A new study published in the Health Service Journal (HSJ) has provided the fullest information yet available on health and social care workers who are dying of Covid-19 in the UK. The study confirmed 106 deaths of currently active health workers from Covid-19 up to 22 April.
However, the real figure may be higher, since the study was based on collating reports from media outlets and social media, and the researchers went through rigorous checks to verify the deaths in question as pertaining to currently active health workers, carers or support staff.
The findings can be read at length here.
The most striking conclusion from the details is that BME and migrant workers are hugely over-represented among those who have died of Covid-19. BME health workers make up:
- 63% of NHS workers who have died (but only 20% of the overall NHS workforce)
- 71% of nurses and midwives who have died (while, again, only 20% of those in work)
- 95% of medical staff who have died (and 44% of medical staff overall)
A majority of health and support workers who have died so far were born outside the UK – a stark reminder that migrant health and support staff have long been at the very forefront of building and running our NHS, often at great personal risk and sacrifice.
The report does not attempt to explain the disproportionate rate of BME people dying. Many factors may play a role. It is not impossible that medical or biological factors may be in play in making BME workers more susceptible, but it is also the case that BME and migrant staff disproportionately occupy lower-paid and more over-worked roles in the NHS and out-sourced support services, and are more vulnerable on average to bullying and exploitative practices in the workplace. Professor Wasim Hanif of University Hospital Birmingham has pointed out that social deprivation is strongly connected with increased mortality due to underlying diseases, commenting: “There have been health inequalities that have existed in the [BAME] population but what is being reflected in this pandemic is that those inequalities are actually coming out.”
The study also found that slightly over half of health and support workers dying so far from Covid-19 are women, in contrast with the trend among the general population, which is that a majority of those dying are men.
There were no deaths identified so far among some groups of workers who are considered at high risk, such as anaesthetists and intensive care doctors; this may be because of greater use and availability of rigorous PPE in these departments. If accurate, this finding underscores the urgency of immediately providing adequate PPE for all health staff and carers, which the government have so far conspicuously failed to do.
The authors describe as “cautiously reassuring” the finding that the ratio of identified health worker deaths to overall Covid-19 deaths is around 1:200, roughly equivalent to the population share of health workers at 0.5% of the general population. This is taken as suggesting that health workers may not in fact be at increased risk of dying from Covid-19. However, this conclusion (which the authors qualify with several caveats) is unwarranted given that health workers are generally below retirement age and are fit enough to be in work, whereas Covid-19 deaths in the general population are heavily concentrated among older people. A comparison between health worker deaths and the rate of deaths in the general population would only become possible if health workers could be matched with a control sample of fit, working-age people in the general population with a similar ethnic composition to the health and care workforce.
Need for greater transparency
The study’s authors finish by noting:
“To further understand this data, there is an urgent need for a central registry of deaths among health and social care workers to establish facts, enable robust rapid analysis and to explore whether social or employment inequalities are impacting on the rates of infection of these staff during the conduct of their duties and causing avoidable deaths.”
Health campaigners will welcome this recommendation, after a series of weeks in which government ministers and senior departmental civil servants have often appeared deliberately evasive on the topic of health worker deaths, resorting to dishonest manoeuvres such as the claim that anonymised numerical figures cannot be released with the consent of the families of the deceased. Evidently, sustained campaigning pressure and advocacy is needed in order to ensure that the public is provided with accurate up-to-date information on the deaths of health workers, support staff and carers.
This study does not appear to have been peer reviewed as would be normal for scientific papers. Helpful critical commentary has been published by commenters on the article at the HSJ website.