36 year old woman dies of coronavirus after being deprioritized by emergency services: is race a factor?

@PlanDeRaccordement

Excuse me?? You think black women five times more likely to die in childbirth is NOT racist? Are you mad? Structural racism in healthcare is a thing. Black women are not believed with regard to their concerns and symptoms hence they die. There may be some slightly increased risk due to other factors but then why isn't our healthcare system actively working towards ensuring that they have the best outcome despite that.

It makes no difference that much of the workforce or much of London is multi ethnic when the system is discriminatory. I doubt that anyone would actively think let me leave this black woman to die but they would maybe not acknowledge her symptoms as much. Had she been white they may have treated her more compassionately, gave clearer instructions or acted sooner.

I work in the health service and it is endemic sadly. Is it a factor in this case? Who knows? Yet why am I not surprised that the first young person to die at home with no health problems was a black woman who was deemed not sick enough by health care workers

@TheProdigalKittensReturn it's been proven by research in the US that black women have worse outcomes in pregnancy compared to white women, and women in general regardless of ethnic background aren't listened to about their pain. Even Serena Williams was shocked not to be listened to.

In London myself, extended family and friends find that your medical treatment depends on:

1. Whether the healthcare practitioner has seen your condition before,
2. If your condition isn't rare they are aware of how serious complications can be,
3. Who you turn up with the next time when they aren't taking you seriously.

Myself and a few people I know have had delayed diagnosis of conditions mainly because the conditions we turn up with are rare. Other people have had serious complications of common conditions because the healthcare practitioners are not aware that they can happen if they don't do the appropriate test or treatment.

So I while I don't think the ambulance crew were racist, due to the husband's previous interactions with the NHS over his own condition he would have probably been reluctant to call them again not realising as Covid-19 is new no-one knows the variations in the course of the disease.

Might not be racism, but definitely racial prejudice. Black women are taken less seriously by medical professionals than their white counterparts as proven many times by social researchers.

As a black woman who lived in London, I can confirm there are still racists there....

I hope that triage services don't take the fact that less women are dying as an excuse to add to the usual medical tendency not to take women's reports of being in pain as seriously as men's.

I would also add that the local hospital, King's College has had at least eight Covid-19 deaths, and an intensive care nurse committed suicide there a couple of days ago, so triage is very clearly essential.

I think class might have had something to do with it - feeling you have the right to call for more help.

Race and sex may well have come into play - women don't seem to die as much although that could be because smoking is less acceptable amongst women in the societies that were first hit.

Overt personal racism and institutional racism aren’t really the same thing. No organisation can feel they simply don’t have any vestiges of IR. it has been too ingrained for too long. It’s refusing to review it, explore it and work on it which is the immoral action.

People can be so defensive about this when there is no need to be so. IR is like a big, undeniable wound from which we are still healing.

Trying to paint the ambulance service as racist when they are risking their lives to save people in a time of crisis (and all other times). Typical guardian, full steam ahead smearing our welfare state. C4 did the same thing recently with the fire service over Grenfell. Discusting really, these pampered 'journalists' have no shame.

Not once in that article does the Guardian suggest the ambulance service was racist. Not once. It simply reported what the family and said, and then what the ambulance service said in response.

Shame on you for being too lazy to read the story properly and then smearing journalists doing their job.

Adding to that, if people reach the point of illness where they need intensive care they're probably more likely to survive in London or a similar city, in that there are multiple world class hospitals and more facilities overall, but they're also more likely to catch anything that's going around. The Londoners who've fled to, say, Cornwall, have lost their damn minds, imo, since not only are they likely to contribute to the spread of the virus, if they do become critically ill the chances of there being no facilities available to treat them are much higher.

Clearly in London you'd expect more triage than in say West Sussex, because there are more ill people as a result of London being crowded.

It's entirely an error to describe this as structural racism as in normal times I imagine London has more beds per person than Sussex, BUT this is a pandemic event which arguably is inappropriate to plan for - it would not be fair to give Londoners vastly better medical care than elsewhere on the basis of once in a century pandemics

More realistic is to note that in pandemics cities will suffer more and do what you can to ramp up, but that can never involve providing a health system that is designed for many times normal need.

The upshot of course is that some people die, which by some values could be avoided, but that happens every day for all reasons- if the police took your licence away instantly for speeding then many of the 1800 annual road deaths would be avoided.

