BAME risk...It's not about ethnicity is it?

[MindTheRiskPlease]

Surely this whole "BAME" (nonsense term btw) people at risk of Covid is not about race ethnicity, is it?

If so, I don't see a great number of people being affected in "BAME" countries. Cases and Deaths are much much lower than that of the UK.

I live in a small town. Everyone is going about their business and following guidelines. Is 'the rona' coming to find me then because... "race" or is there more to it than that?

If two people (one "BAME", other not) come in contact with a covid patient, would the virus "choose" the BAME person and not the other? Wouldn't they both be at risk, depending on some factors? (What has ethnicity go to do with it?)

AIBU to think this whole "BAME people are more at risk" is a bit of a fallacious statement and has to be broken down to factors like geographical location, health, age, job, etc to actually be accurate?

Well, in any case, I shall continue to give my brown (there you go, not BAME, how about "mixed ethnicity?) DD vitamin D Peppa Pig gummies every morning.

@MindTheRiskPlease

I saw four groups of people refusing to wear masks and refusing to follow the directions even when asked to by the staff. All were BAME! One of them even told my friend (also BAME) that she was “letting the sisterhood down by agreeing to wear a mask” and “you shouldn’t agree to to cover your colour”. She just told them they were the ones letting the community down not her!

Wow! Weird. Really really shockingly weird. Have never come across this particular train of thought and I'm intrigued to find out what they're on about.

I know! My friend was absolutely disgusted by the attitude and could not understand their thinking. She said the only problem with having to wear a mask was not being able to fully express her contempt for such stupidity.

@PlanDeRaccordement Interesting. Have clicked on the link, will take a look at it. Thanks.

@contrmary

In general I agree - it's more likely that BAMEs put ourselves at risk. We are more likely to live in homes with three generations of a family which obviously increases risk. There is also the cultural aspect, many BAMEs I know are less willing to self-isolate, wash hands or wear masks than my white friends are. Maybe not a PC statement but as a BAME I can say in my experience it's true.

I suppose it's true that BAMEs are more susceptible to diabetes, which can make COVID outcomes worse.

What on Earth are you on about? Black and Asian people less likely to wash hands, self-isolate or social distance? What utter nonsense, not true of my community at all.

I wondered about fear in some communities might mean not accessing healthcare until it was too late, for example see here, some have unusual ideas and mistrust of doctors, worry around treatment for virus, perhaps understandably in some ways as it is fairly new...

www.bbc.co.uk/news/health-52623455

also there are higher rates of diabetes in young people in some Asian communities such as Bradford.. (Born in Bradford study useful on this)

www.bbc.co.uk/news/health-14202950

I also wonder about genetics and intermarriage (cousin marriage) and the impact of that on underlying health, and disability (2/3 deaths in the disabled) but hesitate to mention it as might be controversial.

www.theguardian.com/society/2019/feb/15/cousin-marriages-cited-as-significant-factor-bradford-child-deaths

The finding is international, though, and cuts across income groups and countries.

African-Americans in poorest parts of Chicago, entrepeuneur Somali immigrants in Sweden, Asian health care professionals in UK. All at higher risk. The finding of a higher risk relationship with ethnicity persists even after adjusting for air pollution in residential area, socio-economic status, age, sex, area prevalence. There is something distinctive about being BAME that creates higher risk. And it's a different risk profile from other viral infections that can cause pneumonia (see ICNARC data). Covid has a special relationship with BAMEness that influenza (for instance) doesn't have.

Age is still the overwhelming risk factor, though. Anything else is just minor adjustments. Some elderly with multiple health conditions stay asymptomatic even after testing positive. Wish we could understand why.

@MintyMabel

If you are a black person living in the UK with an office job, you have a problem and become much higher risk.

If you are a white person doing the same, Vitamin D deficiency can still be a problem, Covid or no Covid.

Which is why I said I have started taking a supplement. (And I'm giving them to my family too). But black people potentially need a higher dosage.

The data I saw was from the US but 42% of people in the US were found to be Vitamin D deficient

a whopping 82% of black people were deficient.

We all have same risk of contracting the virus, with the same contact.

I don't think it is clear why there is a disparity of outcomes.

Before covid African Caribbean patients have a different treatment algorithm for blood pressure regarding ACE inhibitors.
Studies have shown no increased risk of covid complications to patients taking ACE inhibitors.
However covid can use ACE2 receptors as entry point.
Maybe there is something in this?

Vitamin D deficiency, might not be such a problem in sunnier countries but going to affect people with darker

Metabolic syndrome, genetically increased risk in people from South Asian background. This is strongly related to heart disease and type 2 diabetes. These can affect covid illness outcomes.

• darker skin proportionally more.

We must leave this in the hands of the researchers. Otherwise anecdotally we could be making all kinds of assumptions about risk to different ethnicities that might be totally wrong and may even be predjudiced.

However it is really good that this is being looked at. There may be cultural differences in behaviour, but also different ethnicities are more vulnerable to different diseases. Sickle cell for example.

@SmileyClare

MindtheRisk Do you think there is an element of racism or prejudice to this?

