Coronavirus UK: SAGE file says diabetes influences BAME risk

Black, Asian and minority ethnic people are no more likely to die from coronavirus than white people, a study given to government scientists has found.  

Research presented to Number 10’s SAGE panel found there was no greater risk of death for Brits of BAME backgrounds when all factors were taken into account.

It showed that ‘comorbidities’ – long-term health problems – appeared to account for higher rates of hospitalisation and intensive care among ethnic minority people.

Risk among BAME communities has been a sensitive topic during Britain’s outbreak and even given rise to calls for extra protection for non-white NHS staff. 

Statistics show BAME people in Britain are dying of COVID-19 at disproportionate rates, but scientists have struggled to explain why.

The research – done by scientists from the universities of Edinburgh and Liverpool – was one of around a dozen secret papers published last night by the government.  

It did, however, claim BAME people did seem to be more likely to end up in intensive care in the first place. 

The SAGE paper was met with scepticism, however, with one intensive care doctor saying the data it contained did not line up with what the scientists claimed.

Oxford University’s Professor Duncan Young said: ‘I’m not sure why they thought black patients were more at risk of ICU care.

‘The take-home message is that BAME patients admitted to hospital with COVID-19 are no more likely to end up in ICU nor are they more likely to die.’

Researchers said in a government paper that ‘BAME groups are more likely to be admitted to intensive care units’ (Pictured: A member of staff in ICU at the Royal Papworth Hospital in Cambridge)

The research was done by Professor Ewen Harrison and Dr Annemarie Docherty, from the University of Edinburgh, and Professor Calum Semple from the University of Liverpool.

They studied 23,577 hospital patients with COVID-19 in the UK before April 11. 11,690 of them were white, 1,135 were ‘minority ethnic’, 835 were Asian and 568 were black. 

Minority ethnic people were most likely to be admitted to intensive care, with a rate of 22.6 per cent, followed by black people, of whom 22.5 per cent were admitted.

The proportion for those of Asian ethnicity was 22 per cent, while it was significantly lower at 15.4 per cent.

The researchers said: ‘BAME groups are more likely to be admitted to HDU/ICU.’

They explained that although intensive care admission appeared higher for non-white people, the BAME patients were not more likely to die once on the units.

‘When patient characteristics are taken into account,’ the paper said, ‘no excess HDU/ICU [high dependency/intensive care unit] deaths are seen in the BAME group.’

ETHNIC MINORITY PATIENTS MAKE UP DISPROPORTIONATE COVID-19 DEATHS

In NHS hospitals in England, non-white people have so far made up a disproportionate of COVID-19 victims.

Scientists do not understand why, whether there are biological reasons such as higher rates of diabetes, or whether more BAME people have caught the virus because they are more likely to live and work in densely populated cities. 

White people account for 83% of all coronavirus deaths in NHS England hospitals, while they make up 86% of the population.

People of Asian ethnicity – which includes south Asian countries such as India, Bangladesh and Pakistan – make up 8% of the COVID-19 deaths but 7.5% of the population.

Black people have accounted for 6% of all coronavirus deaths but just 3.3% of the general population.

Mixed race people, meanwhile, account for 1% of deaths and 2.2% of the population.

Sources: NHS England/Gov.uk 

However, a higher number of admissions in the group would inevitably lead to a higher number of deaths, even if the survival rate is the same across each ethnic group. 

Professor Duncan Young, an intensive care lecturer at the University of Oxford, said the link between ethnicity alone and ICU admission was not significant in the study.

He told MailOnline: ‘The [data] suggests all ethnic groups were (statistically) equally likely to be admitted to HDU/ICU after all the different co-morbidities and age had been corrected for. 

‘Similarly, hospital survival was not different across ethnic groups. I’m not sure why they thought black patients were more at risk of ICU care.’ 

Professor Young added: ‘To check the result… they took BAME patients and found matching white patients with similar co-morbidities, age, sex and other relevant features, and then compared the hospital survival. 

‘There was no difference in hospital mortality between the BAME patients and the matched white patients.

‘The take-home message is that BAME patients admitted to hospital with COVID-19 are no more likely to end up in ICU nor are they more likely to die.’ 

By way of explaining its claim of higher intensive care admissions among non-white patients, the paper said that long-term health conditions – namely diabetes – were to blame.

‘More admissions to HDU/ITU are seen in the Black, Asian and Minority Ethnic (BAME) group, compared to the White ethnic group,’ it said.

‘These are explained by differences in patient characteristics such as comorbidity. No difference in HDU/ICU admission is seen after adjusting for patient characteristics.’  

After highlighting the importance of the ‘patient characteristics’ in the chance of someone needing intensive care, the report outlined them in two brief sentences.

It said: ‘BAME groups are younger and more likely to have diabetes.

‘BAME groups were less likely to have other comorbidities such as cardiorespiratory disease and chronic neurological disease/dementia.’ 

The study found obesity appeared to be the biggest predictor of whether someone would be admitted to intensive care, raising the risk by 84 per cent. 

But obesity rates were not seen to be significantly different across ethnic groups – 11.5 per cent black, 9.9 per cent Asian, 9 per cent minority ethnic, 10.3 per cent white.

Type 2 diabetes, however – which is closely linked to obesity – was significantly more common in non-white people.

Rates were 40.5 per cent in black patients, 39.3 per cent among Asian patients, 32 per cent in minority ethnic, and 25.4 per cent among whites.

Professor Paul Hunter, a former NHS doctor and medicine lecturer at the University of East Anglia, said: ‘The study shows that BAME are more likely to be admitted to intensive care, once they’ve been hospitalised, and they are more likely to die. 

‘But that increased risk is almost certainly because of other health issues that they have, rather than actually the fact that they are black.’

A study published by researchers at University College London in December last year found that ethnic minority people in the UK have higher rates of type 2 diabetes.

Dr Tra My Pham and colleagues found that, using data from more than 400,000 patients in Britain, type 2 diabetes was 2.3 times more common in people of Asian ethnicity than in white people, 65 per cent higher among black people, and 17 per cent higher in those of mixed race.

Their research was published in the journal Clinical Epidemiology. 

Read more at DailyMail.co.uk

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