The Inequalities of Covid

Professor Martin Green OBE, Chief Executive, Care England

Tragically the UK has recorded over 100,000 deaths in this COVID-19 pandemic. Behind that statistic, lie so many heart-breaking personal stories of families and loved ones left grieving their loss, and coming to terms with the new reality of being without someone they love.

When we interrogate the statistics further, there is also a shocking element that becomes apparent, and that is, that people from the BAME community have been disproportionately impacted by COVID-19 and as the pandemic developed, we saw more and more evidence that people from these communities had higher mortality rates.

As we start to move out of this pandemic and get more people vaccinated, one of the areas that we must focus on in the up-and-coming public Inquiry, is identifying the factors that lead to people from BAME communities being on the frontline of this pandemic and having higher death rates.

We particularly need to know whether or not there were genetic factors that may have made people more susceptible to COVID-19. If there do turn out to be genetic factors, we must make sure that in future pandemics, we focus on protecting those at greatest risk. This may require the health and care system to change the way in which it responds, and this may entail some people having to take fewer frontline roles because they are at greater risk. We need to have a rigorous examination of whether or not, there were genetic factors at play in the transmission and severity of the virus within some communities, so that we can, in future, focus our approach to vaccination and treatment and ensure that those at high risk get access to the best treatment and are a top priority for the vaccination programme.

As well as genetic factors, it is also important to examine whether or not there was social and economic issues at play, which may have led to people from BAME communities being at greater risk from the virus.

We must enquire into whether or not, poverty and overcrowding in peoples housing and living conditions, played any part in the transmission of the virus. Sadly, many of the amazing staff who work in social care and health, are not paid at a level which is commensurate with the amazing work that they do. This can often lead to people living in overcrowded housing, or indeed, having to do other jobs in order to make ends meet. All these factors may have increased the risk of COVID-19 transmission and led to some people having greater exposure to the virus.

Despite the fact that the health and social care system is very dependent on the contribution and professionalism of people from BAME communities, there is evidence that sometimes people from these communities do not seek help from the health and care system when they need it, and this may have also been a contributory factor in the increased death rates from COVID-19. As we come out of the pandemic, we must look at how people access our services, and ensure that they are made more accessible and easier to navigate, and if there are barriers to people from BAME communities accessing our services, we must identify them and eradicate them.

Despite the fact that we are constantly told we have the best health service in the world we have also suffered one of the highest mortality rates in this current pandemic. We need to do a very forensic assessment of what went wrong with our system that meant so many people died.

It is also important to try and understand the issues around access to the NHS at this time of crisis. During the second wave of this pandemic, we saw countless reports of hospitals under pressure, and in some cases, ambulances queueing to get people admitted to hospital beds. Despite the fact that the NHS had spent £200 million of taxpayers money on Nightingale hospitals, these were never mentioned during this time of acute pressure, and I am unclear whether or not, they were used. One of the things that has also come out of this pandemic is an examination of the tendency for governments to make theatrical announcements, which have little or no substance behind them. In future we have got to have some correlation between announcements and delivery and before announcements are made, we need the Government to understand how they are going to implement them and monitor the progress of any new initiative.

I hope that as we do a forensics analysis of how we responded to the COVID-19 pandemic, we will have an opportunity to identify whether or not, inequalities in health played a part in how particular people and communities were impacted by the virus. I also hope that this will be an opportunity for us to look at how our dedicated staff are supported, trained and remunerated, and the COVID-19 pandemic must be our platform for a new beginning for the social care and health workforce.

Clearly there are issues that we do not fully understand that have seen people from BAME communities disproportionately affected by COVID-19. Our challenge is to get to the bottom of what happened, and to put in place measures that will ensure that everybody in our system is protected and supported appropriately and has access to the care and support they need. The COVID-19 pandemic has been a humanitarian tragedy and we must learn lessons from it so that we are better prepared for when we have future pandemics.



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