BAME life chances, Covid inequality and death

“We owe it to each and every one of us to grasp the nettle and to make good on the collective objective to create a decent and fair society – where race is no barrier to life chances, or chance of death from Covid.” Green Party Home Affairs spokesperson and former Deputy Leader Dr Shahrar Ali comments on the racial and social inequality underlined by the current pandemic which must be addressed.

Shahrar Ali, Green Party Home Affairs Spokesperson
Shahrar Ali, Green Party Home Affairs Spokesperson

Image: Stuart Keegan

Dr Shahrar Ali

How is structural prejudice on racial grounds laid bare in our collective response to the coronavirus pandemic? How can we use the galvanising force of a global crisis to properly tackle racial and social inequality? Let’s look at what the evidence currently shows; who, if anybody, is to blame for the predicament of BAME folk; and what sort of response is required of us all.

Analysis of evidence by NHS England shows that for the first 12,600 virus deaths black people were dying at almost twice the rate of their proportion of the population (6.4 per cent of deaths but 3.4 per cent of population). A third of people in intensive care for Covid-19 are also from BAME backgrounds; greatly disproportionate to their population.

Who, if anyone, is to blame? Greens rightly continue to interrogate statements and assumptions made by the government. We ask questions, and raise concerns, about the effectiveness of the lockdown response – from whether the alarm was raised or social distancing implemented soon enough; to why personal protective equipment (PPE) hadn’t reached the frontline yet or why a contact tracing phone app was being piloted without proper safeguards on protection of personal data.

Let’s be charitable in our interpretation of politicians’ actions until or unless it becomes reasonable to suspend this outlook. Public intellectual A C Grayling sought to criticise the government for what he took to be an unforgiveable delay in their acting: “Say it for what it is: Johnson/Cummings euthanasia/mass-murder policy at work. Never forgive this.” Whatever our position on the delay, we should not condone such a cavalier attribution of homicidal intent.

Excessive focus or careless attribution of intent risks overlooking actions with highly negative outcomes due to failures of competence – regardless of good or bad intentions. Blame culture also risks letting souls who take themselves to be virtuous off the hook, all of whom are needed in the fight to combat structural and institutional defects that sustain, magnify and perpetuate social and racial inequality.

Health inequalities are already known to disproportionately affect people from ethnic minorities, whether through lower life expectancy, experience as a group of infant mortality, or increased incidence of a mother’s death through childbirth, say – trends established long before this pandemic reached our shores. We can continue to reliably plot the negative impacts on life chances of race against other key social determinants of wellbeing: such as the prospects of a secure job or living wage; ease of entry into professions with like qualifications or subsequent career progression; down to increased probability of arbitrary ‘stop and search’ or deportation to a country of origin with which one has no familiarity.

It should not then surprise us – when this and previous governments have been allowed to get away with fostering a hostile environment – that ethnic minorities continue to be at the sharp end of the virus and its casualties. Whether it is pregnant nurses who feel unable to resist pressure to work in clinical settings where exposure to Covid-19 patients is made inevitable; or retired doctors who feel bound to return to duty without complaint about their working conditions; such pressures are all the more acute when it comes to how ethnic minorities are made to suffer oppression daily.

Public Health England is now leading a review to better understand how different factors such as ethnicity, deprivation, age, gender and obesity could impact how people are affected by the disease. There is an opportunity for this review to help us see more clearly how institutional racism is still rife across all walks of life; but there is also a risk that we will revert to collective denial about the scale of the problem. Ironically, Labour also announced a review into the impact of Covid-19 on BAME people but refuses to act upon grotesque examples of internal racism revealed in a report leaked just days before.

At the government’s daily briefing on 4 May, a member of the public asked what was being done to protect BAME key workers from Covid-19. Deputy Chief Medical officer Jonathan Van-Tam spoke about a “complicated picture” that would need to account for differences in patterns of medical conditions and deprivation. It was good to hear him acknowledge the contribution of social deprivation, something his colleagues failed to do days earlier.

Van-Tam, advertising his own ethnicity, concluded: “We owe it to minority groups to get this right.” He is only partly right. We owe it to each and every one of us to grasp the nettle and to make good on the collective objective to create a decent and fair society – where race is no barrier to life chances, or chance of death from Covid-19.

Our voluntary decisions – in short, choice – about how we organise society is what predominately lies behind these so-called chances.

Dr Shahrar Ali is the Green Party’s Home Affairs spokesperson and former Deputy Leader. He works in medical education.