‘Biology unlikely to drive Covid-19 risk for NHS staff’
EXPERTS’ STUDY POINTS TO CARE ROLES AND HOME LIFE RATHER THAN ETHNIC DIFFERENCES
THE differences in Covid-19 infection risks between ethnic minority healthcare workers and their white colleagues are likely down to home and work factors rather than biology, according to scientists.
The University of Leicester experts have been leading the biggest and most detailed study on the subject, along with researchers at University College London and University of Nottingham.
Previous research has shown healthcare workers from ethnic minority groups are at a disproportionately higher risk of contracting Covid-19 compared with white colleagues.
Baseline data from the UK-Reach study confirms this. Out of 10,772 healthcare workers on the study, black workers were significantly more likely to have evidence of Covid-19 infection than white workers.
However, once work factors, including job role and location and number of patients with Covid-19 they cared for, and lifestyle factors, such as living with other healthcare workers and age, are taken into account, this difference in risk is no longer seen.
This implies home and lifestyle factors, rather than anything innate/ biological, are responsible for driving the disproportionate Covid-19 risk in ethnic minority healthcare workers.
The study found higher risk of infection from Covid-19 in healthcare workers was associated with working in nursing or midwifery, exposure to increasing numbers of patients with Covid-19, lack of access to PPE, living with another key worker and working in hospital inpatient or ambulance settings.
Those working in Scotland and South West England were at lower risk of infection compared with healthcare workers in the West Midlands,
as were those working in intensive care units (ICU).
Dr Manish Pareek, associate professor of infectious diseases at the National Institute for Health Research Leicester Biomedical Research Centre, and chief investigator for the UK-Reach study, said: “Our study shows the importance of occupational risk and some homelife factors.
“For example, it shows a strong association between the number of patients with Covid-19 attended by a healthcare worker and the healthcare worker’s risk of infection.
“Those working in ICU settings, where long sleeve gowns and respirator face masks are recommended at all times, were at lower risk.
“This supports the idea that upgrading PPE standards for all healthcare workers attending Covid19 patients, regardless of location or type of procedure being done, may have a beneficial impact on reducing infection rates among staff.”
Dr Christopher Martin, academic clinical fellow in infectious diseases at University Hospitals of Leicester NHS Trust and first author of the study, said: “We identified key risk factors associated with Covid-19 infection among UK healthcare workers. Healthcare workers from black ethnic groups in our study were younger, more likely to work in settings such as inpatient care, more likely to see a higher number of Covid-19 patients and less likely to report access to appropriate PPE at all times than white colleagues.
“They were also more likely to live with other key workers and in areas of greater deprivation.
“All these factors increase their risk of Covid-19.
“However, once these factors were accounted for, the difference in infection risk between black and white workers was negligible, suggesting differences in work and home lives of ethnic minority healthcare workers – some of which are linked to inequalities more generally – are driving differing infection rates.
“These findings should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting workers.”
The authors acknowledged the study has limitations, such as the potential for self-selector bias, meaning healthcare workers might be more inclined to complete the survey if they felt they had a greater risk of infection, for example.
However, the sample of 10,772 people is largely representative of the NHS workforce.