To wonder how far cultural differences affect rates of transmission as well as adherence to lockdown?

[Ethelfleda]

Let me preface this by saying that I am in no way ‘blaming’ any one country, or how they behave for how rates of transmission may have panned out. This is an emotive subject, but I am interested in a more scientific discussion...

So my question - if, culturally, some people are more tactile than others - do you think this would directly impact rates of infection? I do not think that Brits are particularly ‘touchy feely’ people, I wonder if this will have any impact whatsoever on transmission rates?
Likewise, our culture seems to be one of finger pointing and I wonder if far more people will adhere to the lock down to ‘avoid upsetting the neighbours’ more than they would do it because the government have asked?? And whether this sometimes isn’t the case in other countries?

Anyway - I am a complete layman so I genuinely want to keep an open mind and hear what others have to say in the hope of advancing my knowledge on the subject... and I know all you lovely mumsnetters are the best peer review I can find for my own opinions

Portugal which is culturally similar to Spain - large family groups, tactile, apartment living, multi generational living etc has had only 470 deaths compared to 16,600 in Spain

Culture is a factor but only one of many

I think it is very interesting. Within cultures in the UK there will be many factors. I live in an area where most my neighbouts and lots of my friends are Asian and we discussed whys more asian people are being affected. Our thoughts included for example Asian people are more likely to be frontline workers (NHS/taxi drivers/bus drivers/dentists/shops), live in multi generational households, attend religious events, and large events, live near family and social together, are more likely to be Vit D deficient, have a different attitude to risk and have higher rates of obesity and do less exercise. So between countries there will be lots of reason why rates differ.

The UK has a funny habit of seeing other places as dirty and crowded when actually this is one of the dirtiest and least-hygienic places I’ve been. The general level of dirt and grime in places like schools, hospitals, cafes etc is very poor compared with almost everywhere else I’ve been in the world. Certainly there’s no other country I can’t think of where you’d walk into somewhere like Costa and be faced with tables piled with full trays, slopped drinks, dirty napkins and then have it wiped half-heartedly with a damp rag. Everywhere else I’ve ever been you sit down at a sparkling clean table with no trace of previous occupants. And that’s not because of the clientele. It’s because the staff are prompt and attentive.

Boulshired, obesity makes complications of infection more likely, but it doesn't make it more likely that you will get infected.

@corythatwas I don't want to be making excuses for people sauntering along in the supermarkets, browsing and being indecisive as this is very annoying! I just want to point out though that some people do have to read the labels due to allergies. I have found that a lot of the brands of foods I usually buy for my daughter are not always available in the supermarket at the moment and what is there varies from week to week, and I have had to look for alternative products. The problem is, she has allergies to peanuts, some types of beans and peas, various nuts, dairy and soya so is often even allergic to most of the free from range in some supermarkets. It's a challenge at the best of times, never mind when the supermarket is half stripped bare. I have tried not to pick products up and put them down again but I am not in a financial position to just put everything in my trolley and buy it anyway for myself, if it's not suitable for my daughter to eat. Where possible I have tried not to be walking round just picking things up and putting them down again and also use a tonne of hand sanitiser during the course of my shop.

The nos of black and Hispanic people in the USA dying are higher but are down to the nos living in poorer areas, crowded buildings and the systemic problems due to work with low income and racism. Next add in the systemic problems due to low income and lack of employment, medical insurance and lack of and underfunding in poorer areas, I. E they would not get an ambulance or sometimes even fire service to attend, let alone a hospital that will admit them.

Free and low income clinics have closed under Trump compounding the problem. People are literally turned away from hospitals.

Yes this happens to low income white Americans but disproportionately more to Black and Hispanic Americans due to institutional and systemic racism leading to lower income, lower quality housing, etc

In the UK, a lot of ethnic minorities do live in larger family groups and work in more front line areas. The thing I see is also a reticence to seek help. So even when ill, they may delay going to the Dr. The other side of the coin is when going the dr, quite often being dismissed (like a lot of women it seems).

But I do think the UKs nos in general are due to low hygiene practices (amazing the amount of people who routinely did not wash their hands), lots of public places Incl buses and train being filthy, slow and poor government response with wishy washy advice for weeks until lock down. Underfunding for a decade of the NHS and austerity cuts in the ancillary services of social services, social care, community health, community mental health, mental health generally, disability services etc, school nurses, children's centres and on and on, which all affect costs within the NHS and cause more money to have be spent in the long run. Ie the cuts work out more expensive than not having had the cuts in the first place.

Add in the exceptionalist attitude of lots of brits who even back in mid to late March thought covid-19 and WHO advice did not apply to the UK.

HOWEVER
Each country has their own problems due to their own culture ie Italians, smoking, family household group and a stubbornness to adhere government advice.

