A leading UK public health academic has told London Assembly Members he has been “flabbergasted” by the failure of national government’s original action plan for dealing with Covid-19 to ensure provision of “tailored messaging” for the country’s diverse population, which would have been particularly valuable for Londoners.
Gurch Randhawa, who is Professor of Diversity in Public Health and Director of the Institute for Health Research at University of Bedfordshire, told the Assembly’s cross-party health committee that despite having a body of law and other “fantastic instruments”, such as equality impact assessments, designed to lessen inequalities in many fields, “for whatever reason, to date the government has not used those tools”.
Although the committee was specifically exploring “the experience of black and minority ethnic (BAME) Londoners during Covid-19”, Randhawa stressed that the disproportionate susceptibility of some groups of people should be thought about as “bigger than BAME communities,” due to health inequalities arising from “a complex interaction between age, gender, ethnicity and social class”.
He said London needs to “take the lead” in deploying equalities criteria as it makes ready for implementing local initiatives against localised flare-ups “in terms of test, trace and isolate, opening schools and supporting employees to go to work” in order to ensure that “nobody is unfairly disadvantaged. If we do that, we will find that not just BAME communities but all communities will get the benefit”.
Randhawa said that higher levels of infection among minority ethnic groups had been predictable, because evidence from around the world about previous pandemics shows that they “tend to mirror the structural inequalities in any society. In a sense, what’s happened in the UK should not be a surprise. Poorer communities, those at highest risk of exposure, need maximum protection”.
He continued: “We knew back in January and February from the data coming out of China and Italy that the elderly, those in frontline-facing jobs and those with underlying [health] conditions had the biggest risk factors.” However: “Back in March, when the coronavirus action plan was published by the government, it really made no reference to any of those three core issues.”
Randhawa said that had the government taken a localised “public health approach” to containing the virus, as was effective in South Korea and Taiwan, rather than a “medical” one which saw energy mostly focussed on protecting the NHS, the UK’s outcomes might have been better, in line with the adage that prevention is better than cure.
The committee also heard from Dr Somen Banerjee, Director of Public Health for Tower Hamlets, who stressed that communicating clear public health messages is more effective if they are delivered by trusted members of individual communities. He said he had concerns about the ability of some in his borough to go about their jobs and lives without incurring greater risks of infection than others: “If you are an Uber driver or a cab driver on a zero hours contract, how do you manage that?”
Banerjee was asked by Susan Hall, who leads the Assembly Conservative Group, if it is the case that BAME Londoners have been more badly effected than others due to inherent biological vulnerabilities to the virus. He replied that the evidence so far is “very inconclusive” but explained that “certain conditions that make being infected more severe” can be more prevalent among some ethnic groups.
Citing the relatively high prevalence of diabetes in South Asian communities, he said, “If you have diabetes and you have coronavirus infection there is a likelihood that you will be affected more significantly,” but added that no genetic causal factor has yet been demonstrated.
Watch a webcast of the health committee meeting via here. Different panelists discussed the mental health impacts of Covid-19 in second section of the proceedings.
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