England's South Asian population was at higher risk from Covid-19 throughout 2020, and the inequality got worse during the second wave of the pandemic, a new study found.
The study of more than 17 million people adds to the weight of evidence that the pandemic affects ethnic minorities more severely than white people.
But while disparities between some ethnic groups were reduced during the second wave, the gap became larger between white and South Asian people.
People from South Asian backgrounds were nearly twice as likely to need hospital treatment or die during the second wave.
“It’s concerning to see that the disparity widened among South Asian groups,” said the study’s lead author, Dr Rohini Mathur of the London School of Hygiene and Tropical Medicine.
“This highlights an urgent need to find effective prevention measures that fit with the needs of the UK’s ethnically diverse population,” she said.
Researchers said the typically larger household size of South Asian groups was one factor that might contribute to the disparity.
Dr Mathur said multi-generational households could increase the risk of exposure to Covid-19, although she said they also offered “valuable informal care networks” and helped to facilitate access to health care.
Health factors were also thought to play a significant role in the disparity, including underlying conditions such as Type 2 diabetes which affects South Asians disproportionately.
More generally, ethnic minorities are more likely to live in deprived areas, work in frontline jobs and have poorer access to health care, researchers said.
“Our study indicates that even after accounting for many of these factors, the risk for testing positive, hospital and ICU admission, and death was still higher in minority ethnic groups compared with white people in England,” Dr Mathur said.
“To improve Covid-19 outcomes, we urgently need to tackle the wider disadvantage and structural racism faced by these communities, as well as improving access to care and reducing transmission.”
Study lays bare racial inequalities in the pandemic
The large data sample for the study, which was published in The Lancet, came from medical records collected by general practitioner doctors covering 40 per cent of England's population.
GP records, which were available on a data platform called OpenSAFELY, broke patients down into five census categories – white, black, South Asian, mixed and other.
There were also 16 sub-groups, which allowed scientists to determine, for example, that Black African people were at greater risk of ICU admission during the first wave than Black Caribbean people.
About 340,000 of the patients studied were South Asian, making up 5.9 per cent of the total sample.
During the first wave, about 0.9 per cent of South Asians tested positive, the study said.
This compared to 0.7 per cent of black people, 0.5 per cent among mixed groups and 0.4 per cent of white people.
In the second wave, there were improvements for some groups. Black people were less likely than white people to test positive, and the disparity in hospital admissions narrowed.
However, South Asian groups were the major exception. They were about 32 per cent more likely than white people to test positive, and nearly 90 per cent more likely to be admitted to hospital or to die of Covid-19.
In addition to a greater risk of illness and death from Covid-19, there are also concerns over lower vaccination take-up among ethnic minorities.
Britain's largest Black African population is from Nigeria, where anger remains over the deaths of 11 children in 1996 after they were administered an experimental meningitis vaccine developed by Pfizer.
Figures published last month by the Office for National Statistics showed that 91.3 per cent of white British people in England over 70 had received a Covid-19 vaccine.
But the figure was only 74.0 per cent in people of Pakistani background and 72.7 per cent among the Bangladeshi group.