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?

Would expect most doctors of that age to have had the BCG vaccine if they grew up in Britain.

Whether they had that or not may be another factor. There are so many variables and possible reasons.

2 of the Drs I read about had both grown up abroad. So big would depend on where that was. But wouldn't they have had a booster working as a Dr in mainly london?

I looked into vitamin d this morning.
I was actually looking at what might reduce ARDs risk. And there was some possibility but d might do that. Or nicotine I think but they said that was unethical.
So I guess the Q is are different races getting covid as easily but different % will get the o2 intervention more and others getting more ARDs? I

I have pics and that is linked to low vit d.

Pcos

@Lily193 No, I can't find much on Pubmed yet either, though there is some research on medrxiv (not as yet peer-reviewed though - mainly due to the fact peer-review can take months under the best of circumstances, I suspect).

I can find Polish research into COVID-19 and possible genetic links but the research itself doesn't seem to have been translated into English yet, unless I'm missing something.

I am obsessed with this virus and have read endless medical journals. 1. In several studies approximately 70 percent of deaths across countries are male and 30 percent female.

1. BAME are also more affected. In America it was more noticeable than in Europe.
2. Some studies found people with A blood are more affected. O blood group least affected.
3. Up to 70 percent of people needing ICU are obese.
4. Smokers who catch it also more likely to need ICU.
5. People who are older also more likely to need ICU and take longer to recover and higher death rate.

7 People with underlying health issues of any age more likely to need ICU, longer recovery and higher death rates. All of above studies looked at one factor. There were some studies looking at multiple of above factors. The worst combination I could find was Chinese study, suspect validity, showing overweight males, over 50, with underlying health issues in most at risk group. Most of these died. Some may have been saved if more ventilators available. Bit D important as is rest as it strengthens immune system. Most people need 100 per day. A lot of people in UK and cooler countries deficit.

Your Dad multi factorial theory likely to be correct.

Can anyone tell me the recommended dosage for D3 supplement?

They say that in the US it has disproportionately affected the African American community too. It is very concerning.

The 13 year old boy who died was Somali.

*Asian people are more likely to be doctors than non Asian

1. Asian doctors more likely to work in cities such as London and Birmingham where the level of outbreak is higher
2. Asian doctors more likely to work beyond 65.
3. Asian people more likely to have type 2 diabetes
4. Asian people more likely to have vitamin d deficiency
5. Asian people more likely to be blood type A.*

I would say that’s a pretty good summary.

For the Asian (or other ethnic minority groups) who are dying disproportionately I’d say that alongside possible vit D deficiency, blood type and diabetes risk there will also be lifestyle and environmental factors at play, as well as in some cases the genetic issues that arise through consanguineous marriages through several generations.

Sorry, my last paragraph should have said for BAME who are Not doctors.

If it's any help this is what we take daily as a preventative in France. But our maintenance dose is 10x the strength of a UK booster dose.

Purely anecdotally diabetes, diabetes, iron deficiency and hypothyroidism (which of course are interlinked to an extent) seem to be more common amongst Indian decent people. That might just be the people that I know though but obviously all the above conditions would make a person more vulnerable to viruses in general.

Re the blood type thing, they found that O-types were less likely to die but I don’t think they’ve found a causal link of anything.

It’s about over representation and also because their initial concerns were not taken seriously. They were made to continue working

This is a simple minded analysis.

Two of the dead were GPs who ran their own practice, one of which staffed by his wife and children. They were plainly not forced to do anything.

Another was 77 and did not work with frontline patients at any point.

Another was retired and working voluntarily.

Two more had volunteered away from their normal jobs to work in A&E.

Another was a consultant geriatrician who went round care homes.

These were senior well-paid doctors who had.all worked for the NHS for decades and received considerable recognition both monetary and non

I am an Asian doctor and also work in frontline looking after Covid 19 patients. It is interesting that so many Asian doctors have died and agree that the reasons are multifactorial. These doctors would have caught the disease 3-4 weeks ago when they were not aware of the level of protection needed. There was a lot of confusion regarding what sort of PPE is needed for certain procedures. Look at the date of public health England's recommendation of PPE. Our understanding of this disease is evolving- there are certain procedures which initially thought did not carry any risk or only minimal risk were proven to be otherwise after the emerging Italian data.
From my memory the doctors who died worked in A and E, ENT where the chances of exposing your self to a high viral load is likely.
Lot of us ( not just Asians) consider this as a vacation and are more likely to work long hours in hospitals after your children have left home etc., You have spent so much time at the hospital and consider it as second home.
We have retired doctors who are still working with us on a part time basis.we really value their skills and advice and are trying our best not to give them any frontline duties and sometimes we have to fight hard with the management to make them realise that they can't be treated like the rest of us.

I know couple of junior doctors who have voluntarily gone to work at Kings college hospitals from an area not that much affected as that's where they are needed and their Asian parents are really worried.

OP, I can see why you are worried for your sister.

I agree that stocking up on Vitamin D is a good idea.

I've noticed that the oxygen in my blood seems low (I have an oximeter and the Samsung health app and have compared my figures with my meat eating DH) , which I partly attribute to me not exercising or getting enough water.

But I'm also a vegetarian and am convinced my iron levels are very low. This would impact the oxygen levels in my body.
I've just started taking iron supplements.

Out of curiosity, is your sister a vegetarian?
If so, it might just be worth exploring, for your sister's health and checking her levels (please note this is just a 'theory' for my own health too and happy to be shot down - but I'd be interested anyway if anybody has some info on anemia/low iron counts).

Of course, this is not a theory that would support the high mortality rates in BAME communities and doctors, but I wanted to mention it just in case it might be of any help to your sister.

ProfessorLayton1

Thank you for all that you are doing . And for your obvious care for the welfare of your colleagues.
.

Yes, thankyou too Professor

It will also correlate with urban/ rural divisions.

I don’t know the stats but I’d imagine there are more BAME doctors in urban hospitals than rural ones?

This is once again about the population being disproportionately in metropolitan city areas where the outbreak is more widespread.

Still doesn’t explain why disproportionate numbers of ethnic minorities are dying in metropolitan areas. 60% of London population is white.

Thanks so much Prof Layton

Thank you OP for this interesting discussion. to all working in the NHS. It must be so worrying for all of you and your families.

EmpressMcSchnozzle

I've read at least two articles in recent days but I forget the details now - I'll try and find them again if I have time today.

@middleager many Hindu Indians are vegetarian but that may be a coincidence. I suspect it's more genetic differences between caucasian and BAME populations. They have similar issues related to diabetes and things like high blood pressure.

Ireland has recommended vitamin D supplements be given to all patients, HCP and the wider population to help build Covid resistance.
It's in the Irish Examiner, if the link fails.
www.google.co.uk/amp/s/amp.irishexaminer.com/breakingnews/ireland/irish-studies-find-vitamin-d-can-build-covid-19-resistance-991995.html