recommendations. The Government’s response is a complete shambles, and the BAME community feels let down and betrayed.
To many, this is like Windrush all over again. Coronavirus isn’t racist, but the pandemic has exposed racism in the system. And every day the Government doesn’t act, more lives are lost. There was no need to amputate the recommendations from the report. They’re all sensible, and they must be implemented without any delay.
It now needs the collective will of politicians to ensure that the injustice of an incomplete review does not hang in the balance. The momentum needs to be sustained to demonstrate to these communities that we are a caring, compassionate society, and so that there is no unnecessary loss of life amongst the BAME community, as well as others identified to be at risk, from this devastating disease.
Dr Kailash Chand OBE is a retired GP in Tameside