omali families living in east London experienced “acutely high” infection and death rates during the Covid pandemic, a new study has found.
Researchers found that a late lockdown and “community-insensitive” public health approach contributed a higher fatality rate in the community during the first wave of the pandemic in March 2020.
High rates of illness were prolonged throughout the pandemic due to the “legacy of historic poverty, housing density and institutional racism”, the report found.
Ethnic minority communities in London suffered a disproportionate number of fatalities during the pandemic and campaigners have called for race to be at the centre of the official Covid inquiry.
The report was authored by Dr Farah Bede, a Somali GP working in the East End, and Prof Joanna Lewis, a professor of history at the London School of Economics (LSE). They aimed to create a “snapshot” of how the pandemic unfolded in the community in the borough of Tower Hamlets.
Data was gathered from anonymised patient records in primary care, in-depth interviews with residents, GP testimony and the feedback of preliminary findings from a group of 100 local council health-workers in the area.
The authors note that Somali men were the first to be impacted by the disease, with occupations such as Uber drivers, hospital porters and street cleaners particularly hard-hit.
Mohammed, in his fifties, was working as a taxi-driver and caught the virus in early April.
“I couldn’t get a test as there was no community testing. I wished I could have known earlier and not passed it onto my family,” he said.
Muna, a community leader, said that at one point “‘there were five deaths a day of people known to us …. We know families that got wiped out”.
The initial high rates of men hospitalised made the wider local community less likely to report symptoms or to delay reporting serious breathing problems. This was due to “a massive fear of going to hospitals and dying alone”, the report said. Many of the interviewees in the report “recalled people falling ill or dying in April”.
The report said that “limited English” was a factor in persistent high death rates as vulnerable patients were unable to seek treatment without assistance from children, friends or neighbours. Over half of respondents recorded issues dealing with receptionists at GP surgeries, with complaints that the health service had “less Somali focused community health initiatives”.
Osob, an elderly Somali woman, recalled how one of her neighbours had deteriorated during the first lockdown, in which all socialising was banned.
“She became very lonely, stopped going out for walks and deteriorated quickly. She was admitted to the hospital and died soon after.”
Many in the community on “fragile incomes” were forced to keep working in frontline jobs throughout the lockdown despite the risk of getting ill. These roles became a “vector of transmission”.
Zamzam, an interviewee, said she had done overnight stays as a carer with recently discharged elderly Covid-19 patients, despite there being no test done on return to the community to confirm they were negative.
The report also mentioned the problem of “poor housing and overcrowding” in east London leading to increased transmission of the virus.
“Of the primary care patient records reviewed, the majority of patients were found to live in one- to two-bed flats with the living room converted to an extra bedroom,” the authors wrote.
“On average there were 4.7 people living in each flat.”
They added: “Disproportionate number of deaths from COVID-19 in BAME communities can be explained in part by the conditions in which people live. More research is required looking at the intersection of multi-generational living and of overcrowded accommodation in the generation of health inequity.”
The report also criticised “inconsistency” in the Government’s public health messaging and communication with patients, which created a “lack of trust”.
It added that vulnerability to Covid-19, mental health and economic inequity are “interlinked”, with the virus affecting people’s ability to find employment and impacting their wellbeing.
Concluding their report, the authors said the impact of Covid-19 on the Somali community was a “perfect storm” that “severely tested and sometimes shattered their coping mechanisms and halted the masking of their underlying precarious health”.
They added that high infection and death rates had last longer due to the “intersection of historic socio-economic and health inequalities that include racism”.
Researchers called for an increase in trained Somali health experts, community sensitive data and an increased number of local networks to help reduce inequalities. A “culturally sensitive” approach is also needed to build up “future resilience” for the Somali community, the authors said.