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 most countries are fudging the figures
That’s easily seen by the amount of people dying at home and in care homes . Probably if the general public nee the real figures we would be social distancing rioting 😂

With regards to Vitamin D for and years years we have been told that we need to use Factor 50 and avoid the sun as it causes cancer.

But I don’t and never have worn sun tan lotion as I’m dark skinned anyway and much prefer catching the sun and getting a good tan .
Even on holiday abroad I never wear sun tan lotion

Worth listening to Prof Sarah Gilbert who is leading the vaccine research at Oxford on Andrew Marr this morning. From what I can gather there are three components to consider:

1. How susceptible our bodies are to attack by the virus. This is down to the “receptors” in the lung cells which let the virus in. Seems there are v little in children and these increase as we get older and there are more in men.

1. Then how our bodies respond to the infection - basically our immune response which decreases as we get older.

1. Then the level of viral load to which we are exposed to has an impact.

That seems to be the 3 cornerstones which they are working from. Maybe the BAME situation is overlaid on top - maybe there are different levels of lung receptors in different populations (but if so - and as I asked up thread if it was this would we not have seen the whole populations in the regions of Asia, Africa, India wiped out by now?)

So that leaves us only with how our bodies immune system responds differently as the viral load I would assume is the same whatever ethnic background the HCP is?

I find it interesting that since it's mainly a respiratory disease, asthmatics don't appear to be disproportionately affected.

Nor have I seen smoking being listed as a risk factor.

Initially the reports said the the higher number of men in China dying, than women, was due to the fact that men smoked and women didn't. Now it seems chromosomes affect immunity so I don't know if the smoking risk counts.

Hi all, OP here, I haven’t been able to contribute much to this thread in the last couple of days as flat out with work, but I have been contacted by several people via PM and also on my twitter including a GP and a medical journalist and will be updating here as soon as I can.

Some information I’m grappling with in the meantime, in no particular order of importance:

14% of the UK population is not white and yet PHE have issued no specific guidelines to GPs about us as an at-risk population. Asthmatics number only 12% of the population, and yet I was told there have been three sets of guidelines issued in the past 18 days.

This is a political issue - the Conservatives were elected on a Brexit mandate which is one that is undoubtedly xenophobic and possibly racist. No government elected on this basis is going to give the safety of people of colour any priority.

This government certainly isn’t going to prioritise the safety of BAME staff in public services as it means acknowledging how utterly dependent the country is upon immigrants and naturalized citizens.

The so-called ‘Public Inquiry’ is a government PR exercise designed to stop absenteeism and non-compliance amongst BAME doctors (44% of whom are not white). There is no end-date by when it has to report, and it will be headed by NHS England and the PHE, who may very well be presiding over their own failures. The children of Dr Tun, for example, specifically cited his concerns about the withdrawal of PPE from his department as being a concern.

The vitamin D3 sufficiency guidelines in the NHS are half those recommended by Indian doctors in India.

Where the fuck has this chestnut about “multi-generational families” come from? Doctors are rich; they don’t live in overcrowded housing with their grannies and their grandchildren. Socially I know perhaps fifty British/Indian families, admittedly only of the middle or upper middle class - but I don’t know of a single multi-generational household.

More to come when I have time.

Oh yes you’re right Gwen it’s all women and yes I get fed up with the delusions on here too. A size twelve used to be 30 waist anyway and size ten was 28. Previously been very unpopular on here to mention vanity sizing.

Apple shapes can’t tolerate many carbs that is my synopsis. Certainly cannot tolerate the western ways of refined carbs at every meal, a gazillion carby snacks, booze, sugary drinks, puddings “you deserve it you’ve had a hard day”, super sized freak shakes...without becoming fat around the middle

"Nor have I seen smoking being listed as a risk factor."

COPD and lung problems arising from smoking are risk factors and I think it's known that smokers are more at risk.
Smokers are more at risk for so many things though so if those things haven't stopped them...

14% of the UK population is not white and yet PHE have issued no specific guidelines to GPs about us as an at-risk population. Asthmatics number only 12% of the population, and yet I was told there have been three sets of guidelines issued in the past 18 days.

Oky so first of all you want all non-white people lumped together as one homogenous 'at risk' group.....

Where the fuck has this chestnut about “multi-generational families” come from? .....Socially I know perhaps fifty British/Indian families, admittedly only of the middle or upper middle class - but I don’t know of a single multi-generational household.

And then you don't.

"Where the fuck has this chestnut about “multi-generational families” come from? "

Same thing was being said about Italy and turned out not to be true at all.

This is a political issue - the Conservatives were elected on a Brexit mandate which is one that is undoubtedly xenophobic and possibly racist. No government elected on this basis is going to give the safety of people of colour any priority.

My God, how offensive. Apart from anything else, why would the safety of people of colour have priority over the safety of white people?

NHS made a mistake asking for HCPs to come out of retirement to help with Covid, age being a risk factor for complications.

I think that NHS staff on the frontline should be vetted and the younger, slim, and female, doctors and nurses chosen to work with Covid patients. Then deaths of NHS workers should go down, including those who are BAME. I don't know if that's possible though.