You cannot take one death and use it to argue for X, unless you consider the reality that avoidable death is in fact built into our society. No we are not willing to increase booze taxes to save thousands of lives, so why should we take a single failure of triage as meaning the system is fundamentally racist when those doing the triage were likely not even white!?

Btw related but do note that for example there are massive differences in maternal characteristics between races - a high % of mothers from certain non white backgrounds are geriatric pregnancies, so merely observing a difference doesn't prove your desired causation....

What @iguanadonna said

I think it’s very possible, though we don’t know the other details such as the race of the first aid responder, so I wouldn’t jump to conclusions. However it has been well documented and the consequences proven in studies (such as the childbirth one) that in the U.K. black women tend not to be listened too by HCPs as much as white women.

."i believe there was some structural racism in the government's failure to protect Londoners"

Eh?

The government is in London. Normally the complaint is spending vastly vastly more on London than other parts of the country.

New York has the same issue as London - due to population density, public transport and high levels of international travel, it is experiencing much worse than somewhere rural.

This is inevitable and reflects the fact if you go out of your flat to the park in say Hackney it's going to be full of people, whereas in say rural Surrey there are just not that many people.

It's maths, essentially, and it's why historically people sought to move out of London. And, incidentally it's the sort of thing that the green types want - higher density living, population much more susceptible to pandemics.

No I don’t think race was an issue here , maybe age .

It is never offensive to ask the question, ‘Was this in any way part of institutional racism?’

I do wonder if we will be looking at disproportionately high numbers of sufferers/hospitalised from BME communities.

Look at diabetes figures:

www.diabetes.org.uk/research/our-research-projects/london/black-african-ethnicity-and-type-2-diabetes-risk

Yes 😐

No 🙄

I also think that we'll see more cases of young people whose symptoms were taken less seriously because they were young and triage is going to be done on the assumption that younger people are less at risk. I wonder if how quickly symptoms accellerate varies by age or other factors. I know with cancer it's often much more aggressive in younger people.

I could absolutely believe that the fact that doctors don't take women's pain as seriously as men's pain, and as a result we're socialized not to complain until it's really bad, could be factors.

With structural racism it’s embedded into the social codes do it really doesn’t matter if the workforce itself is diverse. Bit like the cultural idea that women gossip about each other that you might hear both men and women buy into (linguistic analysis of conversations indicate men and women gossip at the same rate - very human trait). But with embedded patriarchal structure, women are seen as less serious and bitchy by men and women.

So very possible race and other unconscious biases played a part - for example we think covid-19 is an old person’s disease so then we downplay the risk in other age groups.

And in the UK, didn’t they control for pre-existing conditions and weight and still found black women died more in pregnancy/childbirth?

There's good evidence that people find it hard to believe women when we say were suffering, and if we're black then even more so. The judgement that she wasn't ill enough to need care might well have been different if she had been a white man of the same age.

I think it may be a subtle race and class issue. Races and classes have shown statistically to have different ways of communicating and different attitudes towards the NHS and towards resisting/defending/speaking up for themselves. Different attitudes and methods of challenging authority.

NHS told her: call us if your symptoms worsen. It looks from the initial news reports like her symptoms worsened and shedid not call them. Was this because they worsened too quickly? Was it because she has been told ‘you don’t need to come to hospital’ and certain groups, as a cultural issue, just do what they are told and don’t insist on things? Certain other mindsets might have called the hospital and said persuasively ‘it’s got worse, much worse, we need an ambulance now’. Other mindsets will go ‘I feel worse but should I call? Not sure. They said I was fine. I don’t want to look like I’m wasting their to time again’. Are those different mindsets linked statistically to race and culture?

WTF? How many administrators can they possibly need?

This little nugget (also from section 3) may explain the problems within the NHS:

as at March 2019, around 9 out of 10 people employed by NHS trusts and clinical commissioning groups in England were working in non-medical roles (and 1 in 10 were in medical roles)

If this had happened somewhere else they might have a point, but London? If it's a majority white city it's only barely. The health service there is at least 50% non-white. Maybe triage could have been handled better, and it's possible that the advice given about if and when to call for an ambulance again wasn't clear, and if so hopefully they'll review procedures based on that. But I think we will unfortunately be seeing quite a few cases like this where people's condition deteriorates so rapidly from feeling not great to critical that they won't make it to the hospital in time.