Ethnicity will be recorded as part of the death certification process for COVID-19. (Representational)
The UK government has laid out a series of measures as part of a review into the higher COVID-19 death rate among people of Indian-origin and other ethnic minorities, including a mandate for ethnicity to be recorded as part of the death certification process.
Minister for Equalities Kemi Badenoch made a statement in the House of Commons as she presented the first quarterly report to Prime Minister Boris Johnson and Health Secretary Matt Hancock on progress to understand and tackle COVID-19 disparities on ethnicity grounds.
The report follows an official review set up in the wake of a Public Health England (PHE) analysis tabled in Parliament earlier this year, which concluded that older Indian-origin men fall within a higher risk category of coronavirus deaths in England along with other black, Asian and minority ethnic (BAME) groups.
"Today's report marks an important first step in our journey to understand and tackle the disproportionate impact of COVID," said Badenoch.
"Access to the latest public health information and protections should be available to everyone. To ensure that is the case we have invested in a strong package of measures to target messaging, develop the data we have available and make sure everyone is as safe as possible at home or in the workplace," she said.
Besides an ethnicity column on death certificates, the other measures set out by the minister include a new "Community Champions" scheme, worth up to 25 million pounds, to provide funding to enhance existing communication strategies in the most-at-risk places and communities.
The national "Shielded Patients List", or those deemed within the highest risk category and asked to shield at home, will also be enhanced for a better understanding of the risk factors related to the virus and the drivers of disparities.
"It is vital that we understand the key drivers of the health disparities caused by COVID-19 and set out evidence-based, efficient action to tackle them," said Dr Rohini Mathur, the Indian-origin Assistant Professor of Epidemiology, London School of Hygiene & Tropical Medicine.
"This report is a strong step on the path to doing this, highlighting important findings, dispelling damaging misinformation and presenting clear steps to address the impact of the virus on ethnic minority communities," she said.
A related review to the PHE report had claimed that "historic racism" may be behind the disproportionate impact of COVID-19 on ethnic minorities. However, a specially-appointed government adviser has ruled out racism as the key driver and pointed to economic areas, such as jobs and housing, as the defining factors.
"Instead of focusing on ethnicity we need to look at the key underlying risk factors (which are mainly socioeconomic) that are causing their higher death rates - and that will therefore reduce the risk of death in all ethnic groups, including whites," said Dr Raghib Ali, a senior clinical research associate at the MRC Epidemiology Unit, University of Cambridge.
"The main differences are due to increased risk of infection, with black and Asian people more likely to live in deprivation, in densely populated urban centres with higher levels of air pollution, and in larger, multi-generational households. They also have a higher risk of a poorer outcome once infected, due to higher levels of comorbidities, such as obesity and diabetes," he said.
The government has appointed Ali and Professor Keith Neal from the University of Nottingham as special advisers to work alongside the Cabinet Office's Race Disparity Unit to provide further advice and support on action required in addressing COVID-19 related ethnic disparities.
The government said that since the PHE report, "Disparities in the risk and outcomes of COVID-19", highlighted the ethnic variations within the impact of the pandemic it has taken several steps, including 4.3 million pounds of spending on six innovative research projects to better understand the links between COVID-19 and ethnicity.
An additional 4 million pounds has been allocated for targeting messaging at ethnic minority communities and frontline National Health Service (NHS) staff from ethnic minority backgrounds undergoing risk assessment.
"This important report into health inequalities and COVID-19 draws together important strands of evidence to highlight the disproportionate impact on ethnic minorities by identifying the key factors that contribute to their increased risk of infection and adverse outcomes," said Professor Sir Mark Caulfield, Professor of Clinical Pharmacology, Queen Mary University of London and Chief Scientist for Genomics England.
"These include household size, deprivation, co-morbidities and particularly occupation which highlights the vital contribution our diverse communities have made as key workers on the frontline during the pandemic," he said.
Following the quarterly update on the ongoing review, the Cabinet Office said that the evidence and data gathered will be translated into further action required to protect those that are at greatest risk.
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