All the doctors dying are Asian - what’s going on?

[MMXVi]

And why is nobody asking questions about this?

I’m over-invested in the answer because my sister is a doctor very much on the frontline, and we’re of Indian ethnicity. I want her to be protected and if she’s facing some sort of additional genetic, behavioural or dietary risk I want that flagged up to her and other doctors PDQ, not to mention their patients of the same ethnicity.

If I see another glib and possibly slightly racist response about BAME people being poorer and therefore more prone to underlying conditions I’ll flip my lid totally by the way. There’s a world of difference between an Asian hospital consultant on £150k in stockbrokerville and someone Asian on the breadline in an overcrowded council flat, and it isn’t helpful to lump them together in this instance.

So far, I’ve seen a thread about Vitamin D3 deficiency making darker-skinned people more susceptible to respiratory illness. That makes sense to me, and I’ve already ordered some from Amazon for my sister as well as the rest of our family.

My mother (not medically qualified) has a touching belief in the anti-inflammatory and anti-carcinogenic powers of turmeric so I’m making daal as we speak.

My dad (retired very senior doctor and the veteran of more than one pandemic) says probably multi-factorial, but as he’s currently recovering from cancer and therefore very high risk, I’m not going to make him elaborate.

Any other ideas and theories?

Anyone else concerned about why the press have neglected to mention this glaringly obvious information?

I take it you’ve never seen an allocation board on a shift, @AnnUumellemahaye ?

No. Have you? What would it show me?

I am a first generation immigrant.

I disagree that the current language proficiency test is minimal. IELTS is a very difficult exam to pass at score 7.5 to 8.5, which is the usual requirement for medical professionals entering university or the NHS. I taught it and I needed a Teacher's Book for answers, despite being a native speaker, University educated and with a teaching qualification. Most native speakers on the high street would probably score 4 to 5. Download a reading exam module if you're curious and try it.

@AnnUumellemahaye Medical staff do not get to choose which patients they are allocated on shift, a great number of medical staff don’t get to choose which ward they work on unless they have a particular specialism e.g tissue viability nurse. Obviously at the moment most medical staff are working in areas that are not their usual specialism.

I have wondered this, and know about the vitamin D thing - but why wouldn't doctors who know they have low vitamin D not take supplements as a standard thing, seeing how important it is?

There is a minimum language proficiency exam for medics to work in the UK, and if you’ve ever seen it, it is very minimal!

Well if true then that is extremely alarming in itself. But I suppose you'd say it was racist if a patient said they had no faith in a BAME doctor because he or she could not communicate sufficiently clearly with them.

If you are right and they are being given the shit jobs, perhaps it's because their English is not of a standard that makes them safe to take charge of anything more challenging.

On an anecdotal level, last time I was in my local hospital I was in a lift with a group of healthcare assistants when they started an islamophobic discussion. I didn't say anything as my baby was with me but thought that I would not want to be a Muslim patient under their care.

What sort of Islamophobic discussion?

This really needs to be raised at the daily briefing, the only serious national discussion of this subject that I’ve heard has been on LBC (Majid Nawaz and James O’Brien). Both France & Germany have a sizeable BAME population, what are there percentages?

@AnnUumellemahaye and others: if there is any systemic or covert racism in the NHS (and PPs who actually work in the NHS say there is on this and other threads) then the people least able to take that risk for currently unidentified physiological reasons are also at further risk from that systemic racism. I don’t think the practitioners of that racism will be anything other than the majority culture.

Germany's death toll is way way lower than all the other similarly sized and populated European countries - they are a real anomaly. I was literally just looking at the national charts on Worldometer and wondering what Germany's secret was. You could argue that they have a better funded more effective healthcare system than the UK but so does France and they aren't doing well at all.

@Millicent10 Completely agree. Hancock needs to be grilled, and there should be questions asked about this in parliament. One third of NHS employees according to a PP are BAME.

@SimonJT are you a medic in the NHS? If so, are there concerns internally about the mortality and morbidity profile?

On language proficiency: my dad (retired very senior NHS doctor and academic) arrived in the UK in 1974, fresh out of uni in India. English is his second language although he attended English language schools. He’s absolutely fine when dealing with formal academic and professional registers, even public speaking. But he still can’t enjoy reading a literary novel, or even make small talk in English at a dinner party with native proficiency - slang, nuance, register and so on are all so important to expression, but even if a highly educated, highly intelligent doctor doesn’t have mastery of that after half a century, what hope is there for a young Philipina nurse fresh out of college?

Your English can be more than sufficient to do your job in normal circumstances, but these are not normal circumstances. It really isn’t reasonable to expect medics to advocate for themselves in their second language

It seems to be affecting BAME more seriously across the board. And not just in the UK.

