36 year old woman dies of coronavirus after being deprioritized by emergency services: is race a factor?

[WombOfOnesOwn]

www.theguardian.com/world/2020/mar/25/london-woman-36-dies-of-suspected-covid-19-after-being-told-she-is-not-priority

When I saw this story I couldn't help but wonder. I live in the US, where black women are at far higher risk during pregnancy, birth, and with illnesses and injuries because hospitals simply do not take their pain and suffering seriously.

Do you believe black women in the UK are potentially at greater risk in a pandemic situation where prioritization must occur? I think this will certainly occur in the US, and that younger black women will be ignored in favor of older white people, but I wanted to hear the British opinion -- maybe it is less dire there?

I had always hoped so, but this story made me so terribly sad. A mother of three -- I'm about to be a mother of three myself, and this story has made me think deeply about how much more terrifying this time must be for black women, who already know they are seen as lesser by many healthcare providers and must navigate without even their family to advocate for them in the hospital.

I hope that triage services don't take the fact that less women are dying as an excuse to add to the usual medical tendency not to take women's reports of being in pain as seriously as men's.

Might not be racism, but definitely racial prejudice. Black women are taken less seriously by medical professionals than their white counterparts as proven many times by social researchers.

As a black woman who lived in London, I can confirm there are still racists there....

@TheProdigalKittensReturn it's been proven by research in the US that black women have worse outcomes in pregnancy compared to white women, and women in general regardless of ethnic background aren't listened to about their pain. Even Serena Williams was shocked not to be listened to.

In London myself, extended family and friends find that your medical treatment depends on:

1. Whether the healthcare practitioner has seen your condition before,
2. If your condition isn't rare they are aware of how serious complications can be,
3. Who you turn up with the next time when they aren't taking you seriously.

Myself and a few people I know have had delayed diagnosis of conditions mainly because the conditions we turn up with are rare. Other people have had serious complications of common conditions because the healthcare practitioners are not aware that they can happen if they don't do the appropriate test or treatment.

So I while I don't think the ambulance crew were racist, due to the husband's previous interactions with the NHS over his own condition he would have probably been reluctant to call them again not realising as Covid-19 is new no-one knows the variations in the course of the disease.

@PlanDeRaccordement

Excuse me?? You think black women five times more likely to die in childbirth is NOT racist? Are you mad? Structural racism in healthcare is a thing. Black women are not believed with regard to their concerns and symptoms hence they die. There may be some slightly increased risk due to other factors but then why isn't our healthcare system actively working towards ensuring that they have the best outcome despite that.

It makes no difference that much of the workforce or much of London is multi ethnic when the system is discriminatory. I doubt that anyone would actively think let me leave this black woman to die but they would maybe not acknowledge her symptoms as much. Had she been white they may have treated her more compassionately, gave clearer instructions or acted sooner.

I work in the health service and it is endemic sadly. Is it a factor in this case? Who knows? Yet why am I not surprised that the first young person to die at home with no health problems was a black woman who was deemed not sick enough by health care workers

I can totally see that happening, Little. My initial surprise was partly that I've lived in London and compared to where I live now there was a lot less overt racism. I suspect that class also would play a part, as it always does in the UK. Some of my relatives are very reluctant to ask for medical help and do it in an almost apologetic way, especially the women, because they feel like they're bothering people over something that may not be important. So I can see the husband running through a though process of is it even worth calling, will they get annoyed with me if they think I'm calling too often, will they even take me seriously if I do.

@Gwynfluff yes.

Worked to my advantage when I was pregnant as my consultant and the head midwife - who weren't white - were adamant I would not be one of those statistics, even if their junior colleagues couldn't understand what the impact of my rare underlying condition could be.

“Yet why am I not surprised that the first young person to die at home with no health problems was a black woman who was deemed not sick enough by health care workers”

Got a source for this extraordinary claim?
Btw, it’s three times more likely in the US that a black woman will die in childbirth compared to an Asian woman, not five times more likely and not compared to a white woman. If society is racist by favouring whites, then why do white women have the second highest risk of dying in childbirth? Explain that to me. If it’s racism, then it favours Asians and Hispanics (in the US).
The figures in the U.K. have a lot less difference between the races. You can’t assume the U.K. is just like the US.

