BAME doctors warn of dangers of having to work on frontline

HOSPITAL staff from black, Asian, and minority ethnic (BAME) backgrounds have described the “very real dangers” of treating desperately-ill Covid-19 patients on the frontline.

An urgent investigation is being carried out by the Welsh Government to determine why a disproportionate number of NHS workers from these groups are being affected by coronavirus.

Similarly, it is understood that people in BAME communities in general are also being struck down with the virus more frequently than many others.

A new report by the Intensive Care National Audit and Research Centre (ICNARC) found more than a third (34%) of people critically ill with coronavirus in English, Welsh, and Northern Irish hospitals were from BAME backgrounds, compared with making up 18% of the UK population.

Organisations representing BAME medics, including the British Association of Physicians of Indian Origin (Bapio), said urgent steps needed to be taken by governments to address these “disturbing trends”.

Saty Bhatia, a maxillofacial surgeon at the University Hospital of Wales (UHW) in Cardiff, said it was unclear why BAME communities were being hit hard by the outbreak but said the “data speaks for itself”.

“More than 90% of consultants who have died [across the UK] are from BAME backgrounds,” he said.

“There could be various reasons why we are being disproportionately affected, whether it’s social, behavioural, genetic, or even the way they have been exposed to the virus.

“The answers will become clearer in time following further investigation.”

Despite being exposed to a lot of aerosol generating procedures (AGP) as a maxillofacial surgeon – a dual doctor-dentist role which involves treating patients with major mouth, jaw, and face problems – Mr Bhatia said he felt as safe as could be in the current circumstances.

He has been in direct contact with several Covid-19 positive patients by carrying out tracheostomies to help with their breathing.

“Whenever we have needed PPE Cardiff and Vale University Health Board has made sure our consultant group are provided with it,” he said.

“As a doctor I am not afraid of the situation as we’ve had extensive training to cope in these circumstances but I am concerned that my particular group has a high mortality rate.

“While I have a responsibility to my patients I also have a responsibility towards my family to ensure I’m able to look after them and spend my life with them.

“I have two children aged 16 and 14 and I’m sure they feel proud that I have been able to help treat those who have been seriously unwell.”

Mr Bhatia admitted that some of his colleagues on the frontline have been struck down with the virus.

He added: “I have got two close friends who are consultants and ended up in intensive care when they became ill with Covid-19. They are both from BAME backgrounds too.

“Thankfully they have both recovered but it does make you think that little bit more about your own safety.

“However when you look at the data it appears those working in intensive care on the whole have been less affected by the virus. That shows that adequate PPE – which I’ve been fortunate enough to have – is the key to protection.”

Mr Bhatia said Wales could follow the trend of some NHS trusts in England who have identified BAME communities as a “vulnerable group” alongside the elderly, pregnant women, and those with chronic underlying health conditions.

He said doing so could help ensure those from BAME backgrounds are given further protection from the outbreak.

He said one option to protect BAME NHS workers with medical health conditions who look like being at even higher risk of infection was to take them away from treating Covid19 patients “if it is possible”.

But he added: “BAME doctors make up around 40% of medical workforce in the UK. It would be very difficult to move such a large group of doctors away from the frontline.”

He concluded: “This virus has changed the way that we function in the NHS and I’m sure it will shape how we operate in the future.

“There is a huge challenge ahead about how we will manage patients once this lockdown has eased.”

Similarly Dr Viju Varadrajan, an anaesthetist at the Princess of Wales Hospital in Bridgend, is also at the forefront of the Covid-19 crisis.

She has dealt with the most highrisk patients and has put herself in harm’s way on a daily basis.

“An an anaesthetist I’m in quite a privileged position in that I have access to the highest level of PPE that’s available in the UK. We also train vigorously in how to use them,” she said.

“There is definitely an absence of those undertaking high-risk procedures in this mortality group, which comes as a relief to me. But we need to look carefully at the moderate to lower-risk people in the NHS as clearly there is a difference.”

Dr Varadrajan said she welcomed the Welsh Government undertaking an inquiry into why so many BAME people were losing their lives but said the approach needed to be one of caution.

“This virus has completely overwhelmed medical thinking and medical science in every aspect,” she said.

“But there must be something in the fact people from BAME backgrounds tend to have a higher amount of underlying conditions like hypertension, heart disease, and diabetes. That could then increase their risk of becoming very unwell from this virus.”

Echoing the concerns of Mr Bhatia, she said taking BAME staff away from the frontline could actually create additional problems.

“Don’t forget that these doctors and nurses are an essential part of the service. Many are leading teams and have a lot of experience,” he said.

“A lot of these healthcare workers want to make a positive contribution. Moving them might also have an effect on their mental wellbeing.

“I believe each at-risk staff member should be risk-assessed and counselled to alleviate anxiety, which in turn can help in staff retention during this crisis.”

The mum-of-two added that while her children, aged 18 and 15, were “very concerned” about her and their father, who is also a doctor, she said given the choice she would always want to play her part in the outbreak.

“Words are not enough to explain the changes that have been made across every rank, from the consultants to the housekeeping staff,” she added.

“Everyone has rallied and every single person has contributed. If you told me before this began that these dramatic changes had been made within weeks I wouldn’t have believed you. I thought they’d take two, maybe three, years.

“Some things have been for the better. Zoom conferences have greatly shortened the length of meetings and have allowed people to get their voices heard when maybe they couldn’t around a meeting room table.”

Dr Varadrajan is now working at Nuffield’s private hospital in Hensol, Vale of Glamorgan, with non-Covid cancer patients in a bid to reduce the backlog of urgent surgeries.

Nuffield, along with other private hospitals in Wales, have opened their doors to allow more NHS work to be carried out.

“What we are actively doing is collateral damage control,” she said.

“While the Princess of Wales Hospital is looking after Covid patients we are able to deal with the huge backlog of surgeries here.

“You can never eliminate the risk [of contracting coronavirus] but we are doing our best to minimise it.”

More than 90% of consultants who have died [across the UK] are from Bame backgrounds