Unequal impact? Coronavirus and BAME people Contents

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1Introduction

We are at a turning point, let’s not return to what was, but move forward to what can be—a fairer society for all those who live in it.1

Background

1.In the UK, the first death from coronavirus was reported by the media on 6 March 2020.2 On 30 March, we launched the Unequal Impact: Coronavirus (Covid-19) and the impact on people with protected characteristics inquiry, to investigate the impact of the pandemic on different groups.3 That inquiry received over 500 pieces of written evidence. In June, we decided to split the inquiry into three sub-inquiries based on recurring themes that were apparent in the evidence, one of which was the disproportionate impact on Black, Asian, and minority ethnic (BAME) people.4

2.From as early as April 2020, data from the Intensive Care National Audit and Research Centre showed that 34% of patients admitted to an Intensive Care Unit (ICU) with confirmed cases of coronavirus were from a BAME background.5 This compares with an historic cohort, in which 12% of those admitted to the ICU for viral pneumonia were from a BAME background.6 Concurrently, media sources reported that the first ten doctors to die from contracting coronavirus were from BAME backgrounds.7 In June, we heard evidence that 63% of healthcare workers who had died after contracting the virus had come from a BAME background.8 Data from the Office for National Statistics (ONS) published in May showed that BAME people were experiencing the effects of coronavirus more severely and often with more adverse outcomes in comparison to their White counterparts.9

3.On 4 May, it was announced that the Government had commissioned Public Health England (PHE) to conduct a review into the factors that were exacerbating the impacts of the pandemic; ethnicity featured in the terms of reference for the review.10 This review was published on 2 June and it noted the disproportionate mortality rate of BAME people when compared to White counterparts.11 Then, on 16 June, PHE published a set of recommendations to help mitigate the impacts of the pandemic on BAME people.12

Our sub-inquiry

4.When the disproportionate impact of coronavirus on BAME people was first identified, we considered it important to examine why this was occurring. We sought to explore whether pre-existing inequalities, especially regarding health, housing, and employment, had exacerbated the impacts of the pandemic for BAME communities. We wanted to know how the Government’s measures to mitigate the virus had affected BAME people and what could, and should, be done by the Government and other public bodies going forward to mitigate the impacts of the pandemic on BAME people.

5.We held three oral evidence sessions: in the first session, we heard from a panel of specialists on how pre-existing health and housing inequalities had amplified the impacts of the virus for BAME people and the impacts for BAME people from trends in employment. We then heard from a panel of BAME people sharing lived experiences during the pandemic. In the second oral evidence session, we heard further evidence on how housing inequalities were exacerbating the impacts of the pandemic, and about the economic impacts of the pandemic for BAME people. In the final oral evidence session, we questioned ministers from the Government Equalities Office, the Department for Health and Social Care, and the Ministry for Housing, Communities and Local Government. Alongside the oral evidence, we received over 60 submissions of written evidence to the sub-inquiry. We have used written and oral evidence from both the main and sub-inquiries in this report.

6.We are grateful to all those who provided evidence. We are grateful also to our specialist advisers, Fahmida Rahman, Senior Public Policy Advisor at StepChange Debt Charity and Professor Lucinda Platt, Professor of Social Policy and Sociology at the London School of Economics, for their contributions to this report.

7.We are about to describe a ‘perfect storm’ that has made the impacts of the coronavirus pandemic particularly acute for BAME people. The factors discussed in this report were affecting some BAME groups before the onset of the pandemic. As the pandemic progressed, these underlying inequalities made the impact on some BAME groups far more severe than on their White counterparts.

Language

8.Throughout the sub-inquiry, we have used the term BAME (Black, Asian and Minority Ethnic). We acknowledge that BAME is a broad blanket term that is used to refer to most people who are not White British. We understand that there are vast differences between ethnic groups labelled with this term and that there are inequalities within the BAME group. For example, inequalities between BAME groups can be seen in household income: after housing costs, the average household income among Indian households, the wealthiest BAME group, is 46% higher than that of Bangladeshi households, the poorest BAME group (of which we have sufficient data to measure average income).13 This is particularly significant in our examination of pre-existing inequalities and how they exacerbated the impacts of the coronavirus pandemic because these inequalities played out in the types of jobs people do and the homes they live in. So, while we refer to BAME throughout the report, largely due to limitations in data and evidence, these within-group inequalities must be considered when reading this report. Where possible, we will consider differences between ethnic groups and where this report varies from using BAME, it is using the language of the sources of evidence unless otherwise stated.