I was in fact also going to mention this delusion that people who are not white tend to live in close crowded proximity with multi generations. I actually don't know of any family who lives all together.
I know of one Indian (English) man who lives with his mother, one Sri Lankan man (English) who moved back in with his mother post divorce couldn't afford rent on accommodation for ex wife and child and for himself. I know of several, numerous in fact, white (English) people who live with their parents while they save up for a mortgage. I would think that inter-generational living is more prevalent among the younger white English classes.

NeedToKnow101

the younger, slim, and female, doctors and nurses chosen to work with Covid patients

Sounds like an 80's ad for a secretary hhahaha

Maybe we could advertise - only white, female, young and slim need apply.

"NHS made a mistake asking for HCPs to come out of retirement to help with Covid, age being a risk factor for complications."

Not really a 'mistake'. They knew very well when they made the call that this illness is dangerous for older people.

There is an article in the New Yorker about Alaska and their preparations. Native Alaskans are extremely worried, as apparently during the Spanish flu epidemic whole villages were wiped out completely and the death rate was about 50%. Way higher than that of the white population, which stayed at around 2%.

In 1900 Native Alaskans also suffered terribly from a combined epidemic of measles and flu.

I wonder if part of this is hereditary. Generations of Europeans, especially from urban/industrial backgrounds, had been exposed to flu variants and, effectively, the fittest survived, or rather those with the best adapted immune systems. The ancestors of Native Alaskans were far more isolated and so had had far less exposure and so their immune systems may be less adapted.

Apparently village elders have taken matters into their own hands at a very early stage and have been completely isolating remote communities. They may get bored of living on fish, but there are still too many memories of 1918.

Maybe we could advertise - only white, female, young and slim need apply.

What could possibly go wrong?

Geranium Please stop trying to de-rail the thread with your vacuous and oddly defensive contributions. The OP said ‘any priority’ not ‘primacy’. They’re subtly different but even people whose first language is English think they’re interchangeable. They’re not.

MMXVi I was a GP for over 40 years - although now retired and with absolutely no intention of returning to work - and am watching with interest.

It was very poor policy on the part of Johnson, Gove et all to have recently retired doctors to return to duties. As soon as there appeared a clear risk to older age groups - and in fact the age model was quickly in the public domain through the experience of other countries - older staff should have been stood down.

Also I wonder how many older doctors actively rushed to volunteer because they had relevant crisis handling experience. At least one doctor was a Syrian refugee, and another was active in the 1977 smallpox pandemic in India.

I think OP means that as the BAME community seems to be disproportionately affected, this should be included as one of the risk factors? Also the government should bear this in mind when considering a premature end to lockdown (and the lack of PPE for frontline staff). Taking into account who would be most affected by lockdown ending too soon.

I pointed out earlier in this thread that being overweight is very strongly linked to poverty. There are also many people on medication that causes weight gain, people who comfort eat because of mental health issues, and people with restricted mobility (often because of waiting too long for minor NHS procedures). It's not so much being "PC" and not wanting to "fatshame", it's more that it's not always easy for people to do much about it. It's cheap to buy processed carbs like white bread and pasta. Food banks have mostly processed foods. I don't think you get fresh veg from a food bank? Hypertension too. Relentless grinding poverty and poor housing causes ongoing stress that causes high blood pressure. It's not always as simple as telling someone to exercise more and eat healthily. For many that's not so easy.

I wonder in London. In the past I've seen adverts in local papers from hospitals asking for landlords with spare rooms or flats. Their staff, including doctors, can't afford the very expensive housing. Younger doctors in London do often have to live in shared housing. Not necessarily multi generation but flatshares. Probably doesn't help contain the virus.

Asthmatics are not a homogeneous group either, Geranium, in case you were wondering. If there is evidence of disproportionate risk distribution it needs to be addressed.

There is a large degree of victim blaming affecting fatalities amongst minority ethnic populations. Orthodox Jews and Muslims were not observing social distancing and continuing to worship. Actually Christian churches were open right up until lockdown too, but aren’t as well attended.

I would be surprised if the NHS were discriminating against non white doctors but we certainly need to look into what factors cause higher risk eg I believe people are being how to put on masks big enough for men in the NHS and they may really need advice on adjusting them if youa re smaller and female.

The only person living with grandparents, children and grandchildren near my house is an Indian family opposite and definitely the bigger houses around here are liked because of 3 generations often living together - this is in huge £1m+ places by the way. However another neighbour (indian) bought the whole detached house opposite his recently for his mother so not everyone lives with family.

the previous owners of my house were from Pakistan and they had 2 brothers wives and children here and one set of parents but that is just anecdotal.

"I pointed out earlier in this thread that being overweight is very strongly linked to poverty."

Yes, but that's not relevant at all in a thread about DOCTORS who are at the top of society in terms of both income and health education.

ToffeeYoghurt F1 doctors earn about £25,000 so definitely flatshares in London. Very low quality of life, especially because they also have to pay for parking and food. Look into some of the PFI scandal when you have time.

It is one of the main reasons so many young doctors are leaving the NHS to work in industry or overseas.

I can tell you with confidence that 90% of my patients over 45 were overweight after the age of 45. Not just Asians. In my experience they were however less likely to be morbidly obese which is an important risk factor.

BMI is a quondam metric and I don’t know why it is still used in medicine to make assessments when it’s not even used in gyms any longer.