Excuse me?? You think black women five times more likely to die in childbirth is NOT racist?

That's not true.

Firstly there is in general NOT a statistically significant difference between UK-born and non-UK-born women.

In particular, Indian-born women had maternal death rates below the UK average, though it was not a statistically significant difference. Pakistani-born women were higher, but again not statistically significant.

Meanwhile, Eritrean-born women had a rate 12 times higher than the UK average, though that is 3 deaths in total, which is not a large number in absolute terms. This is statistically significant.

www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202018%20-%20Web%20Version.pdf

34.2% of births to African-born women in the UK were 35+. That's far higher than the UK-born figure of 21.1%. And for 40+ it's 9% vs 3.7%.

There is no difference in maternal death rate between 20 and 34. 35+ and under 20 are risk factors.

Over 40 is big risk factor, and 45+ is huge. African-born women were four times more likely to be over 45 than than UK-born.

You cannot baldly state that a black woman is five times more likely to die, because it's not true, especially when you consider that there were three times more deaths of black African women than black Caribbean, yet the black African population is only half the size of the black Caribbean population.

And when you observe that women born in Africa has by far the highest rate of geriatric pregnancy, you find the real issue.

I'm sure that black women do face different treatment from white women in hospital. But I bet the same applies to Indian women, who are NOT dying in significant numbers.

The fact is the NHS is doing a good job, and before you rush to accuse it of racism you should actually try to find the facts, which are as mentioned:

• not black women generally - black African women specifically
• black African women vastly overrepresented in geriatric pregnancies
• correlation doesn't imply causation - just because more black women die as a % of the population does not mean that a black woman of 45 is more likely to die than a white woman of 45.
• overwhelmingly the biggest risk factor is being OLD. MBRRACE does not break out 40+ and 45+, but you are more than twice as likely to die in pregnancy because you are 40+ then younger age groups. 45+ will be much worse. This is biology, not racism.

Is the assumption that the paramedic that came out to see her, and advised that she didn't need hospitalised yet but to call back if she deteriorated, was white? Why? I don't think it's fair to that paramedic to bring racism into this.

I would add to Shoots's post that maternal mortality statistics don't just relate to deaths in childbirth. They relate to deaths during pregnancy and six weeks postnatally. Fortunately, very few women die in childbirth in the UK

Yet why am I not surprised that the first young person to die at home with no health problems was a black woman who was deemed not sick enough by health care workers

Not sure why you think no health problems should count against the NHS here.

A young white woman died of pneumonia 3 weeks ago. She did have health problems but was sent home.

www.manchestereveningnews.co.uk/news/young-woman-went-hospital-cold-17854580

It would seem there should be more culpability in a person with health problems dying than one who is young and has no health problems. A 36 year old without health conditions is not in an at-risk group.

A 21-year-old white woman died at home after being triaged and left by ambulance crews in High Wycombe.

www.mirror.co.uk/news/uk-news/familys-heartbreak-carer-21-dies-21753839

She had been visited by ambulance crews in the early hours of Thursday morning suffering with breathing difficulties but was told to rest at home.

However later that day she rapidly deteriorated.

Another ambulance was called but never arrived, with overstretched medics explaining that she was not a priority.

High Wycombe is NOT the epicentre. Peckham likely is.

The ambulance was called to Chloe Middleton while she was still alive. They did not turn up.

999 was called for Kayla Williams only after she was already dead, but they did turn up, despite London obviously being overwhelmed.

I am struggling to understand people's agenda here.

Williams said: “I called 999 because my wife was breathless, she was vomiting and she had pains in her stomach. As I was talking to them she was getting worse and they told me to put her on the floor and to make her body flat.”

When the paramedic arrived at 8.32am she carried out some tests, Williams said. “She told me the hospital won’t take her, she is not a priority. She did not stay very long and she went outside to write her report and posted it through the door.”

Williams said his wife’s condition deteriorated the next day. He ran her a bath in the morning and helped her to get dressed, before feeding her some soup. After taking a short rest himself, he went into the front room where she had been resting to find his wife slumped head down. “She was already dead,” he said.

