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How can we prevent enduring, unequal transmission of Covid-19 in specific communities and places? Some answers to this question come from a recent report by the ethnicity subgroup of Sage on the causes of the tragic loss of life among Bangladeshi and Pakistani British communities in the second wave of the pandemic.

While all minority ethnic groups remained at greater risk of death from Covid-19 compared with white ethnic groups in the period from October 2020 to January 2021, Bangladeshi and Pakistani groups were at the greatest risk. The Sage advice, which I led on, uncovered the effects of inequality and policy on health outcomes and the urgent measures needed to support hard-hit communities and prevent future tragedies.

The recent Commission on Race and Ethnic Disparities reports that this was a result of “risk of infection”, “as opposed to ethnicity alone being a risk factor”. To the contrary, our findings show that multiple disadvantages faced by ethnic groups join together to produce infection and death from Covid-19.

Bangladeshi and Pakistani groups experience more chronic, debilitating health conditions at a younger age due to health disparities. They mainly work in jobs in small-scale retail, transportation and hospitality, leading to greater exposure to Covid-19. Being precarious employees or business owners means that they are less able to negotiate paid sick leave or to stay home when unwell.

They are more likely to live in crowded housing providing social support to older and younger family members under one roof. This increases risks of transmission within families from workplaces and schools, and prevents self-isolation of sick family members. Stigma and racism are common experiences, due to their ethnic and religious identity, causing physiological effects on health outcomes and creating a barrier to accessing services.

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