The government has published its latest assessment of the relationship between ethnicity and covid-19. The report draws on figures from the Office for National Statistics (ONS), NHS England, and academic research.
Let’s take a look at what it tells us about the risks different groups face, and what might be driving the disparity.
Black people at greater risk of death from covid
In the first wave, black people were considerably more likely than white people to die with covid.
Black African men were at the highest overall risk – 2.7 times greater than white men of the same age, according to ONS analysis.
Black Caribbean women faced the highest risk among females, dying at twice the rate of white women.
Black mortality rate explained by more infections?
The difference appears to be because black people were more likely to catch covid in the first place. Though once they contracted the disease, black people were no more likely to die from it than white people.
We can see this in the “adjusted odds ratio” which shows how likely people from different ethnic groups were to die compared to white people once they had been infected. Anything to the right of the red line indicates a higher risk than the average white person.
Bangladeshi, Pakistani and Chinese people less likely to survive infection
But we can see from the same graph that having caught covid, Bangladeshi, Pakistani and Chinese people were all at greater risk of death compared to white people. That’s even after we adjust for age, sex and underlying health conditions.
Change between first and second waves
Overall, the risk of dying with covid fell significantly for black Caribbean and black African people between the first wave (March to July) and the early part of the second (September to December).
But for Pakistani people, the chances of death rose between the two periods. And in both waves, it was higher than the average risk faced by white people.
We can see from this graph in the report the difference between deaths per 100,000 in the first wave (dark blue) and the second (light blue). The statisticians have adjusted for age.
What’s behind these differences?
Today’s report provides further evidence that certain ethnic groups – in particular, people from South Asian backgrounds – face considerably higher risks from covid than white people.
But as FactCheck has reported throughout this pandemic, it can sometimes be difficult to separate ethnicity from other “confounding” factors that might cloud comparisons between groups. Is it about deprivation? Or underlying health conditions? Or occupation?
The report draws no firm conclusions, but says that based on the evidence it has considered “the changes observed in COVID-19 outcomes among ethnic groups within such a short time period strongly suggest that ethnic inequalities in COVID-19 outcomes are driven by risk of infection as opposed to ethnicity itself being a risk factor for severe illness or death from COVID-19”.
In other words, we should look at why certain groups are more exposed to covid in the first place to understand the disparity.
The report says the government’s SAGE committee of experts is looking into the specific issues affecting South Asian groups, including: geography (the second wave hit hard in areas of the north west with large South Asian populations), the fact that South Asian people are more likely to live in overcrowded and/or multi-generational housing, that some South Asian groups are also disproportionately more deprived than others, and that the types of occupations common in these communities.
But it’s not only the risk of infection that could play a role.
While acknowledging that “health disparities among ethnic groups are largely explained by underlying social differences rather than genetic differences”, the report does point out that there is a cluster of genes considered a risk factor for “severe coronavirus symptoms” and “respiratory failure”.
These genes are more common among South Asians than Europeans (found in 50 per cent and 16 per cent of people respectively) and “may partially explain why the Bangladeshi population have the poorest survival rates” on contracting covid, the report says.
But we’ll have to wait for more data before we can fully resolve these urgent questions.