Covid-19: Cultural, health factors place Asian community at higher risk

(Photo: Alex Davidson/Getty Images).
(Photo: Alex Davidson/Getty Images).

By Shirley Cramer CBE
Chief executive of the Royal Society for Public Health

THE Royal Society for Public Health (RSPH) is monitoring the developing coronavirus situation and striving to share accurate information and advice in this unprecedented time.

As the crisis deepens across the UK and around the world, we must consider which groups are par­ticularly vulnerable and how we can best protect ourselves and them from contracting and spread­ing Covid-19.

So is the British Asian community one of those that is more at risk?

There is no straightforward answer to this ques­tion as the risk of contracting Covid-19 depends on many factors, including age, underlying health conditions, and potential exposure to the virus. While Covid-19 is a new strain of coronaviruses, and there is much more to be learned about it, we know it is spread through droplets emitted when an infected person coughs and sneezes. Any circum­stances that put individuals in close contact with each other can place them at greater risk.

While this virus will affect all communities, there are social elements that are more common in the Asian community that may elevate an individual’s risk. For instance, living in larger joint families will tend to increase the odds of exposure to the virus, and we know that multi-generational households are more prevalent among the Asian community. The Resolution Foundation calculated that 80 per cent of south Asian Britons live in a household with a younger generation present. Living in an extend­ed family unit has many benefits, such as sharing care responsibilities, and parents and grandparents playing active parts as role models in children’s lives. Last year we surveyed religious groups across the UK and found, for example, that 91 per cent of the 1,000 Muslims we polled felt that adult children have an obligation to look after elderly parents.

This was just one way in which an intergenera­tional family spirt was reflected in our broader re­search among British Asian groups, and there’s no doubt of the good this does for the mental and physical wellbeing of all. However, the other side of that coin is that increased physical proximity and contact with family members means a potentially greater chance of being exposed to the virus.

Densely populated urban centres are an exten­sion of this situation – there is a greater chance of virus exposure where more people are located. As the majority of British Asians live in urban areas, this could also place the community at greater risk.

Another issue in a multi-generational household is that the elderly are at greater risk as the natural ageing process weakens the immune system, and younger members of the household could act as carriers of the virus without presenting symptoms.

Additionally, there are certain conditions that are enhanced risk factors for coronavirus and are more prevalent in some groups than others. People of south Asian descent, for example, are up to six times more likely to have type 2 diabetes than the general population, and have a higher risk of devel­oping some heart and circulatory diseases. Con­tracting Covid-19 would be a more serious prospect to anyone with these underlying conditions.

The community spirit of the Asian population also presents a potential opportunity for the virus to spread. Many British Asians regularly gather at temples and mosques and have strong community support networks. Our survey found that 58 per cent of Hindus regularly stop and talk to people in their neighbourhood. Religion and community support may feel important now more than ever before, but this has to be balanced against the fact that bringing people into proximity with one an­other presents a prime chance for transmission. Mosques have now suspended congregations, and many religious organisations are operating online.

So how can we protect ourselves and others?

While it is true that different communities will have different experiences and difficulties in the troubling period we’re living through, the message for the British public must remain loud, clear, and uniform. We should all follow the rules set out by the government on March 23 – that is, to stay at home, and only go out for the following reasons:

— To go to a shop to buy essential items such as food or medicine. See if you can arrange home de­livery for items wherever possible.

–One form of exercise a day such as a walk or run. This should be on your own or with members of your household.

–Travelling to and from work only when it is im­possible for you to work from home.

–Medical reasons such as to provide care for a vulnerable person.

For people living in multi-generational house­holds, particularly with vulnerable individuals at greater risk, practising good hygiene is vital. The advice around hand-washing, in particular, should be adhered to closely. The International Forum on Home Hygiene has released guidance on how to social distance, self-isolate and keep the household hygienic. Personal items should not be shared, and the sick and healthy should be kept separate as far as is possible.

These are testing times for everyone, and the support systems familiar to British Asians should be drawn upon to get through this – but only from the virtual world for now.