I don't. It's got to be a good thing that the BAME risk is flagged up and investigated isn't it? Even taking into account other factors such as location, living conditions, age and occupation, the risk of developing life threatening complications with covid is still statistically higher. I don't know if that is a finding in other countries. You raise a good point there.
I was looking at PHE (public health England) data and analysis

No I don't either (although I never rule out possibilities but I wasn't thinking along those lines).

I think possibly because many BAME people in the UK have contacted it (due to several factors other than because they're BAME) and that has led the government to 'find' it's a specifically ethnicity issue before actually looking into it. I appreciate this statement could be wrong.

However, checking the 'covid stats worldwide', this can only be a UK issue then, as someone mentioned re: vit. D (which means not necessarily just about ethnicity).

There is a quite new, eye-opening ‘public science’ book - ‘She has her mother’s laugh’ by Carl Zimmer - published in 2018 - about the science of heredity - shortlisted for the Baile Gifford non-fiction prize. Not always an easy read but well worth it.

www.goodreads.com/book/show/36391536-she-has-her-mother-s-laugh

There is also higher risk in BAME from other viruses such as HIV for example so may be something genetic there...and also having those underlying problems would increase the risk too..

www.sochealth.co.uk/2020/07/12/covid-19-bame-communities-living-with-hiv-and-a-short-interview-with-dr-ameen-kamlana/

Interestingly one of the drugs used against COVID is useful against HIV too...

On this topic, this probably sounds daft but can someone clarify for me is Hispanic & Latino BAME?

As I saw reports about high rates of Covid in Texas in Hispanics and Latino, mentioned and then started to wonder, Hispanic seemingly means originating from Spain...

Does this link with high Spanish rates also and are the Spanish also considered Hispanic?

It’s not as simple as BAME = more likely to get/die from coronavirus though is it. It’s a virus, it doesn’t discriminate on skin colour enough for that to be the full cause and effect argument. However when you couple the possible skin colour biology related risks with the fact that BAME people are more likely to be of lower socioeconomic standing and therefore work in higher risk situations or professions, the fact that across the board BAME people get less favourable treatment within the NHS (or any health service...), accords the board they see poorer outcomes when compared even with white people of the same socioeconomic status etc etc etc. It’s not the virus doing the majority of the discriminating, it’s the inherent racism in pretty much every white person (and actually racism between lot of BAME people ie Indian vs Pakistani vs Mexican etc etc) which leads to a set of circumstances geared towards poorer outcomes.

@PlanDeRaccordement

Hasn't been proven as a genetic issue so far.

Just going to ignore the study I posted? It’s actually the second scientific study showing a genetic link.

Yes I've seen it now. I'm working my way down the comments.

I can well understand that BAME as an umbrella term must feel dismissive and as a PP said indicative of lack of interest in getting it right. So how do I get it right? Some people don't like being asked where they're from - this has been classed as racist too. I genuinely want to get this right, so what is the right way to go about finding out someone's ethnicity so that you may communicate with them respectfully?

civilservice.blog.gov.uk/2019/07/08/please-dont-call-me-bame-or-bme/

Just found this. Ethnic minorities seems to be the preferred term - for this blogger at least.

@Orangeblossom78

On this topic, this probably sounds daft but can someone clarify for me is Hispanic & Latino BAME?

As I saw reports about high rates of Covid in Texas in Hispanics and Latino, mentioned and then started to wonder, Hispanic seemingly means originating from Spain...

Does this link with high Spanish rates also and are the Spanish also considered Hispanic?

If we go back to the Vitamin D thing 70% of hispanic people in the US were deficient.

Spanish people (excluding those of immigrant/mixed origin) are white.

Hispanic/Latino people are not white. Hispanic doesn't mean originating from Spain, it means originating from Spanish speaking countries. The people we associate with being hispanic originate from central & south America. Areas that the Spanish colonised, but with their own indiginous population.

Regarding the wearing of face masks, before it was compulsory in shops the majority of people I saw wearing them in the supermarket were black and Aisan families. I definitely felt that they thought they were more susceptible to Covid and so were taking the necessary precautions.

@ChazsBrilliantAttitude

BAME is a nonsense term in this context because it is suggesting a homogeneous group with similar risk factors. My North African DH is unlikely to have the same risk profile as a Han Chinese person who is unlikely to have the same risk profile as a Igbo Nigerian.

Spot on.

Thanks comefromaway

Diabetes more common at lower BMIs in Asians, this is of interest. Might be around 22 BMI which is quite low compared to healthy of up to 25 in the general population.

care.diabetesjournals.org/content/38/1/150

I think we're on very shaky ground by making generalisations about Asians not social distancing and black people not washing their hands properly

Agree. Every BAME Nigerian person I know takes general hygiene very seriously....and this is before covid, let alone now. It's a lifestyle instilled from childhood.

More young black and Asian men fined for breaking lockdown rules in UK.

www.theguardian.com/uk-news/2020/jul/27/police-in-england-and-wales-twice-as-likely-to-fine-young-bame-men-during-lockdown