Being “BAME” doesn’t automatically increase your risk of infection and death from C19

[User26272829]

I have a personal interest in this because I’m a black woman. I keep reading that BAME(can’t stand this terminology which basically shoves very different groups into one mass) communities are at higher risk of infection and death from Coronavirus. When you look closer into the available data, there is nothing conclusive to show a link to ethnicity. It’s based on environmental factors such as housing, underlying conditions, deprivation, types of jobs and exposure to the virus/viral load.
I work from home, never use public transport, l’m under 50, fairly fit, don’t have any underlying conditions, don’t live in a deprived area and don’t live in multi generational housing. So how would I be higher risk than a white woman with the same characteristics? So AIBU to think that classing BAME people as higher risk is inaccurate and deeply flawed?

Oh OP, are you me? YANBU. Started a thread last year with the same question. Still feel the same as you, a year on. Interested to hear again what others think.

You might be wrong, OP.
The other factors you mentioned can be adjusted for in stats models and they don't have as big impact as by itself being 'BAME' (I don't like the word much either, but no one seems to have thought of truly better word that is succinct).

If poor housing-education-deprivation-air quality-job types-multi-gen families are the actual explanation for apparent covid&BAMEness relationship, why aren't they just as important to covid as they are to flu and other respiratory viruses. Something is different about the interaction between covid & BAMEness and other respiratory viruses & BAMEness.

BAMEness is still far less important than age or sex as a risk factor for bad covid illness, is also clear.

I'm not sure that they know why the risk is higher. I thought they had factored in the things you had mentioned and the risk was still greater for people who are BAME.

I've only done a quick google and found this:

www.bma.org.uk/advice-and-support/covid-19/your-health/covid-19-the-risk-to-bame-doctors

There may be better resources out there, but that indicates that in people doing the same job (ie health care) the BAME community are more at risk than their white counterparts. I'm assuming that a white doctor and a BAME doctor have similar life styles, housing etc, but that may not be so. I'm no expert.

It's not a personal insult to say that people who are BAME are at greater risk. I have to accept that my obesity is a huge risk factor with covid. It's not a comfortable thought and it is self inflicted to some extent, although I don't think it's as simple as some make out. It's clear that there are risk factors that make you more likely to die from covid and, apart from fat people like me, I don't think anyone is judged for that.

I asked this before - Have to search for that thread now to read it again.
What about those "BAME" people in majority BAME countries. They're not all dying like flies due to Covid. Is there a special type of Covid (UK variant?) that affects BAME people here in the UK or is it the BAME people here in the UK that have this special susceptibility to Covid?

Its an uncomfortable thought, but one of the things they have to look at is whether people receive different/poorer medical treatment (structural racism)

Op can you link to some data that shows that there isn't a greater risk? It would help to see what you have already looked at.

YANBU.

I've not seen a single shred of proof. No concrete evidence. & this society/government has form for scapegoating and gaslighting Black people.

So although I believe of course some of us will get Covid, I do not believe that non-Black people are lower risk.

Given that Black people work on NHS frontline which dramatically increases risk, the way the press & health 'officials' speak you'd think within the past year 1000s of us would've dropped like flies from Covid, and there'd be a massive front line NHS recruitment drive.

& It's not as if they're pulling us off the frontlines to minimise our risk, is it?

Good post but I think it'll just make people rush to read some article/stats-laden piece re-iterating that yes, of course BAME are more at risk.

Some people believe what they read online far more than what they see in the real world. & In the real world, people of all nations catch Covid.

Maybe they're fussing about us having the vaccine and using 'you're more at risk' as persuasion because they're panicking as to who will prop up their health and transport services. So they're trying to instill panic in us. Who knows.

Agree BAME is poor terminology, who on earth came up with that?

There’s an interesting report (August 2020) from Public Health England which covers this specific point.

Report here

Some interesting quotes:

“ An analysis of survival among confirmed COVID-19 cases shows that, after accounting for the effect of sex, age, deprivation and region, people of Bangladeshi ethnicity had around twice the risk of death when compared to people of White British ethnicity. People of Chinese, Indian, Pakistani, Other Asian, Black Caribbean and Other Black ethnicity had between 10 and 50% higher risk of death when compared to White British.”

Later on:
“... These analyses were not able to include the effect of occupation. This is an important shortcoming because occupation is associated with risk of being exposed to COVID-19 and we know some key occupations have a high proportion of workers from BAME groups.
These analyses were also not able to include the effect of comorbidities or obesity. These are also important factors because they are associated with the risk of death and are more commonly seen in some BAME groups. Other evidence has shown that when these are included, the difference in risk of death among hospitalised patients is greatly reduced.”

Later on:

“...However, an analysis of over 10,000 patients with COVID-19 admitted to intensive care in UK hospitals suggests that, once age, sex, obesity and comorbidities are taken into account, there is no difference in the likelihood of being admitted to intensive care or of dying between ethnic groups ”

Worth reading the whole section on ethnicity. There might also be more recent analyses as this is from August.

Yes I believe it is inaccurate.
I'm wondering was this assumed as many of the medical staff who sadly died were Black and Asian.
As far as I can tell obesity is a high risk factor.
Yanbu.