What is interesting is why countries very similar culturally, like Spain and Portugal would have such different nos in positives tests and deaths.

Also interesting to see, is how quickly New Zealand, majority of African and Caribbean countries and some South American countries locked down and it will be interesting to see their nos in the coming weeks. Lock down and testing seems to be the most useful things, so it will be good to see if it's as beneficial especially in countries that locked down quickly ie some with very low and even no deaths at the point of lockdown.

In contrast it will be interesting to see what impact those countries with anti lock down and a disbelief in Corona will see, Ie Brazil, Belarus and Turkmenistan to name a few, where their governments are telling people to carry on as normal.

Corona virus response will be written apart and studied for years to come.

To those mentioning the difference in deaths in Spain and Portugal, I believe Portugal went into lockdown very soon after only a small number of deaths. Their schools were also closed and restrictions placed on large gatherings alot sooner than Spain.
We have friends in Portugal who were very surprised that the UK didn't have similar restrictions in place.

Only 14% of people in England and Wales are from ethnic minority backgrounds, according to the 2011 census, however, the Intensive Care National Audit and Research Centre found that 34% of more than 3,000 critically ill coronavirus patients identified as black, Asian or minority ethnic

Is this not perhaps as simple as the more affected areas - London and Birmingham - having higher numbers of BAME people than other areas?

Seems like up to 40% of Londoners may be BAME ( quick internet search )

A high percentage of the medical deaths are BAME. That would suggest (to me) that biological factors are at play also.

The worst co morbidities like heart disease, cardiovascular disease and diabetes are at a higher percentage among bame due to genetic (and sometimes cultural factors.)

I've found our cultural differences to be sneered at during lockdown, as we are in contact with other households and some separate family members live with their immediate family, parents and grandparents on a site.
The difference is there is no contact with the outside world and when it is necessary fit and healthy members take it in turns and isolate on return, in case they have contracted it.
There have been no cases in the family that anyone knows of yet.

I think it's also the general way different nationalities behave, eg I think Scandi people, and those in Taiwan, Japan etc are more law abiding, more socially responsible, so have done what was asked from the beginning, whereas here there are lots of ignorant/bolshie types who will go out of their way to NOT do what is asked for the common good. We're stuffed.

@ginghamstsrfish those cultures have more belief in the state providing things and doing things for the common good of the population.

More than one of my Nordic friends has explained that charity doesn't exist in their country as the state does it.

There as in the UK we question the state and ensure they don't over step boundaries e.g. ID cards. Also in the UK we were led by a PM and government who were giving out mixed messages until they caught the virus.

No way, it's easy to think it's someone else but from my view of middle class suburbia everyone is flouting the rules and it's that which spreads this infection. What about the British cultural weirdness around supermarkets and queueing, why are people queueing for an hour with 100s of people they don't know when they can turn up at the shop in the afternoon and it's empty. Why are we such huge consumers of stuff we can't stop ordering stuff and getting takeaways. The people down the road we're practically having a street party the other day all sat out on chairs, our neighbour has an army of workmen coming in to finish their home renovations while they're still living there, the people over the road have their kids visit. This is an area full of teachers, doctors and otherwise intelligent people, but they all think they're cleverer than this virus and they're not. That's why it's spreading.

@boylovesmeerkats luckily for me the majority of my neighbours have at least one vulnerable person in the household so they are behaving themselves. The only one who doesn't has a problem keeping her distance. She has managed to piss off postmen and delivery men. My neighbours professions vary but the general population of the area is supposedly highly educated.

Outcomes are worse for BAME but I think more important than culture people should consider racism and occupation. Immigrant BAME communities are over represented in care, healthcare and cleaning. Racism is really important to factor into healthcare, maternal outcomes are worse for a start and although it's not overt or even intentional the type of care differs with BAME patients/mothers been seem more capable of enduring pain for example. In the US there is a massive distrust of healthcare and you only have to remember that it wasn't long since black people were denied treatment and pretty much experimented on (Tuskegee) not to mention access to medical treatment.

I think people have to be really careful drawing conclusions that biological factors are different between races when you're looking at disease. And people wonder why BAME people might be suspicious of healthcare. I know if someone thought I was more likely to die because of the colour of my skin I wouldn't necessarily be trusting them to do all they can.

Kissy-hellos won't have helped. 3 or 4-kissy-hellos even worse for transmission.

I think people have to be really careful drawing conclusions that biological factors are different between races when you're looking at disease.

We know, factually, that genetics can play a part in prevalence and impact of disease.

@LaurieMarlow non-white people particularly those of African ancestry have more diverse genes than white people so be careful of attributing things to biological factors when it is more likely to be socio-economic factors at play.

What about diseases like Sickle Cell Anemia?