PHE Report Review: More Than One Frontline- People’s Occupation and BAME Community

The totalitarian-like measures introduced by the government have not be seen since WWII. While the majority of the brutal warfare in WWII was exchanged across the French border, it was pivotal for the Allied forces to maintain the fight on the Russian border, and advances into the United States with great naval and air force domination. The PHE Report showcases that the pandemic challenges beyond our NHS hospitals.

Public Health England Report: COVID-19 Review of Disparities in Risks and Outcomes

The coronavirus pandemic has shown to target weaknesses and inequalities in our society. The PHE Report provides a descriptive review of the impact the pandemic has had on; age and sex, where you live, deprivation, ethnicity, occupation and care home residence. I analysed the inequalities highlighted in people’s occupation and the BAME community.

People’s Occupation

The PHE Report examined the number of excess deaths and COVID-19 deaths of 10,194 job occupations on the ONS. Excess deaths are the preferred marker for the impact of the pandemic as it considers both the average number of deaths expected (averaged results from 2014-18) and COVID-19 deaths. We can clearly see the disproportionation in which COVID-19 affects certain job occupations (orange region in Figure 1).

Figure 1 Death by Occupation (21st March-8th May 2020)

Government guidelines for work outside of the healthcare sector repeated ‘When managing the risk of COVID-19, additional PPE beyond what you usually wear is not beneficial. This is because COVID-19 is a different type of risk to the risks you normally face in a workplace, … not through the use of PPE.’ However, looking at Figure 2, you can see that only 3 of the top 14 occupations to exceed 100 excess deaths are in healthcare. Boris Johnson’s claims to ‘follow the science’ and ‘protect the vulnerable’ in our communities yet they have missed those jobs most impacted.

Figure 2 Occupations with Excess Deaths>100

I further examined government guidelines in the top 6 occupations most affected in Figure 2. It is staggering to see the number of excess deaths for Road Transport Drivers (310.4), Sales and Retail Cashiers/Assistants (318.6) and Security Occupations (279.2) exceed the number for those who work as Care Workers and Home Carers (232.2). However, examining the government guidelines ‘Working safely during coronavirus (COVID-19)’ provides insight into the striking overrepresentation in certain job sectors.

All these jobs involve close contact with the public from a range of neighbourhoods. Analysis of guidelines showed greater detail to protect its service users with minimal steps for employers to protect their staff. Road Transport Drivers guidelines only highlighted the optional use of protective screening and face coverings. Workers in sales/retail were encouraged to stagger break times in common areas, stagger arrival and departure times, limit face-to-face meetings, and provide protective coverings. Elementary security occupations do not have their own specific guidelines, only to be referred to the generic ‘Working safely during coronavirus (COVID-19)’ document. The Labour Party should hold the government to account on their promises to ‘protect the vulnerable’ by extending measures to our job sectors. PPE (FFP3 masks etc.) with stricter and clearer public health interventions must be enforced in these sectors.

BAME Overrepresentation

The report highlights the overrepresentation of COVID-19 deaths in the BAME communities (Figure 3). The Royal College of Nurses (RCN) conducted a wider-member survey to investigate the disproportionate BAME representation within the nurse workforce. Only 43% of respondents from a BAME background felt they had enough PPE in stark contrast of 66% of white British nurses. 40% of BAME nurses felt they had a lack of PPE training compared to 31% of white British respondents. Nearly a quarter of BAME nurses had no confidence in their employer protecting them from COVID-19 in comparison to 11% of white British respondents. Donna Kinnair, General Secretary of RCN said ‘“These results reinforce our call for BAME nursing staff to have specific risk assessments to reflect the risks they face as a result of COVID-19.’ There is no evidence that clearly identifies why certain communities are at greater risk of being infected with coronavirus but that should not stop us protecting them.

Figure 3 Age Standardised Death Rate for Confirmed Cases by ethnicity

The PHE Report has showcased coronavirus ability to strike inequalities that exist in our society. The Labour Party should challenge the governments’ efforts to ‘follow the science’ and protect those most vulnerable.

Hasnain Khan is a 4th year medical student at the University of Sheffield. He is currently the President of the Sheffield Medical Society where he is running a COVID-19 Volunteer Scheme, sending over 150 medical students to hospitals, GPs, and NHS babysitting services across South Yorkshire. He also has volunteers for the coronavirus vaccine trials and Track and Trace System.

He tweets at @HazKhan07


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