A new study found out that the South Asian communities in the United Kingdom are more likely to get infected by Covid-19, become severely ill and even die than any other minority ethnic community during the second wave of the pandemic. The research has been published in The Lancet medical journal and is based on 17 million adults in England, in what is thought to be the largest study to date.
Partially anonymized data of 17,288,532 patients on the OpenSAFELY database were studied by researchers in the study. Ethnicity was self-reported by participants and grouped into five categories – white, South Asian, black, other, and mixed.
During the first wave in the country, which lasted from February to September 2020, all minority ethnic groups were found to be at a higher risk of getting infected by the virus, getting hospitalized, being under intensive care, and eventually dying when compared to the white community.
For example, a study of the Covid-19 deaths in the UK between March and May last year found that mortality rates were highest for the blacks. While the reduced risk among blacks and mixed ethnic groups during the second wave has been encouraging, it has been noted with concern that an opposite trend emerged for South Asians, for whom the risk of more adverse Covid outcomes was increased in the second wave, the study, published on 30 April, noted.
However, during the second wave from September to December 2020, all other minority ethnic groups have fared better, except for the South Asian communities. “Despite the improvements seen in most minority ethnic groups in the second wave compared to the first, it’s concerning to see that the disparity widened among south Asian groups.
This highlights an urgent need to find effective prevention measures that fit with the needs of the UK’s ethnically diverse population”, said Dr Rohini Mathur of the London School of Hygiene and Tropical Medicine.
Among a range of factors responsible for the differential impact of the virus on south Asian communities, one is that more than any other community, South Asians tend to live in multi-generational settings and households, the study said. The 2011 census showed 21% of south Asian groups lived in multigenerational households, compared with 7% of white groups.
Other factors would include blood pressure, body weight, and other underlying health conditions, along with socio-economic deprivation in the form of relatively limited access to healthcare, living in backward areas or having frontline jobs, and greater occupational risk. Also, stigma and underlying racism may have a role to play in why the virus is known to pose a greater risk on minorities.
“Our study indicates that even after accounting for many of these factors, the risk for testing positive, hospitalisation, ICU admission, and death was still higher in minority ethnic groups compared with white people in England. To improve Covid-19 outcomes, we urgently need to tackle the wider disadvantage and structural racism faced by these communities, as well as improving access to care and reducing transmission” said Dr. Mathur.
More intensive strategies to help improve outcomes in South Asian communities are being called for by the researchers, as well as help to reduce structural disadvantage and inequality. There were many benefits to multigenerational living, she said. “Such households and extended communities also offer valuable informal care networks, and facilitate engagement with health and community services.”
But those communities must be encouraged to be vaccinated. “In light of emerging evidence that minority ethnic groups are less likely to take up the Covid-19 vaccine, co-designing culturally competent and non-stigmatizing engagement strategies with these communities is increasingly important,” she added.
Dr. Daniel Morales, of the University of Dundee, and Dr. Sarah Ali, of the Royal Free London NHS Foundation Trust, said that tackling vaccine hesitancy is now the main challenge. “Unless vaccine hesitancy is tackled head-on, differential vaccine uptake may further exacerbate health inequalities faced by minority ethnic groups,” they said.