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?

That's even lower than I expected horseandhound shockingly low salary. They probably can't afford to eat well especially when you add in the lack of time. They work such long hours even when there's no pandemic. Then the stress. I suspect many doctors, through no fault of their own, aren't in the best health, even if they're slim.

(Just on obesity but interesting - Telegraph

"Being overweight has emerged as one of the most important risk factors in getting admitted to hospital with severe forms of coronavirus, the biggest study of British people with the disease will say.

The Telegraph understands analysis of 15,100 hospitalised patients from across the UK has identified how carrying excess weight increases the likelihood that severe complications will develop from Covid-19.

Scientists from three universities have analysed data obtained from Covid-19 patients to draw up the most comprehensive profile yet of how the virus exploits age, sex and underlying health conditions.

The study, based on statistics and samples obtained from 177 UK hospitals, has been analysed by scientists from Edinburgh and Liverpool Universities and Imperial College London and then compared with studies in China, where coronavirus first emerged....
"

"Not necessarily multi generation but flatshares. Probably doesn't help contain the virus."

How would a flatshare be any different to being in a nuclear family?

I suppose I was being charitable saying it was a 'mistake' the government calling for doctors to come out or retirement. At the time I thought 'WTF' as it was already well-known that age was a risk factor.

Yep, an older doctor I knew was saying it was stupid, but he's still gone back.

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.

I understand that it's a pretty good metric for the general population, it just falls down in those with muscular development significantly outside of the broad average. It makes sense that gyms don't use it because that's precisely where one would expect to find said muscular development.

London is a very good place to train, though. You come across so much variation in humanity.

You end up with more questions than answers though.

Medical statisticians do not set much store in the experiences of GPs because we do not provide much in the way of data but we see so many patients and get to know them over a long period of time so that we do have empirical evidence. One of my questions is the role of aerobic exercise in the BAME population. I used to suggest swimming or cycling (on a Boris bike - such irony) as an exercise but rarely were my BAME patients confident swimmers or cyclists, no matter their social class or educational attainment levels.

Academics at King’s College London are doing some excellent qualitative research into healthcare inequalities both in the general population and in the NHS but I don’t know how interdisciplinary the teams are. In the future we would all benefit from including sociologists and anthropologists, not just doctors and medical researchers, in the formulation of public health policy.

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.

I know several multi-generational British Indian families who live in 6/7/8 bedroom properties who send their children to private schools.The houses are not overcrowded because they only have two or three children each.

Gwen the sort of place you'd get on a £25,000 salary in London will likely be poor quality housing. Also sharing a kitchen and bathroom with unrelated strangers whose levels of hygiene and cleanliness might not match your own. Multigenerational families often have a grandparent living with them as a valued family member to be cared for. Sometimes with an additional bathroom or a "granny flat" annex. It's not always for economic reasons. I know of white British and BAME families who do this.

With obesity being a major factor in Covid hospital admissions I'd be interested in seeing any statistics about income. I suspect the poor are being harder hit for various reasons.

PFI was such a disaster. One of the reasons why I blame Labour as much as the Tories for the problem the NHS has. Decades of mismanagement and underfunding from all parties.

I would hazard a guess that it’s just another example of victim blaming, Clavinova. Let’s see what the demographic analyses reveal in a year’s time. There’s a school of thought that tries to ‘other’ and diminish minorities in order to bolster their own position, and these people seem to have been more vocal since the Brexit vote.

Many British Bangladeshis grew up in abject poverty and overcrowding as their parents were refugees and later victims of trafficking and what we now call modern slavery. They are still struggling to assert themselves. Their immigrant experience is completely different to the expelled Ugandan Indians, who were able to settle quickly in Britain because they all arrived with sterling bank accounts. That experience is different again to doctors recruited directly from India who tend to be academic outperformers and whose children (including Krishnan Gurumurthy and our new chancellor) are the same.

We don’t systematically underpay our juniors, Toffee. Pay rises very quickly.

Which leads me to another topic. The NHS pension is a big reward and many people - particularly doctors from overseas - who have joined the scheme at a later stage in their career work to a later age to achieve the full pension entitlement.

Expedited trials are already being conducted into D3 but here in the UK we’re lagging behind on what some countries call nutritional medicine. Until we know more, it’s odd that sunbathing has been expressly forbidden by the police in the circumstances, and we know there is very little harm from D3 supplements in the short term even at high doses. I would go so far as to say everyone should be taking them at the moment, ready for the post-lockdown period.

The BCG vaccine is a funny one. Many argue it’s no longer protective and yet it was often in short supply in the London borough where I worked and when it finally came back into stock there would be queues of patients.

Again I am only speaking from experience, but people arriving from developing countries have a good uptake of vaccines as they know about epidemics from hearsay or even experience. Often there are very well established preventative health programmes in their countries of origin which would put our own uptake figures to shame.

"Gwen the sort of place you'd get on a £25,000 salary in London will likely be poor quality housing. "

Were the doctors who died in this income bracket?

Thanks for your posts horseandhound I'm finding it very interesting.

I think it's mostly middle-aged or older doctors who've sadly died (but some younger nurses and other healthcare staff). The younger ones might (unwittingly) help spread it but are mostly young and healthy enough to fight it off? I wonder the effect on their future health. Irrelevant for this pandemic of course but I've read the lifestyle (which clearly isn't always a choice) led in your 20s and 30s can have a big impact on your later health.

The data from South Korea, which had an intense testing programme, showed people in the 20-29 age group were the biggest carriers of Covid-19 so you are right.

Asymptomatic carriers

The challenge here is how to manage such a fast-moving scenario.

We can’t stand down 44% of doctors just because we suspect - in the current absence of data although I know that’s being addressed - they’re at heightened risk. Many of them are there very willingly, because medicine is a team sport.

Happy to stand up and be tested for anything and everything. I was 40 years ago in the irresponsible 20-30 cohort. I am AFAIK, after four weeks of social distancing, free of contagion, and I have not had a cold for 15 months as DC are finished with school. Daily exercise (either a walk or Pilates) so I should be good as a member of a control group.

Very good points from horse that we may discover XYZ - eg more men than women get it badly but not much can be done about that or if you are 3 stone over weight it could be bad (a bit late to lose that in a week - although a good plan to get started on it).

I would really like to know how many have had it in the UK - eg if 20,000 deaths tends to mean xyz number have had it even without symptoms we could begin to work out if most or hardly any of the UK population has had it. How many infections per 1 death for example. Our 120,000 diagnosed cases is almost irrelevant as vast numbers have had it without being tested, the tests don't work very well anyway and even more have probably had it but never knew they had.

www.theguardian.com/world/2020/apr/18/failure-to-record-ethnicity-of-covid-19-victims-a-scandal-says-bma-chief?CMP=share_btn_fb&fbclid=IwAR3wIoqDcL4d6kaDOGj27lUyVYTDZv_9ZQOzeOFnzW9v0eDwtOfsyWiP3EU

"Also sharing a kitchen and bathroom with unrelated strangers whose levels of hygiene and cleanliness might not match your own. "

How is that any worse than living with a relative whose hygiene standards do not match your own? In any case, when we're talking about doctors catching the illness, it's through their work mainly isn't it, so why does the hygiene of your housemate matter?

Looks like this is being taken seriously now:

www.hsj.co.uk/workforce/trust-treating-all-bame-staff-as-vulnerable-and-at-risk/7027500.article