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Working on the ward: investigating the risks of COVID-19 for ethnic minority healthcare workers

by Guest Author on 29 Jul 2020

Crucial evidence is now showing that after taking into account age and other sociodemographic factors, Black, Asian and minority ethnic (BAME) people are nearly twice as likely to die of COVID-19 than white people.

In an urgent response to this, UK Research and Innovation’s Medical Research Council is working with the National Institute for Health Research (NIHR) to funding a multimillion-pound investment into a number of immediate research projects to investigate COVID-19 and ethnicity.

One of these urgent projects already underway is UK-REACH (UK Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers). Led by Dr Manish Pareek, UK-REACH will calculate the risk of contracting and dying from COVID-19 for ethnic minority healthcare workers, using existing data held by national healthcare organisations. We caught up with Dr Pareek and his team to find out more about the importance of this urgent research, what its main aims are – and what it’s been like working with COVID-19 on a daily basis.

“As an Infectious Diseases specialist, we’ve had to look after patients with COVID-19 from the early days of the pandemic. I remember clearly being on call the week when things started to worsen. Although we had seen what was happening in China and Italy, we hadn’t ever seen anything like this before.”

This is Dr Manish Pareek. Based at the University of Leicester, he’s leading the UK Research Study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH). Its aim? To calculate the risk for ethnic minority healthcare workers of contracting and dying from COVID-19.

The study, which has already begun with urgency, will follow a group of ethnic minority healthcare workers over 12 months to see what changes occur in their physical/mental health. Dr Pareek and his team will interview a smaller group of ethnic minority healthcare workers to understand how risky their jobs are, and how they have changed their professional/social behaviours in response to COVID-19.

“Using staff data and linking it to healthcare data may be sensitive,” Dr Pareek says, “and so we will explore how to do this in a way that is acceptable. We want the findings of this research to be useful for healthcare workers and so we have a stakeholder group of major national organisations to help us do the research, publicise the findings and make recommendations.”

Dr Manish Pareek

Dr Manish Pareek

This is a vital, wide-reaching study that aims to provide rapid evidence through five interlinked work packages. Work package one, for example, will provide expedited linkage and analysis of anonymised General Medical Council and Nursing and Midwifery Council registration and NHS datasets, within a Trusted Research Environment (SAIL databank) to calculate the incidence of, and outcomes from, COVID-19 amongst healthcare workers. Work package five, meanwhile, will develop a multi-professional, national stakeholder group to facilitate rapid dissemination and translation of the research findings for healthcare workers, employers and policy-makers.

Dr Pareek and his team are acutely aware of the potential impact their research will have on governmental policy, and so are working fast to answer the critical questions. But this isn’t only about analysis and figures—for Dr Pareek’s team working on the study, dealing with COVID-19 in this context has been very real.

“I was one of the first doctors to see and treat the first patient with COVID-19 in Leicester.” This is Dan, a registrar on the research team. Of Chinese ethnicity, Dan contracted COVID-19 early on. “In some ways, as someone so involved in the local COVID-19 response, it was not a surprise when I got COVID-19 myself. I knew instantly when I started getting fevers, chills, aches and pains. I was hopeful that I would get over the illness since I am young with no comorbidities.”

Dan was hoping to improve but after seven days of non-stop fever, breathlessness and coughing, he ended up in the infectious diseases unit he works in, requiring oxygen, and eventually needing to go to the intensive care unit.

For Dr Pareek, these have been challenging times, but ones that have united his healthcare team. “Patients were arriving very unwell and requiring a lot of care,’ he says, recalling the start of the pandemic. “It was stressful for everyone (and I particularly include in that families of those who were unwell). But from that adversity, the hospital and staff from all specialities and levels of seniority came together in a common purpose of dealing with the pandemic.”

As the urgent study now continues, Dr Pareek wants the research to answer two simple questions: if, how, and why, ethnicity affects COVID-19 clinical outcomes in healthcare workers, and what is the impact of COVID-19 on the physical and mental health of ethnic minority healthcare workers

“By undertaking this work,” he says, “I want us to understand what the risk is and help inform the government on how we can reduce that risk so as to prevent healthcare workers, my colleagues, becoming unwell and dying.”

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