Is the COVID-19 message reaching Britain’s minorities?

There is strong evidence that certain groups of the UK population are disproportionately impacted by the COVID-19 pandemic, in terms of risk of infection, more severe symptoms, and death. While the strongest factor is age, the most politicised is certainly race.

Tribal identity politics have driven several unhelpful political interventions. The disproportionate impact of COVID-19 on ethnic minorities was simplistically framed by Mayor of London Sadiq Khan as an “injustice”, and described by former shadow Home Secretary Diane Abbott as “a form of violence”. On the other side of the political spectrum, Tory backbencher Craig Whittaker offered the view that COVID-19 infection rates in his region of West Yorkshire were primarily down to British Muslim communities flouting social distancing rules and ignoring public health advice.

However, the truth is never simple. Firstly, only comparing white and ‘BAME’ obfuscates significant complexities: a report from the Institute for Fiscal Studies suggests that certain ethnic minorities, such as British Chinese people, have fewer COVID-19 deaths per capita than white British people. Further, after accounting for age and geography, they conclude that non-British white minority groups have higher-than-expected excess deaths compared to white British people. Crude racial categorisations may not give the full picture.

Secondly, there are myriad factors which feed into COVID-19 disparities that must be considered before proclaiming injustice. Geographically, some ethnic minorities are far more likely to live in more densely-populated urban areas when compared with white British people. Indeed, six in ten of Britain’s African and Caribbean communities live in London. The corresponding figure for white British people – only 8 per cent. Further, while only 2 per cent of white British people live in overcrowded households, the corresponding figure for the country’s Black Caribbean and Black African communities are 7 per cent and 16 per cent respectively. With younger-to-older viral transmission an ongoing concern, it is worth noting that while roughly 30 per cent of white households with someone over the age of 70 do have any younger people living with them, the corresponding figure for black households is 50 per cent.

In terms of employment, when compared with white British people, certain ethnic-minority populations are more likely to be in occupations with higher risk of COVID-19 exposure. For instance, one third of the working-age black African ethnic group are ‘key workers’, a proportion 50 per cent higher than the equivalent white British group. Within the healthcare sector, black British people are disproportionately likely to be front-line (patient-facing) healthcare workers. There are also  differences in pre-existing health conditions: increased mortality and disease severity are associated with diabetes, which black British people are around three times more likely to develop than white people.

But there is also the critically important issue of whether public health advice is being effectively communicated to, and absorbed by, certain British ethnic minorities. A recently published pre-print of a 32,000-respondent survey found that, after adjusting for a range of socio-demographic characteristics, Britain’s black and non-British white minorities had 42 per cent lower odds of correctly identifying of core COVID-19 symptoms, compared to white British people. This in turn may reduce the possibility of comprehensive COVID-19 self-isolation measures being adopted within these communities. Based on these findings, the report recommends that “targeted communications for these groups may help improve adherence and increase knowledge of common symptoms of COVID-19.”

There is certainly a discussion to be had over the UK’s preparation for this crisis, the degree of justifiable state intervention in response, and whether there should have been targeted messaging for certain ethnicities. But anyone with a reasonable understanding of “Urban Britain” and the workings of the coronavirus, would have known which ethnic groups were more exposed and vulnerable, and less likely to understand the basics of the disease.

The question is – how should the UK Government address the situation?

Public health authorities must give clear advice regarding containment measures against in-house transmission. While this admittedly difficult, it is particularly important for the crowded, multi-generational households more typical of ethnic minorities, where mixing of active young and vulnerable old people is common. In such households, along with the “core” government advice on washing hands, not touching one’s face, and covering coughs and sneezes, other suggestions should include regular disinfecting of shared bathrooms, separate storage of toothbrushes, the cleaning of objects which are frequently touched (such as door knobs, kettles, and remotes), and additional care being taken when distributing food at family meals. Crucially, there must be effective communication of the main symptoms of COVID-19 – and the risks of onward transmission.

This will be more difficult for lesser-integrated ethnic groups, and those for whom there are strong language barriers, such as people of Somali, Ethiopian, and Eritrean origin, and perhaps the non-British white minorities represented in the survey. Grassroots social groups can be employed as an effective and trusted “bridging resource” between public institutions and local communities.  It must be considered that public trust in the central government’s management of the pandemic has declined over time – and that trust in political institutions is traditionally low within British Black Caribbean communities.

Robust and honest enquiry must be conducted to investigate whether all groups adhere to social distancing measures when infected with COVID-19, whether due to lack of trust, or ignorance of its main symptoms. The economic and other health-related impacts of the recently tightened government measures will be difficult to justify if large sections of the British urban population cannot – or will not – comply. Such vital investigations must not be undermined by political correctness, lest the lives of the most vulnerable ethnic minorities become even more at risk. And unhelpful conclusions supporting one’s previous political convictions must be avoided, until we have established all the facts.

This article was published on CapX here: https://capx.co/we-cannot-let-political-correctness-undermine-the-fight-against-covid/

Published by Lily Geidelberg

Research Postgraduate in modelling of infectious disease epidemics, Imperial College London lilygeidelberg(at)gmail.com

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