I’d hazard it’s at least partly physiological but exactly what, no one has a clue.

@MMXVi Could you ask your Dad as a retired senior NHS doctor what his thoughts are? Also your sister who is a NHS dr.

I’m sorry MMXVi but I think that’s bollocks. Your dad may not choose to read for pleasure in English. Ut that doesn’t mean he can’t express himself clearly in it.

You seem determined to find a racism angle to this. But as I said, whatever the reasons for BAME people dying of Covid 19 in such numbers, it is not the fault of white people, or the because of racism. Many things are, I’ll admit, but this isn’t one of them.

Age must be a factor in this somewhere - the UK appears to have far fewer physicians over the age of 55 (as a percentage of the healthcare workforce) than other European countries and we know that 2 of the Asian doctors who died were aged 79, 2 were aged 76, another was described as being in his 70s. Other doctors were in their 60s. Perhaps Asian doctors make up a much larger share of UK doctors aged over 55/60.

^"There has been a rapid ageing of the (healthcare) workforce across much of the EU as the baby-boom generation has started to reach retirement age.This is reflected in the estimated share of physicians who were aged 55 years and over, which rose from 28% in 2007 to 38% by 2017; this comparison is based on information for 21 EU Member States which accounted for 85% of all physicians in 2017; it also uses alternative reference periods for some countries to complete the data set.The share of physicians aged 55 years and over in the total number of physicians was within the range of 43-48% in Hungary, Luxembourg, Cyprus, Belgium, Germany, France, Estonia and Latvia, while a majority of all physicians in Bulgaria (51%) and Italy (55%) were aged 55 years and over. In most of the remaining EU Member States for which data are available, the relative importance of this age group in the total number of physicians was between one and two fifths, with only the United Kingdom (14%) below this range;

ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_personnel_statistics_-_physicians#Healthcare_personnel

British Journal of Cardiology:

Authors: Kiran Patel, Yin May Yan, Kamlesh Patel, Parminder Judge, Janki Patel, Sandeep Johal, Sukhdip Johal, Paul Do, Francisco Leyva

"We undertook a seven-year in-depth review of all reported obituaries of medical practitioners in the BMJ to assess the age and disease distribution of mortality of medical practitioners in order to identify relationships between mortality and discipline, ethnicity and other demographic factors. In total, 3,342 obituaries reported in the BMJ from January 1997 to December 2004 were reviewed."

"The majority of obituaries were of male doctors. Doctors who qualified in the developed world appeared to live longer (mean age at death of 78 years) than those who qualified in Asia (mean age at death of 70 years). White-European doctors lived significantly longer than doctors from other ethnic groups."

"There was no significant difference in longevity between doctors working in the primary care sector and those in the secondary care sector. An eighth (12.5%) of doctors died between the ages of 60 and 70 years and, of these, nearly half died between the ages of 61 and 65 years."

"In conclusion, cardiologists are not immortal and need to retire, as do their colleagues in other specialties. Retirement at ages of 65 years or above would disadvantage nearly one in six medical practitioners.Those likely to be most disadvantaged by a mandatory rise in any retirement age, in terms of reaping the benefits of their pension contributions, are those of a non white-European ethnicity."

bjcardio.co.uk/2009/11/lifespan-and-cardiology/

@mrshoho

My dad is long retired, self-isolating because he has cancer, and 300 miles away. He has happier subjects he’d rather discuss.

I haven’t seen my sister since 17th March, because that’s when she last had a day off. Our phone contact currently consists of Whatsapp messages to which she doesn’t have time to reply, so I take the blue ticks as evidence she’s still alive

That may be what you think, now, @AnnUumellemahaye but let’s wait and see.

I’m not “determined” to blame systemic racism at all, as you would know if you read the thread in full.

www.google.com/amp/s/amp.theguardian.com/world/2020/apr/15/pregnant-healthcare-workers-pressured-into-covid-19-frontline

And this horror x

@Gutterton The NHS is looking like a really negligent employer isn’t it? We make excuses about its lack of resources, but many commercial companies run on far stricter budgets and are still capable of treating their employees safely.

At the beginning of the thread I did say that my father felt the disproportionate risk was multi-factorial, and the more knowledgeable people on this thread seemed to agree with that, and have suggested many possibilities.

One sure way of dismissing the issue, though, is of accusing those concerned of being “determined” to blame racism. If it were just racism I doubt many professional people of BAME origin would give a shit - they/we encounter racism in its many forms all the time, but we shrug it off and get on with making a living. It’s the fact that HCP’s very lives are in danger that we need to ask questions and implement changes to medical advice and practice if needed.