Failure to publish data on BAME deaths could put more lives at risk, MPs warn

  • 4/17/2020
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Public Health England must publish the data it holds on the deaths of BAME patients from Covid-19 as failure to do so could be putting lives at risk, politicians and pressure groups have warned. With patients from ethnic minority backgrounds over-represented in critical care units and among NHS staff who have died, the government on Thursday agreed to an inquiry into why they appear to be more affected by the virus. But with no comprehensive data about the ethnicity of those who have died as a result of the virus publicly available, critics said the failure to publish the information could create the impression that the problem doesn’t exist. On Thursday, the government said there would be a formal review by NHS England and Public Health England into why ethnic minorities appear to be disproportionately affected by the virus. But no information about what – if any – data would be shared or timeframe was provided. BAME (black, Asian and minority ethnic) campaigners said it was imperative that figures were shared quickly so that analysis could begin as soon as possible. A Guardian analysis found that of 53 NHS staff known to have died in the pandemic so far, 68% were BAME. They include 22 nurses, two porters, a radiology support worker, a patient discharge planner and a hospital bus driver. While the proportion of people from a minority ethnic background is higher in the NHS – 20%, rising to 44% for medical staff – the respective mortality rate, like the proportion of critical care admissions, is out of kilter. Lord Woolley, director of Operation Black Vote, said: “Anecdotally, we know that Covid-19 is having a devastating impact on BAME communities, particularly in England. We suspect that BAME individuals, including frontline and essential workers, are disproportionately exposed to this virus. If Public Health England has ethnic data on who’s dying in hospital, they must release it. Only with transparency of data and quick action from all relevant agencies will we save lives.” The government’s low-key announcement of an inquiry came after the head of the British Medical Association (BMA), Dr Chaand Nagpaul, gave an interview with the Guardian last week calling for an official investigation. He said: “At face value, it seems hard to see how this can be random.” The Guardian understands that Public Health England is collating and analysing data on the ethnicity of patients who have died of Covid-19 in healthcare settings. However, it is not clear how long it will take to gather and publish the data. Dr Zubaida Haque, deputy director of the Runnymede Trust, said: “If you’re not disaggregating by ethnicity, that means we have no idea whether there is any racial disproportionality at all. If you don’t ask the questions in data, then you don’t have answers. If you don’t measure it, then that problem doesn’t exist.” Asian and black patients are over-represented in critical care and account for a third of patients in hospital, despite making up a quarter of the population in the same areas. A study of 3,883 patients in critical care with Covid-19 from the Intensive Care National Audit and Research Centre showed that BAME patients accounted for 33.6% of patients with the virus, despite accounting for just 14% of the population, according to the 2011 census. Asian patients make up 14.4% and black patients accounted for 11.9% of those in critical care units. However, when the figures are tallied against the local population, black patients are over-represented by a factor of two. The BMA called for an inquiry based on the early critical care figures. More than a dozen healthcare workers from the Philippines have died from coronavirus in the UK. At least 23 people of Filipino origin are known to have died since the start of the outbreak. The shadow equalities secretary, Marsha de Cordova, welcomed the review, but said it was “not yet clear whether it will be independent, when it will be concluded, and who will be leading it”. Rachel Logan, Amnesty UK’s law and human rights programme director, said the government review was needed, but had to be transparent. “There’s been much talk of how coronavirus is a ‘great leveller’, but these figures appear to show that some communities are suffering more than others,” she said. “It is essential that the government ensure it is properly investigating why.” Responding to the inquiry, Nagpaul said: “We are pleased that the government has heeded the BMA’s call for this review. However, if the review is to have any meaningful impact, it needs to be informed with real-time data to understand why and how this deadly virus can have such a tragic disproportionate toll on our BAME communities and healthcare workers. This must include daily updates on ethnicity, circumstance and all protected characteristics of all patients in hospital as well as levels of illness in the community, which is not currently recorded. “It also means taking vital steps now to protect our BAME communities until we can develop a detailed understanding of the threats they face. This could include that those at greatest risk, including older and retired doctors, are not working in potentially infectious settings.” Yasmin Qureshi, MP for Bolton South-East, has also called on the government to release data about BAME deaths. Along with a group of 27 Labour MPs, she urged Matt Hancock, the health secretary, to examine why such a large number of BAME doctors were dying. “When I became aware of these statistics I asked the Department of Health to explain,” she said. Ethnicity is not collected on death certificates in England and Wales, unlike in Scotland where it was added in 2012. This means that based on current mortality data it will not be possible to assess who has died from the virus outside hospitals. A spokesperson for the Office for National Statistics said work was underway to match data on Covid-19 deaths to other data sets to understand more about how ethnicity and deprivation are related to who is dying. However developing the new data is expected to take weeks, by which time it is anticipated the peak of the first wave of the virus will have passed. The chief medical officer, Prof Chris Whitty, said the intention of the inquiry was “to look at this in some detail and then what we really want is, if we see any signal at all, we want to then know what next we can do about it to minimise risk”.

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