Trevor Phillips
Monday April 20 2020, 12.01am, The Times
You do not need to hail from the Indian subcontinent to feel pride and sorrow at the selflessness shown by Asian heritage doctors and nurses who have died from Covid-19. Nor do you need to be a product of plantation slavery for the report that black Americans are dying in huge numbers to send a shiver down your spine. But both pieces of news have prompted an urgent question, now being raised every day at Downing Street briefings: are people of colour more at risk than others? And if so, why?
Research linking race with disease is explosive. Many believe it should be off limits as a matter of principle. I don’t agree. The families of minority health workers are daily watching the mounting toll of dark faces in horror. Try persuading them that race is merely “a social construct” And knowledge about our differences can be revelatory. In the late 1990s a Pakistani-heritage medical researcher, Sadaf Farooqi, pointed out that Asian families, despite suffering higher infant mortality than average, were significantly less prone to sudden infant death syndrome, a fatal respiratory condition. Her brilliant insight into the way that Asian infants were positioned in their cots contributed to research that reduced the annual death of some 1,500 babies by more than half. In the case of coronavirus, we need to know everything we can. Unwarranted sensitivities could mean some other family grieving for a loved one; political squeamishness could block the path to a treatment.
So far our experts have had little to say about whether the virus has been doling out its grisly rations evenly. Their reluctance to guess is understandable. The combination of medicine, race and politics does not have a happy history. In 1932, American researchers, some of them black, concerned about the effects of syphilis on minorities, undertook a publicly funded programme of research in which they deliberately withheld treatment from 399 African-American men. The ghastly experiment was only terminated after 40 years, by which time 28 of the men had died of the disease, a further 100 perished from related causes, 40 wives had been infected and 19 children born with syphilis. More recently, the suave, British-educated president of South Africa Thabo Mbeki, citing his country’s history of blaming black people for previous epidemics, scoffed at evidence that Aids was a viral infection. His health minister prescribed quack remedies — garlic, beetroot, lemon juice. It is estimated that as a result, over 350,000 people died unnecessarily.
A month ago, rumours began to circulate on social media that black people were unusually resistant to Covid-19. Asked about this, I joked that history suggests we wouldn’t be that lucky. But the grim consequence of this misinformation may have been that African-Americans were slower than others to respond to the threat. In Chicago, a city one-third black, over two thirds of virus deaths have occurred in the black community. Non-urban areas have shown a similar pattern.
Concern about this known unknown was etched on the face of the chief medical officer as he addressed the issue at the weekend; factors like genetics, culture, language and religion could be quietly undermining scientists’ attempt to predict the spread of infection. Public Health England has rightly begun an inquiry. But however hard they try, scientists can’t keep pace with the rumour mill and must ensure the emerging conspiracy theories and knee-jerk victimhood do not go unchallenged.
I have worked with my friend and colleague, Professor Richard Webber, perhaps Britain’s most distinguished geodemographer, to see what public sources can tell us. You can see the detail in our preliminary paper at webberphillips.com. But our headline finding is that, on a per capita basis, coronavirus has struck London boroughs such as Brent, Southwark, Lambeth and Harrow far harder than it should have done; broadly speaking, the higher the proportion of non-whites in an area, the higher the rate of infection.
The pattern isn’t easy to explain. Assumptions about racial biology are unlikely to hold good across a range of non-white groups who are in most ways more unlike each other than they are different from whites. As for poverty, the list of the seventeen most afflicted local authorities includes low-income Brent, but also features multi-ethnic Wandsworth, where median weekly earnings, at £720, are 50 per cent above the national average. And of the virus hotspots, only two appear in the list of England’s ten most overcrowded boroughs. The most significant hotspots outside the capital, Liverpool and Sheffield, are 35th and 107th respectively out of 126 boroughs in order of population density.
So what might explain these data? First, age. Britain’s non-whites are, in general, younger than average. In the multigenerational households common in some minority communities young people, more likely to have had the virus without symptoms, might unknowingly have infected older relatives. Second, many minorities work in high exposure occupations — retail, public transport and the health service. And most intriguingly, might some minority communities have complied more readily with government guidance than others?
One puzzling finding in our report concerns not who is being infected, but is who is not. Were poverty the key determinant, we would expect the virus to be running rampant among Britain’s Pakistani and Bangladeshi Muslim communities. Yet they are conspicuous by their absence in the list of hotspots — no Blackburn or Bradford, no Rotherham, Rochdale or Luton. The London borough of Tower Hamlets is more than a third Muslim — the highest density of any in England — and is sandwiched between two Covid-19 hotspots, Newham and Southwark, both home to substantial non-Muslim minority communities. Yet Tower Hamlets lies in the bottom third of the capital’s infection list: 22nd out of the 32 boroughs.
Maybe there is a revelation to be had here; if one key to stopping transmission of the virus is hand washing, might a faith community many of whose members ritually wash before five-times-a-day prayers have something to teach the rest of us? And does an ethnic group where almost 40 per cent are economically inactive — and therefore not regularly using public transport, for example — merely underline the protective value of social isolation? Many believe that only faith will deliver us from this particular evil but even they must know that only science will tell us how.