The head of the British Medical Association has called on the government to urgently investigate if and why black, Asian and minority ethnic people are more vulnerable to Covid-19, after the first 10 doctors in the UK named as having died from the virus were all BAME. Those doctors have ancestry in regions including Asia, the Middle East and Africa. Even allowing for the overrepresentation of BAME staff in the NHS – they comprise 44% of medical staff compared with 14% of the population of England and Wales – the fact that they were all from ethnic minorities was “extremely disturbing and worrying”, the BMA chair said. “At face value, it seems hard to see how this can be random – to have the first 10 doctors of all being of BAME background,” Dr Chaand Nagpaul said. “Not only that, we also know that in terms of the BAME population, they make up about a third of those in intensive care. There’s a disproportionate percentage of BAME people getting ill. “We have heard the virus does not discriminate between individuals but there’s no doubt 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.” As well as the 10 doctors, three out of six nurses named as having died have also been BAME as was a hospital pharmacist and at least one healthcare assistant. The overall death figures in the UK have not been broken down by ethnicity but early research published this week showed that 35% of almost 2,000 patients in intensive care units were non-white. Nagpaul said BAME health professionals were understandably concerned about the deaths of their colleagues and what it might mean for them. The BMA chair said it might be too early to get firm answers but that it needed to be investigated. Among the factors he speculated could be contributing was whether BAME doctors felt less able to complain about inadequate personal protective equipment (PPE) – a recurring complaint among healthcare workers during the crisis – thereby putting themselves in danger. “BAME doctors often feel bullied and harassed at higher levels compared to their white counterparts,” he said. “They are twice as likely not to raise concerns because of fears of recrimination.” He said the death of BAME doctors was particularly upsetting because of “the vast majority – I think only one was born here – who have come from overseas and have given their lives to the NHS, to save the lives of others”. Among the wider BAME population, he suggested the fact that many were in key worker roles, combined with their living arrangements, could be contributing to their disproportionate presence in intensive care units. “You’ve got a high proportion of BAME people not able to stay at home, serving the nation, putting themselves at risk,” he said. “If you add that to overcrowded and multigenerational occupancies, the infections can be brought back home and spread to other members of the family.” Nagpaul questioned whether enough was being done in terms of translating information leaflets about Covid-19 and physical distancing for people for whom English is a second language, suggesting mosques and temples could be used by the government to help relay the message. He said difficulties speaking English could lead to problems accessing NHS 111 either online or on the phone. Nagpaul also highlighted the higher prevalence of diabetes, heart disease and kidney disease among BAME communities than in the white population, adding: “Previous inequalities will be greater at a time of crisis. This [coronavirus] may be bringing into focus historic inequalities facing BAME communities.” He said the best advice for BAME doctors to protect themselves against Covid-19 until more was known about the virus was the same as for any of their colleagues: ensure they are wearing appropriate PPE. He urged them not to risk their life if it was not forthcoming. “We need to safeguard our BAME population and the BAME medical officers,” he said “These are workers who are already experiencing significant hardships working for the NHS. They are serving the nation at a time of unprecedented crisis. The government must take steps to address this.” The Department of Health and Social Care said it was working hard to protect all communities, adding that translations of the public information leaflet, posted to all 30 million households in the UK, were available on its website.