Healthcare assistants hit by high covid-19 death rates

The PHE’s review of disparities in the impact of the virus found “nursing auxiliaries and associates” was one of three occupational groups “where the increase in deaths in 2020 was significantly higher than the increase for everyone aged 20 to 64”. It found the death rate for that group was 2.5 times the normal rate between 21 March and 8 May. There were 128 coronavirus deaths among that group. 

This put them joint second alongside chauffeurs, taxi and cab drivers. Security guards had the highest increase – with 2.6 times the normal death rate. The ratio among the total working age population is 1.5. 

The occupational groups are from the ONS, which defies “nursing auxiliaries and assistants” as those who “assist doctors, nurses and other health professionals in caring for the sick and injured within hospitals, homes, clinics and the wider community”.

It is not clear how the makeup is split between NHS staff and social care staff, but the second category of “care workers and home carers” has seen 548 deaths in the period — 1.7 times more than normal. The “nurses” group also saw 1.7 times more deaths than normal, at 233.

Medical practitioners saw 2.5 times more deaths than normal, at 47, according to the PHE figures, but this is not considered to be a significant difference to the overall population rate because the small overall number means the comparison is less certain.

The review — commissioned in particular to look at racial and ethnic disparities — also said the country would likely find it difficult to control the spread of covid-19 if it does not address disparities in outcomes between different groups of the population.

Older people, men, people from more deprived communities, and people of Black, Asian and Minority Ethnic heritage are more likely to die from the virus, the review found, echoing previous research.

“As the numbers of new covid-19 cases decrease, monitoring the infection among those most at risk will become increasingly important,” the PHE review said. “It seems likely that it will be difficult to control the spread of covid-19 unless those inequalities can be addressed.”

PHE called for the results of the review to be “widely discussed and considered by all those involved in and concerned with the national and local response to covid-19”.

It also said it was “already clear” that guidance, “certain aspects” of recording and reporting data, and “key policies” should be changed to “recognise and wherever possible mitigate or reduce the impact of covid-19” on the groups of people shown by the review to be most affected by the disease.

The review found the inequalities in the likelihood of covid killing people in different age groups, different sexes, or different levels of deprivation largely reflected existing inequalities in these sections of the population. However, it found covid reversed the normal pattern when it comes to ethnicity, of BAME groups typically having lower all-cause mortality than white.

Death rates from covid-19 among black men were shown to be 3.9 times higher than in white men; 2.5 times higher for Asian men. It was a similar picture for women, with black women were 3.3 times more likely to die from covid and Asian women 2.3 times higher.

An analysis using more detailed ethnic groups found people of Bangladeshi ethnicity had “around twice the risk of death than people of White British ethnicity,” after accounting for the effect of sex, age, deprivation and geographic region.

The review cautioned that while the analysis adjusted for factors including age and deprivation it did not adjust for comorbidities or obesity “which are likely to have an important impact on the different risk of dying between ethnic groups”. It also did not include the effect of occupation — “an important shortcoming” as different occupations have greater risk of being exposed to the virus and some occupations have a higher proportion of workers from BAME groups.

The greatest disparities in risk according to the PHE review were between age groups. People aged over 80 were found to be 70 times more likely to die from covid than people aged under 40. People aged between 70 and 79 were 50 times more likely to die of the virus; those aged between 60 and 69 were 27 more likely to die from it.

The review also found death rates during the covid outbreak in the most deprived areas were more than double those in the least deprived areas. It also found the number of cases peaked earlier in the least deprived areas than the most deprived.

The PHE review said the findings “need to be widely discussed and considered by all those involved in and concerned with the national and local response to covid-19”. It said as the number of new cases decreases “it seems likely that it will be difficult to control the spread of covid-19 unless these inequalities can be addressed”.

Deputy chief executive of NHS Providers Saffron Cordery, said: “This review supports earlier findings by the Office for National Statistics, helping to give us a clearer picture of the disproportionately large toll this pandemic has taken on black and minority ethnic people and communities and the reasons why.

“Trust leaders are concerned about increased risk to BME staff, reflecting the wider inequalities long faced by BME staff in the NHS workforce, and this report will add to existing resources supporting a more informed response to this challenge.

“We look forward to seeing how the government plans to respond to these concerning findings.”