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 think it's a bit racist to suggest Asian people have some sort of deficiency that makes them more susceptible to dying than white people.

It’s just factually true that different diseases can affect racial groups differently.

I find it concerning that people don’t know this. Or are more interested in displaying woke credentials than engaging with the facts.

There are also cultural / religious practices and beliefs that may have an impact on the way someone cares for themselves or their family. Many Hindus and Sikhs are vegetarian, many Caribbean people distinguish between carbohydrates grown under ground or above ground.

Absolutely, and this is where social, religious and cultural factors will come into play irrespective of class, educationor economic status.

I’d be absolutely fascinated to see further breakdowns between different BAME communities as at the moment there are none, at least none that are publicly available. I did read that Orthodox Jews are among those more highly affected and they in many respects tend to live most similarly to devout Muslims as far as I can tell. I don’t know whether vegetarianism among Hindus or Buddhists is relevant, but while the lung capacity/vit D/diabetes theories all have merit I feel there must be other things compounding it. But what? I’d there one missing link or not? It seems odd that there could be a common factor among Jews, Indians, African Caribbeans, Sudanese and Somalians but not south East Asians or white people. If it’s vit D then why Orthodox Jews who are not dark skinned in general? Other than that they dress very conservatively and don’t show skin?

I didn’t know that about the above/below ground carbs though, can you tell me more?

I read about the ultra Orthodox jews in places like Stamford Hill. I suspect that is more how they live than genetics for covid 19 as they might have 11 young children and live with grandparents or close to them in over crowded houses and then (although they may have stopped since lock down) the boys be in closely packed Torah study all day etc etc. It is a close communal life which would spread disease more easily although I suppose if in theory they kept totally to themselves and did not travel abroad (they do for weddings etc never mind work) it would never have been introduced there in the first place.

The other interesting thing about covid 19 is more men than women go to intensive care with it even just looking at BJ and his girl friernd who both had it - that could in their case be he is over weight and old enough to be her father but more generally it may just be once they get to about 60 more men than women are overweight and carrying their weight on their tummies.

I would have expected overweight middle aged BAME doctors to be at risk but not thin young female Asian doctors for example and they often are very healthy, very thin and exercise a lot at least when younger but I am not sure we have enough data divided by age and weight yet to know. If we stripped out anyone with a pre existing condition and who is over 60 and who is not over weight that would be the good cases to compare perhaps to see if vitamin D or skin colour or genetics played a part.

Agree Xenia

I think it's a bit racist to suggest Asian people have some sort of deficiency that makes them more susceptible to dying than white people.

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

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

"Labs currently researching possible efficacy of BCG in relation to secondary infections caused by c19"

That's interesting because I went through a time of really regretting I'd been given that vaccine. It caused a lot of pain and children used to hit each other in that area. I still have a scar about 30 years later. When I was exposed to TB having had the vaccine was a DISADVANTAGE as I couldn't have the test for it and had to go for a scan. It would be good to think something good came out of that vaccine.

We've also been told it doesn't protect against many strains of TB so not very useful.

"We also saw a resurgence in TB in 1980s and 1990s in Asian first and second gen immigrant groups in northern cities in the UK - could this also have led to weaker lung capacity / pre existing pneumonia scarring in these groups?"

Was it nothing to do with contact with Asia iteself?

I didn't get that vaccine - I deliberately stayed off school that day because I was a bit needle phobic in those days and I had heard so much awful stuff about what a big needle it was, how much it hurt afterwards etc. My mother was so distracted by other things that if never even occurred to her to ask, or check and in those days schools and GPs didn't follow up on stuff like they do now.

I am starting to feel a bit nervous about having missed that vaccine now. (Although I am white and not otherwise in a high risk group apart from being a bit fat.)

1 in 5 nhs employees is BAME. 4 in 5 NHS deaths are BAME.

The workforce stats are available by searching the workforce racial equality standard for the NHS.

But it's not as simple as that @WearyandBleary . Not all hospitals/settings will have a workforce ratio of 1:5 BAME personnel.

Look I see your points here it's just reading some of the things being said here, it wouldn't look out of place in a white supremacist forum. I think trying to look at ways to explain away the disparity is a good thing but when it veers on to looking at the physiology of the people involved it looks a lot like victim blaming. Oh it's these people's fault for being more susceptible to diabetes so we can wash our hands of all responsibility.

No I think we need to look at the actual reasons for the disparity and I would posit that they are more to do with things like Institutional racism from within the Health services and patients themselves rather than chasing this idea of racial superiority that explains away everything so conveniently.

Gewn I had it (BCG) and my older 3 children and then with the twins I paid £400 to get them done privately -one wasn't very pleased because of the arm scar but I am glad I did - I just wanted parity between all my children and also TB used to be called the white man's plague and was a terrible disease in it is time. My grandfather left school at 12 in the 1890s because of it and had a year in bed and he never went back.

