Asian-British, I found statistics last week about ethnicity and coronavirus very worrying. Black, Asian and ethnic minority patients more than one third of them are in critical care with Covid-19 and 17% of deaths from viruses.
Even taking into account age and socio-economic factors, we are still more likely to get a more serious coronavirus than white people.
That certainly happened in my family. My husband, also an Asian Englishman, and I both suffered very badly with coronavirus a few weeks ago. We are usually very healthy without health conditions and have been taking vitamin D supplements for years. But we both had symptoms of debilitating fever, severe muscular and chest pain, shortness of breath and fatigue, which in my case lasted for three weeks. I was hospitalized for several days and given antibiotics for pneumonia. Luckily we both made a good recovery but it made me unsure whether being a BAME contributed to the severity of our illness.
As doctors, we were tested, but not until the second week of illness with negative results. We have classic coronavirus symptoms and in my case a chest radiograph also showed changes in the Covid-19 lung. Testing is recommended within five sick days and this will explain our negative results even though we might be in between Up to 30% of patients who test negative for the virus, even though we already have it.
I am now very aware of my safety and responsibility to maintain the safety of my patients and staff, with adequate PPE. As a practice, we are fortunate to have at least a short term supply.
Some of our colleagues – BAME and white – are very bad with the symptoms of Covid-19 and this is an alarming time. We have put everyone we can at home working with only important admins, admissions and four doctors in surgery every day. All appointments are through telephone or video clinics, unless it is an urgent Covid or non-Co issue that requires a face-to-face consultation, in this case we wear our PPE and see it hot (Covid-19) or cold (non-Covid) 19) area.
Everything is very draining and stressful, even though we are not busy with the number of patients we meet. Last week’s statistics were of course anecdotal borne by my operation. I have seen BAME patients with acute coronavirus symptoms who need hospital care both with and without underlying health conditions – a black patient in his 40s with controlled blood pressure treated with Covid-pneumonia and requires oxygen support and 59 years. Old Asian men without health conditions spend two weeks in hospital. In general, BAME patients with coronavirus disease are younger, compared to white patients.
NHS England launches risky task for staff. Recommendations could include the re-mobilization of those at risk to areas with a low likelihood of Covid-19 exposure or working from home. In my operation, we have implemented this through Covid and non-Covid rotas, effective social distances, use of screens and limiting hotdesking. But it is hard to see how this works in the practice of small general practitioners or those with many BAME staff. At present there is no occupational health support in primary care. After routine NHS face-to-face work begins to increase again or there is a second wave of labor shortages will occur if staff mainly work from home because of the shield.
My concern is that the risk assessment process will not be strong enough. Staff must feel that they can raise their own safety concerns without feeling guilty or anxious for their work. But many BAME medics feel unable to do this. A former colleague of mine in northeast England was told that a risk assessment in surgery was unnecessary because he was the only BAME staff member, and would be “really fine” if he took vitamin D. And even though I already had coronavirus, I’m not sure How to immune to me now.
All people, regardless of ethnicity, need to be assessed risk and have a voice. If not, there is a danger that this assessment becomes meaningless when staff face criticism for reporting PPE deficiencies and the risk that BAME and more junior staff, or those with disabilities, are not heard.
Preventing further death from BAME patients and those working in the NHS requires more effort and care than small talk and check box tools.
• Zara Aziz is a GP partner in Bristol
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