Intended for healthcare professionals

Letters Covid-19 and ethnic minorities

Are we responsible for the racial inequalities of covid-19?

BMJ 2020; 370 doi: (Published 22 July 2020) Cite this as: BMJ 2020;370:m2873
  1. Varathagini Balakumar, third year medical student1,
  2. Arangan Kirubakaran, foundation trainee year 22,
  3. Shabnam Tariq, third year medical student1
  1. 1School of Medicine, Cardiff University, Cardiff CF14 4YS, UK
  2. 2Darent Valley Hospital, Dartford, UK
  1. balakumarv{at}

The covid-19 pandemic has revealed the depth of social and racial inequalities in the United Kingdom. These inequalities existed long before the pandemic, but they have taken on a greater significance in the past few months. Perhaps this is a direct result of the death of George Floyd and the ongoing Black Lives Matter protests, which have brought inequalities and institutional bias to the forefront of public consciousness. The NHS, for all its merits, should not be exempt from scrutiny.

The circumstances around publication of the Public Health England report are a perfect illustration of the problem at hand. The apparent delay in publication and potential suppression described by Khunti and colleagues1 is striking: if we were not in the middle of worldwide anti-racism protests, would this report have gone quietly unnoticed?

Although the reasons for the adverse effects of covid-19 seen in the black, Asian, and minority ethnic (BAME) population are subject to debate, ranging from differences in genetics to socioeconomic factors,2 there is, to some extent, an insidiously dangerous mindset among policy makers and major stakeholders. The predominance of sickle cell disease in the Afro-Caribbean population and the prevalence of diabetes in the South Asian community are well known, for example, but these issues are rarely described as key national policies for the betterment of public health.

Our categorisation and characterisation of these issues is also problematic as they are often framed as intriguing statistical variations among ethnic groups rather than key priorities for public health policy. Combatting these inequalities is a difficult and multifactorial process that will not be easy to reverse. Nevertheless, as a society, and particularly as healthcare professionals, we must take collective responsibility for resolving these problems.

Covid-19 has brought us to a sombre reflection: through our inability and reluctance to solve these inequalities, have our actions (or lack thereof) as healthcare professionals and as a society contributed the steep death toll of covid-19 in the BAME community?


  • Competing interests: None declared.

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