Lessons must be learned from COVID-19's unequal impact on minority groups, UK report says

The COVID-19 pandemic had a disproportionate impact on ethnic minority and migrant communities, and evidence-based, responsive policies could have significantly mitigated disparities in infection rates and mortality, according to a new report by UCL researchers.

The comprehensive report is in collaboration with the Race Equality Foundation and charity Doctors of the World, and drew its data from UCL's Virus Watch study, which regularly surveyed a cohort of 60,000 people in England and Wales during the pandemic.

The comprehensive report drew its data from UCL's Virus Watch study, which regularly surveyed a cohort of 60,000 people in England and Wales during the pandemic.

The report found that ethnic minority and migrant communities faced:

• Increased vulnerability: Depending on the ethnic group, individuals were found to be between 5% and 88% more likely to contract the virus. This alarming disparity underscored the urgent need for targeted interventions to address the specific challenges faced by these communities, the report said.
• Excess deaths: By April 2022, the end of community testing, Asian communities in England had over 10,500 excess deaths and Black communities almost 6,000. These are people who would likely have been alive were it not for the pandemic. Black and Asian communities had around a 23% higher risk of experiencing excess deaths and the same trend exists for other ethnic groups too.
• Limited access to sick pay: Black, Asian, and minority ethnic workers were found to have less access to sick pay, while undocumented workers had no access to it at all. This lack of financial protection not only compromised the health and well-being of individuals but also perpetuated the spread of the virus within these communities.
• Inadequate support schemes: Many Black, Asian, and minority ethnic individuals reported limited support from existing schemes. This insufficiency exacerbated the economic and social hardships faced by these communities, hindering their ability to cope with the pandemic's impact effectively.
• Unequal vaccination coverage: The vaccination program failed to reach migrants and Black, Asian, and minority ethnic communities adequately, leaving them without the same level of protection as their White British counterparts. This disparity threatened to prolong the pandemic and perpetuated health disparities among different demographic groups.

The report underscored the urgent need for evidence-based policies and practices that prioritize the needs of Black, ethnic minority and migrant communities. It called for a comprehensive and inclusive approach that addresses the systemic barriers to health care access, ensures equitable distribution of resources, and tackles the underlying social determinants of health.

Co-author Professor Rob Aldridge (UCL Institute of Health Informatics), who led the Virus Watch Study, said, "Too often, pandemic policies did not consider or prioritize ethnic minority and migrant communities. Instead, our research demonstrates how the policies and decisions that were taken entrenched the inequalities exposed by the pandemic and exacerbated the poor outcomes experienced by these communities.

"For example, sick pay rates in the U.K. are among the lowest in the developed world, and our analysis revealed that South Asian workers were around 40% more likely to lack access to sick pay than white British workers. We also found that living in households without space to shield, socially distance or isolate may explain one third of the increased risk of getting COVID for migrant communities. We call for the evidence in this report to be urgently used to stimulate change that will provide comprehensive assistance to individuals and communities facing challenges in the future."

Jabeer Butt, chief executive, Race Equality Foundation, said, "The government policy decisions made during the pandemic did not appreciate the impact on existing inequality, and nothing was done to actively mitigate the risk of policies for certain groups—e.g., the call to work from home.

"Many people from Black, Asian and minority ethnic backgrounds were in jobs that could not be done from home, and were more likely to live in shared houses, high rises and have less access to green space and therefore had difficulties isolating. They were then much more vulnerable to exposure to catching and passing on the virus.

"Our report provides evidence on the unequal impacts of the pandemic on ethnic minority and migrant communities. We want this report to be the springboard to policy making that uses existing evidence to prioritize addressing inequality.

"Policy making that does not try to explain away racial inequality but focuses on the action that will need to address the racism that perpetuates it. And we need for this change to take place now, because the same inequalities that led to increased infections and deaths, are exposing these communities to comparatively poorer health every day. We sincerely hope that lessons from the pandemic are reflected on, are learned, and these missteps are never repeated."

Simon Tyler, executive director, Doctors of the World, said, "The needless exclusion, disregard, and suffering of thousands of people living in the UK during the COVID-19 pandemic has gone largely unnoticed, and needs to be addressed by this government. For many years Doctors of the World UK has warned of the risk that hostile migrant health policies present both to individual and public health.

"During the pandemic, the government failed people who were most in need of help, leaving entire communities without essential information or the resources to protect themselves. It also failed the U.K. public with its short-sighted approach to health care in a time of crisis, focusing on upholding barriers to vital services and their cruel anti-migrant agenda.

"Health care is a human right. It was and remains the responsibility of those in power to ensure that everyone living in the U.K. is able to access medical care, including those in the most vulnerable of situations. When we protect one, we protect all."

The report urged policymakers, health care professionals, and community leaders to:

• Develop targeted interventions and public health campaigns to raise awareness and mitigate the disproportionate impact of COVID-19 on ethnic minority and migrant communities.
• Implement inclusive and accessible sick pay policies to ensure financial security for all workers, irrespective of their immigration status or ethnicity.
• Strengthen support schemes to provide comprehensive assistance to individuals and families facing socio-economic challenges during the pandemic.
• Prioritize equitable vaccine distribution and actively engage with disempowered communities to address vaccine hesitancy, promote trust, and ensure equal protection against the virus.