Shoots, forgive me if I am missing something obvious (I am going to blame menopause brain...😂). Does your last post concur that BME populations are at greater risk, is that irrespective of other (known) factors? Previous threads had all but convinced me that this was not so, especially when you consider the number of BME people working within the NHS and Care sectors.
Well a couple of things but we have an employment study www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/coronaviruscovid19relateddeathsbyoccupationenglandandwales/deathsregistereduptoandincluding20april2020 and the BME people working in the NHS are irrelevant to the larger picture, since NHS staff are at no greater risk than the population as a whole.
I think they have been highlighted because dead nurses make more emotive stories than dead taxi drivers, but the latter group has far more deaths.
As far as care workers go, that's an excess risk for men but not for women. But most care workers are women. The raw number of excess male care worker deaths is around 30 people, which wouldn't explain things at all.
We have seen that things like factories and slaughterhouses actually have a much higher risk of infection, and it's obvious that all ethnicities are not equally likely to be lawyers (very low risk of infection & death) and factory workers (high risk), for example.
People working in routine jobs are not only more likely to have been infected because of the nature of their work, but also are more likely to be in poor health. Teachers and doctors are generally healthier than the population as a whole, while people in the lowest-paid jobs unhealthier, more likely to smoke, etc.
Anyway, we know:
- ethnic minorities are relatively more urban in residence than white people, which increases infection risk
- ethnic minorities do different jobs from white people, some of which have higher infection risk
- ethnic minorities are more likely to live in larger family units, which increases infection risk
- ethnic minorities are more likely to be morbidly obese, which seems to have been a very significant factor in young people's covid-19 deaths (which hit the headlines), but is not so important for older people
- ethnic minorities are more likely to have diabetes, which has been shown to increase risk
Overall ethnic minorities are much more likely to have been infected. We don't know if this is because of social, religious, leisure and cultural practices beyond employment differences, but it seems from the example of Jews that this is likely. It is not obvious that Jews tend to do work with increased risk of infection, and it might be that religious practice has spread the illness.
It would be likely that cultural practices in ethnic minorities also did some of the infection spreading, especially if we consider that the virus essentially infected millions of people by late March, so a lot of the spread would have been entirely unconscious since probably to whatever extent people mixed with others or don't, during normal times, they would have done so up to a point late in the spread.
It's possible of course that more educated people took earlier steps to distance themselves, and I know that Muslims and Christians in some countries have said that religious practice is more important than covid-19 risk avoidance, and it's reasonable to assume that up to the point where it was illegal, religious people were continuing communal activities, since these activities were both legal and important to these people.
I'm not sure specifically why black people are most likely to have been infected with covid-19, but it follows that they caught it from work, family, or leisure.
Once one adjusts out the much higher likelihood of infection, if there is any extra risk of death following infection, it will be relatively less important than sex and much less important than age.
It has been theorised in this thread that because black and south Asian people produce less melanin, they are at greater risk of dying from covid-19. This might be distinguished from the greater risk that certain ethnicities have of diabetes, which I assume is more linked to diet, albeit that poor people generally have worse diets and greater risk of diabetes, in that a lack of melanin is biological to being black, whereas eating chapatis say, is not. Indeed lots of countries have had drastic dietary changes (for the worse) in a few decades.
There doesn't seem to be robust evidence that black or south Asian people are more likely to die following covid-19 infection, and indeed while they are more likely to have contracted covid-19 in the past, that's not necessarily the case in the future as people go back to work and leisure, and covid-19 is well dispersed and potentially worse now in Hull compared to Hackney, which was not true at all at the height of the pandemic.