Ethnicity should be considered a risk factor in determining priority for Covid tests, two national think-tanks have said, amid warnings that ethnic minorities will be disproportionately affected during a second wave.
The Institute for Public Policy Research (IPPR) and Runnymede Trust (RT) concluded it is unlikely that the Government will be able to meet the demand for Covid tests this winter, and called for a triage system to be introduced that ensures those most at risk get access first.
In a report, examining ways to tackle health inequalities, the think-tanks said the current list of priority groups for testing, which includes NHS and care workers, should be extended to feature ethnic minorities, ‘given the large unexplained excess risk of death’ from the virus many face.
They added: [The triage system] would help ensure that groups of people who are more likely to be exposed to Covid-19, more likely to expose others to Covid-19, or more at risk of suffering worse consequences from Covid-19 are able to access testing first.’
The IPPR and RT said the extra risk of death among minority groups ‘is one of the starkest health inequalities in recent times’. It estimated that 58,000 more coronavirus deaths would have occurred in England and Wales had the white population experienced the same risks as black communities, and 35,000 more if the risk matched that facing the Asian population.
The organisations called on the Government to launch a ‘comprehensive strategy to mitigate ethnic inequalities’, which includes delivering an emergency funding package to all local authorities to facilitate local outbreak planning and deal with increasing cases this winter.
IPPR and RT analysis also found that ethnic communities were disproportionately impacted by public health budget cuts in recent years, with the 10 most ethnically diverse local authorities having suffered over £15m more in public health budget cuts compared to the 10 least ethnically diverse local authorities.
The Government should embrace community-led approaches, as they are ‘critical to reach marginalised populations, who are often less likely to receive and act on public health messaging’, the report added.
It also recommended that the Government scale up its scheme of offering empty hotels to NHS workers and the homeless, to ensure temporary accommodation for ‘all who need to isolate but live in difficult conditions’ this winter.
The thinktanks highlighted that many from ethnic minority backgrounds find it harder to self-isolate, with nearly one third of Bangladeshi households and 15% of Black African households classified as overcrowded, compared to only 2% of white households.
The report also urged the Government to work on removing barriers to accessing healthcare for minority ethnic groups, in light of research that showed non-white patients with Covid-19 are presenting to accident and emergency (A&E) more acutely unwell.
Cause of inequality
The IPPR and RT said the prevalence of comorbid diseases among ethnic minority groups does not explain the disproportionate impact of Covid, estimating that it leads to the black population being only 5% more likely to die from Covid-19 than the white population.
‘Higher deprivation levels explain the disparities to a greater extent, but the majority of the additional risk of death from Covid-19 experienced by minority ethnic communities is unexplained,’ the report said.
‘This reflects the difficulty of linking health and social data, and the paucity of data on ethnicity. Some commentators have looked to fill this void with claims about genetic differences. But the evidence is clear – there is no genetic basis for race or ethnicity. Genetics cannot explain why every minority ethnic population, given huge genetic diversity within and between these groups, has a higher risk of death from Covid-19 than the white ethnic population.’
It added that the inequality is instead likely to be down to structural and institutional racism, which results in variances in social conditions, including occupation and housing, as well as differential access to healthcare.