People of Black and Asian ethnicities are up to twice as likely to be infected with Covid-19, compared to white individuals, a comprehensive analysis has found.
The data also suggests that the risk of being admitted to intensive care after catching coronavirus may be twice as high for Asians when compared to those from white ethnicities.
The analysis, published in the EClinical Medicine by The Lancet, is based on pooled data from more than 18 million people who had taken part in 50 studies in the UK and US.
The scientists said that their findings should be of “importance to policymakers going forward”.
However, they added that any decisions on whether those from Black and Asian backgrounds should be on the priority list for a Covid-19 vaccine will need to come from the government and Joint Committee for Vaccination and Immunisation (JCVI), which advises the government on all aspects of vaccination.
Interim guidance from the JCVI listed 10 groups it deemed high-risk and priority for a vaccine – but makes no mention of BAME people, despite itemising seven separate age categories. The government has repeatedly failed to answer HuffPost UK’s questions as to whether it will be accepting the JCVI’s recommendations wholesale, or whether it had any idea why BAME people are not mentioned once on the list.
Dr Manish Pareek, associate clinical professor in infectious diseases at the University of Leicester and a senior author on the paper, said: “We must remember that there are several high-risk populations – notwithstanding individuals who are elderly, who have underlying comorbidities (and) individuals in nursing homes.
“So the government and JCVI will need to make important and difficult discussions and decisions about how to allocate what will undoubtedly be limited vaccine at the outset.
“I don’t think we’re necessarily suggesting that individuals of ethnic minorities should be a priority group necessarily, but I think what we’re saying is that there are several priority groups and the government needs to make those difficult decisions.”
As part of the first ever meta-analysis of the effect of ethnicity on clinical outcomes in patients with Covid-19, the researchers looked at 50 studies published between 1 December 2019 and 31 August 2020 in peer-reviewed journals or as pre-prints waiting for peer-review.
The researchers found people of Black ethnicity are twice as likely and Asians were 1.5 times more likely to be infected with Covid-19, compared to white individuals.
The data also showed that those of Asian ethnicities may be twice as likely to be admitted to an intensive therapy unit (ITU), compared to those who were white.
They said “a higher degree of morbidities within these populations” could be one of many factors why Asians were at higher risk of severe Covid-19.
The team said it did not find any increased risk of ITU admissions for people from Black and white ethnicities.
However, the researchers cautioned that all studies investigating ITU admission included in the meta-analysis had not yet been peer-reviewed.
Dr Jatinder Minhas, National Institute for Health Research (NIHR) academic clinical fellow at the University of Leicester, added: “In terms of (the risk of) death, it (the result) was very borderline.
“But there was some signal to suggest that Asian individuals are at higher risk of death as compared to white individuals… This wasn’t seen in those of Black ethnicities.”
Dr Pareek added: “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.
“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 where working from home is not an option.”
A Public Health England (PHE) report published in June, entitled Covid-19: Review of disparities in risks and outcomes, indicated that a range of people, including those from ethnic minority backgrounds, were most disproportionately impacted by Covid-19.
It found the increased risk of death involving Covid-19 for people from a Black ethnic background was two times greater for males and 1.4 times greater for females compared with white people.
Last month, HuffPost UK revealed that the proportion of intensive care beds filled with Covid patients from BAME backgrounds was back at the level it had been during the first peak – despite pledges from the government to learn lessons and protect the vulnerable.
The JCVI even adds in its own recommendations: “Any vaccine programme will need to ensure every effort is made to get good coverage in Black, Asian and minority ethnic (BAME) groups, in areas of higher socio-economic deprivation, and in areas with outbreaks or high levels of community transmission.” But no mention is made of prioritising any of those groups.