Look I see your points here it's just reading some of the things being said here, it wouldn't look out of place in a white supremacist forum. I think trying to look at ways to explain away the disparity is a good thing but when it veers on to looking at the physiology of the people involved it looks a lot like victim blaming

On my god, you don’t have a frigging clue, do you? 🤯

@LaurieMarlow don't speak to me like that. If you disagree with me fine but don't take that tone with me, it's disrespectful and I won't stand for it.

I’m sorry, but you have to earn respect.

You don’t seem to understand the basic facts that diseases DO affect different racial groups differently. That’s not racism or victim blaming, but scientific, verifiable fact.

Oh it's these people's fault for being more susceptible to diabetes so we can wash our hands of all responsibility.

How on earth can it be anyone's fault for having a genetic susceptibility to diabetes or anything else? No-one has suggested that at all.

The truth of the matter is that the overrriding reason for this is far more likely to be physiological than anything to do with racism within the NHS. How you can even think that that might be a major factor when BAME people who are not employed by the NHS are dying disporportionately too, is beyond me.

I think you'd have to reach very far indeed to find a way to pin this on racism in a way that can be given serious consideration, rather than on genetics/physiology.

in fact, please do try to explain how you think it could be rooted in racism. The only think that might explain it would be BAME at the poorer end of the spectrum being more likely to be affected in the first place than a middle class white person because of living conditions. But that doesn't explain why middle class well educated BAME are dying and the white working class poor are not. Generally speaking.

I see nothing sexist about stating that women or men are more prone to certain types of diseases. I see nothing wrong with stating the fact that women have a longer life expectancy than men. I see nothing wrong with exploring the factors involved here - though I doubt a bunch of MNers will come up with any useful information on the subject.

Only thing that I'd possibly suggest would be to look at Black, Asian and Middle Eastern as separate groups, rather than lumping them all together as one homogenous group. Not sure whether the stats are different among the three groups?

To the numpty trying to troll this thread by claiming it sounds like stormfront, i think it's being goady and actually racist of you to try and distract a thread made by someone who is actually Asian and has concerns on the disproportionate impact of corona on Asian and other minority ethnic / BAME groups by claiming it sounds like white supremacy. You know it isn't to discuss different impacts on different ethnic groups, physiological or cultural. Stop being goady. It's derailing a good discussion.

You can’t understand disease without looking at physiology.

It is institutionally racist not to take into account the physical differences between different ethnic groups.

Re the BCG - please don't panic if you haven't had it. It's very much an unknown and untested idea. It also seems to have mixed results or limited efficacy in adults.
Correlation doesn't indicate causality

If there is a heightened susceptibility to corona, it is likely to be multifactorial, as OP mentioned earlier on.

What concerns me here is how much there is to unravel. We need much more granular detail on how it affects specific ethnic groups.

There’s also a lot of work to be done be to understand the relative importance of physiological, cultural, social factors.

It’ll be a long time before we have the info we need to act smartly.

If the death rate is the same across the 3 ethnicities of BAME and different in the fourth (white), then it's quite likely that you can rule out cultural/dietary factors as they vary massively across Black, Asian and Middle Eastern people. That's when you could start to look at physiological factors such as darker skin colour and potential Vit D deficiency for e.g. But I'm not sure whether we have separate figures for the 4 main ethnicities being discussed. Anyone know?

British Heart Foundation:

"Your ethnic origin can increase your risk of heart and circulatory disease and diabetes. Dr Sandy Gupta, consultant cardiologist at Whipps Cross and Barts Health NHS Trust, explains" ...

Does South Asian background affect heart risk?

"We’ve known for more than 50 years that the risk of coronary heart disease (CHD) is up to 50 per cent higher in first-generation South Asians than in the white European population in the UK.The sad thing is, it’s still a problem, despite us knowing this for so long."

"What is the reason for this increase in risk?"

"It is partly to do with body shape and diabetes. South Asians mainly develop central obesity (fat around the middle). Extra fat, particularly on the middle, increases insulin resistance (meaning you must produce more insulin to stabilise blood sugar, among other processes) and therefore risk of developing type 2 diabetes. For this reason, the waist circumference indicating increased risk is lower for a South Asian person than a white European."

"South Asians are diagnosed with type 2 diabetes at a much younger age, and at higher rates (rates are at least twice as high in South Asian communities as in the general population). It’s often a silent condition, so a diagnosis may come years after onset, when blood glucose levels have been unstable for some time and have already caused harm to the body."

"Lifestyle factors may play a role, but part of it is genetic" ...

www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/south-asian-background

@LaurieMarlow don't speak to me like that. If you disagree with me fine but don't take that tone with me, it's disrespectful and I won't stand for it.

Long and the short of it is, most of us here are not privy to a breakdown of death rates, so this entire thread is conjecture and rather futile imo. I'd hazard a guess that 90% of us are not qualified to study such data even if we had it. It's an interesting phenomenon, but I don't think we're going to be useful to the OP or her sister.

OP your sister may have friends in research fields of this - they will be best placed to advise her if there's anything significant that stands out.