OP, I have wondered if it is the kind of jobs (less likely to be able to wfh), multi-generational housing, diet and other factors about lifestyle. Seems a bit inconclusive and so reasonable to doubt as you suggest.

Hmmm how do you account for the higher death rate / infection rate amongst non white Doctors? They aren’t paid less than their white counterparts, and tend to live comfortable middle class lifestyles.

Some illnesses (eg sickle cell anaemia) are associated with different risks for different ethnic groups, aren't they? So it's possible that covid could be too?

@Onsiesarethenewblack

Its an uncomfortable thought, but one of the things they have to look at is whether people receive different/poorer medical treatment (structural racism)

I would think this would be a factor.

I've lost a very fit, healthy colleague to Covid and a young neighbour (28) who also had no underlying health issues.
The only connection between them is that they were both middle class and both BAME.
I get what you are saying OP but I wish BAME communities could be offered the vaccine with a degree of priority.

I was also under the impression that BAME (although in this case I've only heard this about black people, I don't know about other ethnicities) suffer more from heart disease and diabetes, which are both risk factors? But I don't know if it is actually true on a 'biology' level or seen as another effect of deprivation etc.

I agree, I’ve always thought the correlation is more to do with societal conditions (ie living in closer quarters, multi-generational living) than the actual colour of your skin/ethnicity. It’d annoy me being all lumped in together like that too. YANBU.

I agree with you OP.
Personally I find the terminology BAME distasteful. I know nobody meant it like that but it just feels another way of saying " Everyone Non white" or "All colored people". I just wish people stop using it.

@MindTheRiskPlease

I asked this before - Have to search for that thread now to read it again. What about those "BAME" people in majority BAME countries. They're not all dying like flies due to Covid. Is there a special type of Covid (UK variant?) that affects BAME people here in the UK or is it the BAME people here in the UK that have this special susceptibility to Covid?

For Africa I believe that the average age of the population is lower. Also haven't studies shown that Vitamin D deficiency plays a role in Covid outcomes, darker skin makes it harder to absorb.

What about those "BAME" people in majority BAME countries. They're not all dying like flies due to Covid.

They are in South Africa. Peru. Guatemala. Brazil. Mexico...

@MindTheRiskPlease

Oh OP, are you me? YANBU. Started a thread last year with the same question. Still feel the same as you, a year on. Interested to hear again what others think.

Great minds and all that

In your particular circumstances, you probably aren't at higher risk.
However the BAME (I don't like the term either!) do seem to have been particularly hard hit.
People of SE Asian ethnicity do have a higher genetic risk of type 1 diabetes, so that could be a factor, even where standards of living are higher than "average".
Some of the higher risk occupations (based on ONS last set of statistics) such as bus drivers, care workers, security guards may well have a higher proportion of BAME employees.
On the other hand, factory and logistics workers are high up the figures for deaths, but, certainly in my sector (food manufacturing) thd biggest group would be Eastern European. Although these factories and warehouses have massive infection rates, to the point where PHE are telling them not to bother reporting, the deaths aren't disproportionate to thd infection rate.
But for ONS purposes, it includes e. g. textile industry workers, who ard more likely to be Asian.
Anybody's guess, I suppose, without access to a full statistical breakdown.

You may have lower vitamin D levels. 10 000 years ago all inhabitants of the UK were black. Their decedents became white. Because of the strength of the sun in the uk, paler skin means higher vit D levels. So this could be part of what makes non white people mire vulnerable

@knittingaddict

I'm not sure that they know why the risk is higher. I thought they had factored in the things you had mentioned and the risk was still greater for people who are BAME.

I've only done a quick google and found this:

www.bma.org.uk/advice-and-support/covid-19/your-health/covid-19-the-risk-to-bame-doctors

There may be better resources out there, but that indicates that in people doing the same job (ie health care) the BAME community are more at risk than their white counterparts. I'm assuming that a white doctor and a BAME doctor have similar life styles, housing etc, but that may not be so. I'm no expert.

It's not a personal insult to say that people who are BAME are at greater risk. I have to accept that my obesity is a huge risk factor with covid. It's not a comfortable thought and it is self inflicted to some extent, although I don't think it's as simple as some make out. It's clear that there are risk factors that make you more likely to die from covid and, apart from fat people like me, I don't think anyone is judged for that.

I haven’t seen any data to show an increased risk purely down to ethnicity. I just think until we have proof it’s just inaccurate to state that, I don’t think it’s an insult to BAME people, just pretty lazy

@Onsiesarethenewblack

Its an uncomfortable thought, but one of the things they have to look at is whether people receive different/poorer medical treatment (structural racism)

Structural racism was also mentioned when the report looked at deaths of NHS staff who were from a BAME background

I dislike the "obesity" negative undercurrent too. What they're really saying is 'all Black people are fat'. Which of course, we arent.

It's also not quite recognised.
that (a) we aren't a monolith and (b) we know what vitamins are thanks.

Just something patronising and othering about the whole way it's spoken of, as if being healthy is un-natural to us.

If obesity is a risk factor then I definitely wouldn't think that risk solely falls on Black people...look around.