“I put her on the ground – because that is what they had told me to do before – and I rang 999 again and they told me to put my hand on her chest and pump her chest.”

Three cars and an ambulance arrived at his home a short time later, he said. The crews tried to revive his wife, but were not successful.

as at March 2019, around 9 out of 10 people employed by NHS trusts and clinical commissioning groups in England were working in non-medical roles (and 1 in 10 were in medical roles)

I don't think that stat fully explains the problem in the NHS. The figure doesn't include any other clinical staff at all, just medical staff.

As for whether the death of this woman was impacted by racism, isn't it like so many thing we read? That really there just isn't enough information to be able to judge.

What the hell? No I do not think she was left to die because of her race.

On Mumsnet racism doesn’t exist, unless it’s anti-white racism.

A young ( white) woman of 21 was similarly de-prioritised in recent days and died too.......Really don't think this has anything to do with race.

My white male middle-aged working-class neighbour (to categorise him) has just had a major emergency brain op, and was sent straight home even though horrendously ill. In the normal way, he'd have been kept in. At the moment, they're doing all they can to keep everyone out of hospital. So I don't think we can judge on that awful case, when there are so many terrible and sad things happening.

Afterwards, researchers can look at the statistics, and see. I wouldn't be surprised if some classes of people are treated better than others. But how can we judge from that one case, when there are so many similar ones?

I do notice though that those who expect better treatment are often treated better. DH is from a working class background, and he has such low expectations and doesn't want to trouble anyone. I'm middle class, and have much higher expectations.

On Mumsnet racism doesn’t exist, unless it’s anti-white racism.

It's true that white people often underplay the extent of racism. At the same time, just because racism exists it doesn't mean that racism is always the causal explanation for a black person being disadvantaged.

"A young ( white) woman of 21 was similarly de-prioritised in recent days and died too.......Really don't think this has anything to do with race."

Exactly and today I heard that a 37 year old, white man with no underlying health problems had died from the virus. He was the UK deputy ambassador to Hungary.
This virus does not respect race, age, sex, class or religion.
To be honest, with all that is going on, I find trying to turn this into a race issue is frankly disgusting.

We have laws in the UK that make any discrimination on grounds of race a criminal offence.

Add to that the very large proportion of NHS staff in London who would themselves be BAME, and it looks highly unlikely.

It’s a chilling thought and I hope not. As a pp has pointed out other ‘stand out’ cases include a 21yo white woman and a 37 white man.
PP have mentioned that many richer people have left London, I don’t know anyone who has (anecdota I know) and one thing that Londoners were acutely aware of even before this is what a privilege it is to have so many fantastic teaching hospitals as our locals. I’d be really interested to find out how many really have left- not that it takes many to spread it.

King's College Hospital, certainly isn't world class. It was in such a bad way pre-Covid-19 it was in special measures. Has been for a number of years. I suspect the experience of poorer Londoners differs from that of the more affluent.

Over 40 is big risk factor, and 45+ is huge. African-born women were four times more likely to be over 45 than than UK-born

That's interesting - given the group which gets most criticism for being older mothers is white, middle - class women supposedly delaying motherhood for career advancement.

Black women are taken less seriously by medical professionals than their white counterparts as proven many times by social researchers

Not denying your experience in being sidelined and not taken seriously, but it is not exclusive to black women. My father has tremendous 'bad luck' with the NHS...and has had to jump hurdles on many occasions even to have his complaints taken seriously.

He was once discharged from hospital at almost midnight, in the middle of winter, without a coat.........He has no car, either......so had to take a taxi home. He's been taken to hospital by an ambulance because he'd fallen head first down the stairs...and lost consciousness for a time.

Over a year later, which was how long it took him to get taken seriously, it was discovered he had actually damaged and displaced various neck vertebrae ( leaving him with a permanent inability to raise his head) - and he is still waiting, almost two years, later for proper treatment.

He thinks he's being dismissed because he's older ( although only 78 years old).......and this is not the first time he's had really unprofessional treatment. He's also been left with really painful kidney stones for many, many months.......and seems to have slipped off the radar.

He'd been taken to hospital

I'd like to think not, but I can't lie and say it didn't cross my mind when I saw her picture