GP describes frustration about BAME coronavirus impact
A GP has explained the frustration among the healthcare community about the delay in recognising the disproportionate impact of coronavirus on black and Asian communities.
Dr Rupa Parmar has seen patients remotely and face to face during the pandemic, in both NHS and private settings in Birmingham.
She said she has "absolutely" seen higher number of coronavirus cases among black and Asian patients, and said the outcomes for these patients had been poorer.
Dr Parmar said the healthcare community needed to "make some very loud noises" in order for the issue to be raised in the early stages, particularly as ethnicity was not being recorded on death certificates.
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It was reported earlier this month black patients were twice as likely as white patients to die from a Covid-19-related death after taking into account socio-demographic characteristics.
Britons from Bangladeshi and Pakistani backgrounds were also found to be more at risk by the Office for National Statistics, with men 1.8 times more likely and women 1.6 more likely to die than white people.
Public Health England is carrying out a review into factors impacting health outcomes from Covid-19, including ethnicity, and findings are set to be published at the end of the month.
At Birmingham City Hospital, 64 per cent of coronavirus deaths in March were from the black African and Asian communities though this fell to 50 per cent the following month.
Dr Parmar is spending one to two days a week seeing NHS patients via an out-of-hours GP service and the “hot hub” for patients affected by Covid-19.
She spends three days seeing private patients at Midland Health at Cornwall Street, including through the GPDQ remote appointments service.
Dr Parmar, who was an NHS GP partner for 10 years, said: "There were a lot of conversations in the community about what was going on here.
"I have absolutely seen the disproportionate impact among patients. We are seeing much higher figures for Covid-19 in BAME communities and much poorer outcomes.
"My NHS work is predominantly based in deprived areas where there are larger numbers from these communities.
"At Midland Health, there are equal numbers of white caucasian patients as those from BAME backgrounds.
"Social deprivation has a big factor to play. It’s more common in BAME families to have four to five generations in one household, where they can’t socially distance.
"Among the healthcare community, we had to make some very loud noises [about the disproportionate impact on the BAME community] when we could see in the early days who has being particularly affected. We are frustrated about that.
"Of course, these communities are struggling with other health conditions. New data is coming out on vitamin D deficiency and its impact on Covid-19 outcomes.
"Lots of doctors now are advising 1,000 to 2,000 IU of Vitamin D daily, particularly for people from a BAME background, to protect from Covid-19.
"With NHS patients, we are doing a triage process. There is a phone call from a doctor first and then we may see them face to face.
"If they have got Covid-19 symptoms, they go to a hot hub. They are seen with extra caution.
"Initially, when it first kicked off, we did have a lack of visors and FFP3 masks. I had concerns for my own safety.
"A lot of us have never been faced with such a pandemic. Once we had initial training, we felt a lot more comfortable managing patients in PPE.
"I haven’t been tested yet. I have had a few mild symptoms but not the classic symptoms.
"Privately, we are picking up some of the slack from the NHS. Lots of people’s appointments are being cancelled for routine tests, immunisations, pap smears – things that really affect patients.
"A lot of cervical smears are being delayed or pushed back. Privately, we are supporting some of the patients on that.
"Health care has to go on. Covid-19 has been a problem, but delivering health care cannot stop."
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