The first meta-analysis of the effect of ethnicity on the clinical outcomes of patients with Covid-19 has analysed 1,500 articles, and data pooled from 18 million people in 50 studies from the UK and US, between December of last year and August.
Researchers found that people of black ethnicity were at higher risk of ICU admission and are two times, and people from an Asian background 1.5 times, as likely to become infected with Covid-19 than those who are of white ethnicity.
This report has added to and analysed the many academic studies that have examined the racial disparity of Covid-19, as well as those who did not focus on ethnicity. And is supplementary to a recent study that linked Covid-19 infection with stroke by racial background, and a Government report that causally related Covid-19 infection with socioeconomic profile.
Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester, Consultant in Infectious Diseases at the University Hospitals of Leicester NHS Trust and a senior author of the paper, said: "Our findings suggest that the disproportionate impact of COVID-19 on Black and Asian communities is mainly attributable to increased risk of infection in these communities.”
Covid-19’s disproportionate ethnic impact, in terms of mortality and rate of infection, was deduced to be mainly related to structural socioeconomic factors, rather than the severity of the infection.
Dr Pareek said: “Many explanations exist as to why there may be an elevated level of COVID-19 infection in ethnic minority groups, including the greater likelihood of living in larger household sizes comprised of multiple generations; having lower socioeconomic status, which may increase the likelihood of living in overcrowded households; and being employed in frontline roles.”
Evidence of structural racism
Although there is evidence that racism and structural discrimination may have contributed to increased risk of infection in two American studies, and also, it could potentially have featured in many other countries, as racial blame for Covid-19 was used as a political tool to marginalise and scapegoat minority communities – especially towards Chinese diasporas and African refugees.
As another study had reported that some ethnic minorities and migrants groups had been less likely to stick to government guidelines, be tested, or seek care when they had symptoms: ‘Due to barriers and inequalities in the availability and accessibility of care.’
This meta-analysis research concluded that subsequent studies need to examine closer the data surrounding ethnicity, as many studies had not disaggregated by ethnicity or had treated certain ethnicities are homogenous groups. As well as recommending that governments and health policymakers consider strategies to address 'social determinates, structural racism, and occupational risk underlying inequalities.'
Dr Shirley Sze, NIHR Academic Clinical Lecturer and Specialist Registrar in Cardiology at the University of Leicester, and a lead author of the paper, said: “We must work to minimise exposure to the virus in these at-risk groups by facilitating their timely access to healthcare resources and target the social and structural disparities that contribute to health inequalities.”