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Men and certain ethnic groups appear to be more at risk from Coronavirus

22nd May 2020

Men and certain ethnic groups appear to be more at risk from Coronavirus

The Coronavirus pandemic is still spreading across the world. In Europe, some countries seem to have passed the peak of the virus and are slowly trying to ease lockdown.

We now collectively as a world know more about the virus and how it affects people and a few different trends have been observed in different countries; one is that men seem to be more likely to die of Covid-19 than women and also some ethnic minority groups seem to be more adversely affected too. The reasons for these differences are not yet fully understood.

One of the most pronounced differences that have been observed in most countries is that the death rate for men with Covid-19 is higher than for women. According to figures released in April in the UK, more than 70 per cent of patients with the Coronavirus admitted to critical care were men – the figures come from the UK’s Intensive Care National Audit and Research Centre (ICNARC) and were based on a sample of 7,542 critically-ill patients confirmed as having Covid-19.

The report also found that men were more likely to die in intensive care, with 51 per cent dying compared to about 43 per cent of the women who were admitted. Similarly, the US has reported that nearly twice as many men have been dying of the virus as women. Similarly, 69 per cent of all the Coronavirus deaths across Western Europe have been male. Similar patterns have been seen in China and elsewhere.

So, why are men worse hit than women? One theory is that women’s immune response to the virus is stronger. There is already documented evidence that women have stronger immune responses to illnesses and to vaccines, with more aggressive and effective responses compared to males. This could offer one explanation and could be down to genetic differences. Another factor could be lifestyle choices. For example, in some countries, the number of men who smoke is much higher than for women, e.g., in China.

It could be that; women are more likely to seek medical help earlier than men. There is not enough evidence at this stage to determine the exact reasons for the differences, but the fact it has been observed in most countries is significant.

Recently in the UK, it has been observed that people from certain ethnic minorities are also more likely to die with the Coronavirus than other ethnic groups. In the UK people from a BAME background make up around 13 per cent of the population yet account for around 30 per cent of people admitted to critical care units with Covid-19. As the virus cases increased, it was observed that people from BAME communities seemed to have a disproportionately higher mortality rate from the virus as compared to their percentage of the local population.

This prompted calls to investigate if people from BAME communities were more at risk and what the mortality rates were. The office for National Statistics (ONS) conducted a study and reported that after accounting for age, where people live, and some measures of deprivation and prior health, black men and women in England and Wales were twice as likely to die with the Coronavirus as white people.

In addition, they found that people from Indian, Bangladeshi and Pakistani communities also had a significantly higher risk of dying, with Bangladeshi and Pakistani males 1.8 times more likely to die of Covid-19 than white males, and females from this group are 1.6 times more likely to die of the virus than their white counterparts. The risk of Covid-19 death for people from Chinese and mixed ethnic groups was found to be similar to that for white people.

The statisticians conducting the study tried to determine if the differences in deaths were driven mostly by socio-economic factors or if there was an ethnic component. They adjusted for age as well as region, rural, and urban classification, area deprivation, household composition, socio-economic position, highest qualification held, household tenure, and health or disability as recorded in the 2011 census.

The ONS report concluded that some of the higher death rates seen in BAME groups could in part be explained by socio-economic disadvantage and other circumstances. For example, people from BAME communities are more likely to have jobs that require interaction with the public, such as jobs in transport – about 12.8 per cent of workers from Bangladeshi and Pakistani backgrounds work in public-facing transport jobs such as bus, coach and taxi driving, compared with 3.5 per cent of white people.

The NHS also has many BAME front-line workers; nearly 21 per cent of the staff are from ethnic minorities, compared with about 14 per cent of the population of England and Wales. Working in occupations that require interaction with the public could potentially increase the risk of catching the virus. Higher rates of diseases such as diabetes and cardiovascular disease in these groups are another risk factor.

However, after taking these into account, the ONS concluded differences still remained in the mortality rates and a remaining part of the difference has not yet been explained.

Differences have also been reported in America: In the US, black Americans make up around 14 per cent of the population but 30 per cent have contracted the Coronavirus. By early April Chicago had recorded that 72 per cent of people who died with the Coronavirus were black despite the fact they only make up 30 per cent of the city’s population. Again, differences in socio-economic and health care could in part explain some of these differences, but more research is needed to determine the risk factors for BAME groups.

Public Health England has already initiated a scientific review into the impact of Covid-19 on frontline workers from ethnic minority backgrounds and the wider community. This will examine health records to try to establish a clearer understanding of the emerging evidence that the virus is having a disproportionate effect on certain ethnic groups. The findings of this review are expected at the end of the month. The ONS has also said it plans to conduct further work to identify occupations that are particularly at risk.

Rachel Kayani
Editorial p2

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