The long read: Asians high on UK’s Covid grim list

People with sub-continental and non-white origins have been significantly more impacted by Covid than others. What are the reasons for this vulnerability?

Scratch the surface, or read between the lines, and a different picture emerges. The grim headline that is better known across the globe refers to the United Kingdom suffering one of the worst impacts from Covid-19: over 150,000 deaths and more than 4.3 million cases. But less known outside the country is the disproportionately high impact of the virus on non-white communities comprising large numbers of people with origins in the Indian sub-continent. It is not only Rajesh Jayaseelan, 45, who moved to the UK from Bengaluru a decade ago and made a living in London as a taxi driver, but also several respected doctors such as Abdul Mabud Choudhury, 53, Poornima Nair, 56, or Anton Sebastianpillai, 70, who passed away after contracting the virus.

Last week, the UK observed the anniversary of the first lockdown imposed on March 23, 2020, but the day also marked the metaphorical tombstone of some of the first Covid-19 casualties from non-white communities. The country has gone through two waves. According to the latest official data based on a comparison of the first wave in 2020 and the early second in February, the figures have improved for some ethnic groups including Black Africans, Black Caribbean, Chinese and Indians but have worsened for Pakistanis and Bangladeshis, prompting more action from the Boris Johnson government to deal with the issue.

Known in official UK parlance as BAME (black, Asian and minority ethnic) communities, its members have been dealing with the pandemic at various levels. The largest numbers of doctors working in the National Health Service (NHS) who gained qualifications outside the UK are those from India, from where professionals have historically arrived to train and gain higher qualifications since the NHS was founded in 1948. The grim list of such doctors categorised as ‘Indian’ in Covid-19 death records include Jitendra Kumar Rathod, Krishan Arora, Rajesh Kalraiya, Pooja Sharma, Jayesh Patel, Vivek Sharma, Kamlesh Kumar Masson, Amarante Dias, Sophie Fagan, Hamza Pacheeri and Amrik Bamotra. There have been many more from other parts of the sub-continent.

But Asian casualties in the medical profession tell part of the story. The BAME communities constitute 13 per cent of the UK population, but are disproportionately represented in the high numbers among the dead, those admitted in intensive care units or in the number of new cases. In England alone — the largest and the most populated of the four constituents of the United Kingdom — latest figures show that the ‘Indian’ category has the highest number of the dead within the BAME group, constituting 3 per cent of the casualties, followed by the ‘Pakistani’ group at 2 per cent. The grim figures are: Indian: 2,202; Pakistani: 1,796; Bangladeshi: 688; any other Asian background: 1,184; Caribbean: 1,339.

The community factor

Several studies by government departments, think-tanks and charity organisations have highlighted the high impact on close-knit BAME communities. The reasons include socio-economic status, cultural practices and environmental conditions (largely influenced by structural biases based on ethnicity) collectively driving inequalities; existing co-morbidities (such as diabetes); as well as wider social and structural disparities such as racism, deprivation, living conditions, nature of employment. They have a large presence in public-facing employment roles in transport, hospitality, airline and other sectors. The challenge of dealing with the virus in BAME communities includes the larger incidence of multi-generation households compared to the white community. The impact has been felt at various levels due to restrictions, including financial (job losses), inability to join family events (such as funerals, marriages), mental health issues due to prolonged isolation and increase in domestic violence. London-based wedding planner Saheli Mirpuri says the industry has been severely hit, with tens of thousands of weddings cancelled. Some studies also suggest that in the early stages of the pandemic key public messages (for example, ‘Stay home. Protect the NHS. Save lives’) did not reach sections of the non-white communities who are not familiar with the English language.

Says Chand Nagpaul, council chair of the British Medical Association: “Covid-19 has had a devastating and disproportionate impact on people from black and ethnic minority communities. Progress in both, recognising and then tackling this, in order to stop more BAME people becoming ill and dying, has been far too slow. It’s positive to see the steps the government now appears to be taking. Of course, the success of this work can only be judged by the impact it is having on the ground, closing the gap between the way Covid affects different communities. Black and minority ethnic people still account for 28 per cent of people within critical care with Covid-19. BAME people are over-represented in frontline occupations, low-income jobs and many are self-employed or gig economy workers. They must be provided with better protection from the virus, as well as financial support — including for those asked to self-isolate — to ensure people are not risking their lives and those of their family simply to put food on the table.”

A new report of workforce race equality standard in the NHS concluded that Covid-19 did not create race inequality, but the pandemic has thrown it into sharp relief. The report found that BAME staff in the NHS is 2.5 times more likely to have personally experienced discrimination at work from a manager, team leader and/or colleagues compared to their white colleagues.

Says Prerana Issar, NHS chief people officer: “The country and the NHS have been challenged like never before by the Covid-19 pandemic, a disease that has been shown to disproportionately affect black and minority ethnic people. The murder of George Floyd in the US spurred an immediate and long-overdue global conversation about race inequality. Attention has not been so sharply focussed on this agenda for decades, and it is right that we examine these findings with a view to quickening the pace of change, against this backdrop. This year’s (workforce race equality standard) report shows that, at the point at which the pandemic struck, inequalities were already present in the NHS.”

A complex Asian matrix

If the picture of the impact of Covid-19 on non-white communities based on data from the Office for National Statistics or Public Health England — ‘from above’ — is stark, similar is the situation ‘from below’ in areas such as Ealing Southall, Brent, Leicester and Birmingham, which have a large population of Asian origin.

In Southall, the complex matrix of job cuts, restrictions on movement, school and workplace closures has led to an increase in domestic violence, among other issues. Says Virendra Sharma, senior Labour MP from Ealing Southall: “In London, the number of Covid-19 cases has been the highest in Ealing Southall, but now the people understand the importance of following official guidance. There has been an increase in mental health issues, also domestic violence. For example, earlier a typical family’s day would be the husband and wife going for work in the morning, kids in schools, and all returning home in the afternoon or evening. Their interaction was less; now they are together 24 hours at home, which leads to friction. This is not the situation in every household in my constituency, but in many of them. The stress level is high, also because houses are small and the numbers of living in them are more.”

(Prasun Sonwalkar is a London-based journalist.)