Heightened COVID-19 risk for BAME healthcare workers to be examined in major UK study

More than £2m of Government funding has been awarded to academics at the University of Leicester to investigate why people from BAME (black, Asian and minority ethnic) backgrounds have a higher risk of developing severe COVID-19, after higher proportions of associated deaths were recorded within these groups - more than twice that of the white population.

Jointly funded by UK Research and Innovation (UKRI) and the National Institute for Health Research (NIHR), the £2.1m University of Leicester-led UK-REACH study (UK Research study into Ethnicity And COVID-19 outcomes in Healthcare workers) will work with more than 30,000 clinical and non-clinical members of staff to assess their risk of COVID-19, based on the analysis of two million healthcare records.

A new UK wide study was also awarded more than £120,000 to examine why people from BAME backgrounds have a higher risk of developing severe COVID-19, by drawing on datasets from the UK Biobank and using statistical modelling. The study will assess whether greater exposures to risk factors leads to an increased risk of COVID-19 specifically in BAME groups.

Science Minister Amanda Solloway said: “COVID-19 has had an enormous impact on all of our lives, but sadly we have seen that people from Black, Asian and minority ethnic backgrounds are disproportionately affected by this terrible disease. There is an urgent need to better understand the complex reasons behind this. These new projects will enable researchers to work directly with ethnic minority groups to improve our evidence base and, crucially, save lives."

Health Minister Lord Bethell said: “I am deeply concerned by the disproportionate impact of this horrible virus on some minority communities. We need to find out what’s causing this, so we can stop these deaths. These research awards will give Britain’s scientists resources they need to answer the urgent questions behind these disparities so we can address the root causes and save lives.”

Chief Medical Officer for England and Head of the NIHR Professor Chris Whitty said: "With evidence showing that people from Black, Asian and minority ethnic backgrounds are more severely affected by COVID-19, it is critical that we understand what factors are driving this risk to address them effectively.

“The diverse range of projects funded by the NIHR and UKRI will help examine this association in detail, so that new treatments and approaches to care can be developed to target the ethnicities most at risk. This research will have embedded patient and public involvement with Black, Asian and minority ethnic groups at all stages of the research."

Dr Manish Pareek, Associate Clinical Professor in Infectious Diseases at the University of Leicester and Honorary Consultant in Infectious Diseases at University Hospitals of Leicester NHS Trust is the chief investigator of the UK-REACH study. He said: “Globally, we have evidence that people from BAME backgrounds have a higher chance of going to intensive care and dying from COVID-19 – this may also be the case for healthcare staff.

“This is the first UK study to be conducted on a large scale investigating why BAME healthcare workers could be at greater risk of COVID-19. A recent PHE report highlighted how 63 per cent of healthcare workers who died from COVID-19 were from a BAME background. We want this research to improve the lives of healthcare staff – to this end, we have a stakeholder group of major national organisations to research and publicise our findings.”

Professor Thomas Yates from the University of Leicester is the chief investigator of the Biobank study. He said: “BAME communities are disproportionally suffering from the effects of COVID-19, which is acting to widen health inequalities - the reasons for this are not known.

“This funded research will be an important step in identifying key drivers and will start to unpick why minority ethnic groups may be at increased risk, and whether this is spread equally across the population. The study will help to build a picture of how the increased risk in BAME communities may be prevented or managed and help to tailor public health policy in the future.”

The research is supported by the NIHR Leicester Biomedical Research Centre - a partnership between the University of Leicester and University Hospitals of Leicester NHS Trust.

Academics at the University of Leicester have played an integral role in bringing the issue about the severe impact of COVID-19 on BAME populations to the fore, and have led a campaign to increase the number of BAME people involved in COVID-19 research to address the disproportionate impact of the virus on BAME communities.

Kamlesh Khunti, Professor in Primary Care Diabetes and Vascular Medicine at the University of Leicester, is the Director of NIHR Applied Research Collaboration (ARC) East Midlands and leads the Centre for BME Health. At the start of lockdown, he raised concerns about findings from Intensive Care National Audit and Research Centre (ICNARC), which highlighted that up to a third of people who were critically ill with coronavirus were from BME backgrounds.

National ONS data shows that people from minority ethnic groups, particularly South Asian and Black and African Caribbean communities, are up to four times more likely to die from COVID-19, however the reason for this increased risk is not known.

The UK-REACH study will follow a group of BAME healthcare workers for a period of 12 months to see what changes occur in their physical and mental health, how they have changed their professional and social behaviours in response to COVID-19, and associated risks in their line of work. The study will also include non-clinical staff integral to the day to day running of healthcare institutions, including cleaners, kitchen staff and porters.

A stakeholder group of major national organisations* will help to conduct the research and provide evidence to policymakers so that decisions can be made.

Researchers working on the Biobank study will have access to an existing UK Biobank project already designed to investigate ethnic health, which includes a dataset of half a million adults. Through this application, the team will also have access to linked COVID-19 data, which will include test results, hospitalisation and mortality. By providing greater context around the risk of COVID-19 to BAME groups, the study will help to inform public health policy in the future.

Professor Nishan Canagarajah, President and Vice-Chancellor of the University of Leicester, said: “As the first institution to have raised concerns about the disproportionate number of deaths from COVID-19 affecting people from BAME backgrounds, the University of Leicester has played an integral role in driving forward debate and demanding greater scrutiny into this important issue.

“I am immensely proud of our achievements today – through their vital research, our academics have demonstrated what true citizens of change we are. The findings from this research have the potential to shape the way we respond to COVID-19 and most importantly, save lives.”

UK Research and Innovation Chief Executive, Professor Dame Ottoline Leyser, said: “It is now abundantly clear that COVID-19 disproportionately affects people from Black, Asian and minority ethnic backgrounds. Urgent action must be taken to determine and address the factors underlying this disparity. There is unlikely to be a simple answer and we must consider all possibilities, reflected in the range of projects we have funded, so that we can save as many lives as possible during this pandemic and any future outbreaks.”

Professor Kamlesh Khunti, who leads the Centre for BAME Health in Leicester said: “The University of Leicester has been internationally leading on work relating to the impact of COVID-19 on ethnic minority groups, including the development of a national Risk Reduction Framework for NHS staff and a comprehensive report recommending a series of policy actions to reduce health inequalities related to COVID-19. These studies will help us to develop and to refine these recommendations with the overall aim to mitigate further disparities in COVID-19 outcomes for ethnic minority healthcare staff.”