The government removed a key section from Public Health England’s review of the relative risk of covid-19 to specific groups, HSJ has discovered.

The report was published on Tuesday.

The review reveals the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those with Asian, Caribbean and black ethnicities. It makes no attempt to explain why the risk to BAME groups should be higher.

An earlier draft of the review which was circulated within government last week contained a section which included responses from the 1,000-plus organisations and individuals who supplied evidence to the review. Many of these suggested that discrimination and poorer life chances were playing a part in the increased risk of covid-19 to those with BAME backgrounds.HSJ understands this section was an annexe to the report but could also stand alone.

Typical was the following recommendation from the response by the Muslim Council of Britain, which stated: “With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to tackle the culture of discrimination and racism. It may also be of value to issue a clear statement from the NHS that this is not acceptable, committing to introducing change.”

One source with knowledge of the review said the section “did not survive contact with Matt Hancock’s office” over the weekend.

The review was published with very little pre-publicity, following claims government was delaying it because of concerns it would stoke racial tension.

Senior NHS figures who had been closely involved with the review were unaware of the report’s impending publication or that the chapter containing responses from the stakeholder and community engagement consultation process had been removed.

A tweet from BAME activist Dr Addy Adelaine on Wednesday morning describing the review as having been ”whitewashed” was later shared by Yvonne Coghill, director of the NHS England Workforce Race Equality Standard programme.

HSJ understands the responses may be used to inform a set of recommendations to be possibly published later by PHE.

Launching the review’s work on 4 May, Professor Kevin Fenton, regional director of public health at PHE and NHS London, stressed that it would engage a wide range of external experts, independent advisors, and diverse constituencies and communities.

In a webinar on 22 May, he said the work had three components but would all be submitted to government in late May for release. The second component was the lived experience and recommendations from the groups and individuals who had engaged with the report. The third would look at other vulnerable communities and inequalities. 

A PHE spokesman said this evening: ”Professor Fenton has been engaging with a significant number of individuals and organisations within the BAME community over the past couple of months, to hear their views, concerns and ideas about the impact of covid-19 on their communities. The valuable insight he has gathered will help inform the work the equalities minister is now taking forward.” He later stated that nothing had been removed from the document. 

Professor Fenton tweeted this evening: ”I’m looking forward to working with the Equalities minister to progress work to further understand the impacts of #COVID-19 on #BAME communities and prepare a full Government response. This important work continues and at pace.”

Reacting to the review, health secretary Matt Hancock said he understood why many were “understandably angry about injustices” and that he felt a “deep responsibility because this pandemic has exposed huge disparities in the health of our nation”.

Speaking at the daily coronavirus briefing, Mr Hancock said “much more work” needed to be done to understand “what’s driving these disparities”, before adding: “We are absolutely determined to get to the bottom of this and find ways of closing this gap.”

A spokeswoman for the Department of Health and Social Care denied a chapter had been removed from the report but did not repond when asked if material detailing responses from organisations had been removed.

Updated 8.45pm 2 June with additional comment from PHE, and at 7:30am and 9.02amon 3 June to include reaction and further detail of Professor Fenton’s work..