In my opinion, headlines in the news media (e.g. BBC) are rightly being over-cautious while reporting deaths within South Asian communities linked to the Pandemic. Headlines such as “South Asians are most likely to die of coronavirus” have stoked fear among the South Asian community. This is particularly so, as reported death among health care workers of Asian origin is much higher compared to other populations. Although it is of high priority to focus on the safety of BAME/South Asian community especially when they represent a considerable proportion of frontline/key workers, it is indeed of utmost importance to have clarity about the issue so that appropriate approach can be adopted to identify most vulnerable members of the society. I have been working on COVID19 with my fellow academics and researchers within the UK and elsewhere in the world (Ireland, Germany, and India). As of now, despite higher death incidence in the BAME community, there is no concrete evidence or peer-reviewed reports showing a direct association between COVID19 susceptibility and ethnicity in general. Higher mortality in the South Asian community has been linked to factors such as a higher incidence of diabetes and cardiovascular diseases or a higher risk of occupational exposure.
Scientifically, COVID19 belongs to a well-known family of coronaviruses with RNA (Ribonucleic Acid) as their genetic material. One of the mechanisms by which this virus gains entry into the host cells is via the ACE2 receptor. Recent scientific research has revealed that circulating ACE2 levels are higher in men and in patients with diabetes or cardiovascular diseases. This partly explains higher mortality in males and in patients with underlying conditions such as diabetes or cardiovascular diseases. It is well known that diabetes and its associated complications are more prevalent in people from South Asian descent; however, this cannot be construed to generate general headlines reported by media outlets. It could be assumed that diabetic individuals from any ethnic background with comparable lifestyles would be equally likely to succumb to COVID19. Socio-economic and socio-cultural factors including maintenance of social distancing due to cultural traditions and economic deprivation are likely to be key determinants in mortality associated with COVID19 patients within the BAME community. In addition, it would be important to thoroughly examine the patient data sets from both BAME and other communities. This should include multiple factors such as economic disparities, cultural factors, and quality of life. It may emerge that healthy individuals or individuals with underlying conditions from any ethnic backgrounds and similar professional and economic status are equally likely to have COVID19. In this context, I would refer to an article recently published in “The Guardian” by Dr. Winston Morgan, a Clinical Biochemist (University of East London), stating that “Structural Racism” is the key underlying cause of high mortality in BAME community. Given the reported higher mortality among the South Asians, it is indeed a time for introspection within policymakers and managers for taking positive steps to identify the underlying scientific risk factors and work practices to improve quality of life and avoiding undesirable exposures of COVID19 within the community. While the media generalisation should be taken with a pinch of salt, the communities need to be vigilant to follow government rules to protect themselves from this merciless killer! ‘Stay safe’!
Dr Vikram Sharma
Lecturer in Biomedical Sciences, University of Plymouth
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