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?

McDonalds/KFC/Nando’s is affordable and also aspirational for many youngsters of BAME background. Just look at the number of chicken shops in poorer/ high immigrant population areas
Of course it is that too but tradirional Indian diets also contain huge amounts of carbs, fats and sugar. My parents live in South London. I took my kids to an Indian sweet shop and bought them my favourite sweet as a child. They couldn't even eat it it was so sweet! In India you dont eat as much of it as it's not so cheap, you go out more because of the weather and are more physically active. Many of the people who died were doctors. They were not all poor or deprived just because they were immigrants.

I think some posters are running too far with the stereotypes 🙄

Times of India - "How healthy is Indian food?"

"we are often acknowledged as the diabetes capital of the world along with adult and child obesity threatening an average Indian’s health."

"While we know how healthy Indian food is, where we often go wrong with is our over-indulgence in fried Indian snacks."

timesofindia.indiatimes.com/life-style/health-fitness/diet/how-healthy-is-indian-food/articleshow/9023674.cms

It does seem odd doesnt it...and very sad. I was thinking alot of the people dying have ancestry from very hot countries and hotter countries tend to have less instances of flu dont they? I'm sure I read that flu viruses are less contagious in humid air and much more contagious in very cold dry air? Could it possibly be that people with ancestry from hotter countries have less genetic immunity or are more genetically vulnerable to flu viruses?
I mean i might be talking nonesense... it really does need looking into tho doesnt it because I've seen many newspapers reporting that BAME people are being statistically more effected by this than white people.

123bananas posted this over on the stats and graphs thread

Fri 17-Apr-20 23:26:20
Just a thought that popped into my head this evening re: BAME cases and deaths.

My DH is black and has sickle cell trait, under certain conditions such as low oxygen environments (high altitude), increased pressure (diving) and dehydration rarely people with the trait can have crises like that of sickle cell disease. As many as 3 million people in the USA have SCT and many are unaware that they carry the gene.

This paper seems to say that blood flow in sickle cell trait is oxygen dependent and viscosity becomes higher impairing blood flow in lower oxygen conditions.

pubmed.ncbi.nlm.nih.gov/30033564/
I wonder if some of the BAME cases are undiagnosed SCT, severely impacted by low oxygen due to breathing difficulties associated with Covid-19.

I have had Covid 19 and as someone with an autoimmune disorder taking immunosuppressants, I am in the highest risk group for developing complications.
I recovered and didn’t need to go to hospital and it may be coincidence but I take 100ug of vitamin D3 a day as well as a high strength B complex vitamin.
I have been prescribed D3 by the GP but a low dose and it made no difference to my symptoms of fatigue and joint pain so I did some research.
My Gastro consultant was horrified at the dose I was taking until he saw my bloods and realised that the higher levels did not elevate my calcium.

Interesting @MrsPnut that is 10x the recommended dose!

It is but my bloods are good and I feel worse if I have stopped taking it for a few months.

BBC says

""One thing very visible to us in London intensive care units now is how diabetes, high blood pressure and possibly being a little overweight, seem to be such potent risk factors for having a severe lung illness, perhaps even more so than having an existing lung disease which you would think would be a greater risk," Dr Patel said.

"All of these risk factors are more common in Black and Asian patients, so there could be a link here which needs further exploration."

The research on critical care patients with Covid-19 also found:

the average of patients was 59.5 years
there were nearly three times the number of men as women - 72% male; 27.9% female
more than a third were overweight - with a BMI of 25-30
38% were obese - with a BMI of over 30
the younger the patient, the more likely they were to survive"

www.bbc.co.uk/news/health-52338101

It's been known for several months those conditions have the highest mortality rates with Covid. It's possible they're higher risk than some of those on our government's shielding list.

Interesting MrsPnut Some research suggests immunosuppressants might help with Covid so possibly its actually a protective factor rather than increased risk. Obviously we don't know for sure at this stage. I'm glad you had a good recovery.

Being overweight is NOT always a choice. Many people are on medication that causes weight gain, others have mental health issues, and some people are mobility restricted. And a major contributory factor to obesity is poverty. It's often much harder eating healthily on a very restricted budget, food banks don't have fresh food, some people don't have proper cooking facilities.

Remember that the thread is about Asian/BAME doctors, not the victims in general. Drs being wealthy and highly educated don't seem to suffer as much from overweight as the population as a whole. I don't have any stats so just going on observation. There may be a difference for those who work long/irregular hours though and maybe more of the Covid victims work in A&E and other places where the hours are long and irregular.
Were many of the UK doctors who dies of Covid overweight?

Just from my impressions, there seem to be many, many more nurses who are overweight.

I take 75ug of vitamin D per day. It's well known that the RDA for this is way too low.

Can I just ask what is meant by hypertension/high blood pressure in this context. I presume it's high enough to need tablets for it rather than just getting a worried look by the nurse when you're tested? Asking for a friend.

I always thought prolonged or extreme stress could cause hypertension. Am I mistaken? It will be especially stressful to be a doctor or nurse right now. If there's also already a genetic disposition that might be one explanation?

I would assume that too. If someone's worried I'd say they should check with their nurse or doctor. Ask if it's anything to be concerned about, should they take tablets, is there anything else they could do. I think some foods can lower blood pressure too. There's something known as white coat syndrome. People get higher blood pressure readings than they are normally because of the stress of knowing they're being tested.

Yes, but in recent years some people have been saying that white coat syndrome high blood pressure is also a problem.

Really? I didn't know that. I'd check with the nurse or doctor to see what they suggest. I assume they can't be too worried if they haven't prescribed anything? I think less serious cases can be controlled by diet, exercise, less salt, less caffeine, less stress (perhaps the hardest thing to control especially at the moment!).

It was just a general question. Getting an appointment at my surgery is almost impossible at the best of time. Not going to bother them with that now.

Hopefully someone else here will know more. It's worth calling your surgery. I know several people are finding it easier to get appointments at the moment. They're doing telephone triage first.

Sounds stupid but my dads suffers from HBP he’s also diabetic and has COPD and has always been overweight .
He was always feeling light headed and dizzy in the morning and would take ages to get out of bed due to dizziness and this was a regular occurrence a few times a week often resulting in falls over .
But In the last 2 months or so he’s been eating 2 tins of sardines a day most days but always at least one can A day .

The change in him has been significant . He no he longer feels dizzy in the mornings , his BP is a lot better and he has also lost weight which is strange as he is not active and does no exercise at all . and has been on lockdown for over a month

It might be a combination of things but the one thing he has changed is eating these bloody sardines 😂 and I read that fish in particular sardines are great for helping lowering BP

I have a tin of sardines in the cupboard, but feel disgusted at the thought of eating them, being squeamish and a former vegetarian.

The sardines will be helping to balance his omega 3 fatty acids ratio to omega 6. This reduces inflammation which is one of the factors behind HBP. If he can get his blood sugar levels more balanced that would help too. And as said, exercise and weight reduction will help too (the latter via something like the blood sugar diet).

Are more frontline BAME doctors men - and, although many women are doctors now, they are not frontline but more likely to be GPs so less in contact with the virus.
Women's XX chromosomes and oestrogen are providing more immunity compared to men with only one X and less oestrogen.

Sardines are extremely high in fat & calorific.

They are also extremely good for you. No one should be avoiding high fat, calorific HEALTHY food. It’s the highly processed, high sugar crap we should be avoiding. Without too much of that our systems we can afford to eat high fat but healthy, natural foods. In fact we need them.