Excess deaths from Black, Asian, and Minority Ethnic Doctors during the Covid-19 Pandemic
I would like to display some information that I have collected during the course of the pandemic this year, and unfortunately finish on a low note.
Most weeks in the British Medical Journal we can read six obituaries to UK doctors who have died. They will not make up a full list of doctors who have died but they are interesting to read. I have recorded for a few years the ages and causes of death, but 2020 is particularly interesting as we can see the personal effects of Covid-19. In recent years the causes of death have been clearly displayed in the BMJ. During 2020 up to November 7th there have been 245 obituaries displayed with cause of death not stated in only 5.
The obituaries are accompanied by names (obviously) but also photographs. It has therefore been possible to assess the ethnicity of those who have died. I have divided them into two groups, White and BAME (Black African and Asian minority Ethnic groups).
They are displayed in Figure 1, a bar chart in which each column represents each of the 25 doctors who have been reported to have died from Covid-19, and the height of the columns represents the ages at death.The youngest death was at the age of 46 years and the oldest at the age of 107 years.
What is most dramatic and disturbing is the complete lack of overlap between the ages at death of the white and BAME groups.
Age range White: 84 to 107
Age range BAME: 46 to 79
Average mean age White: 91
Average mean age BAME: 62
As with the Cigarette Smoking and Lung Cancer study, published in 1950, we are dealing with only doctors, a homogenous group. We can therefore eliminate confounding factors such as income, housing, or socio-economic status.
The only one thing that the two groups do not have in common is skin pigmentation, but it is the one thing that the members of the BAME group do have in common. They might come from a range of nations within Africa, the Middle East, India and Pakistan, and South-east Asia, with different traditions, religions, and inheritance, but they share a melanin-rich skin.
These findings will be very uncomfortable to many people in government, and rightly so. Their advisors have declared that the high death rate of BAME people is due to socio-economic factors, but this cannot be the case with doctors. The BAME doctors have died 30 years on average younger than their white counterparts. This is a major cause for concern and it must not be dismissed. I can think of no explanation other than skin colour.
The link between skin colour and Covid-19 deaths in the UK is deficiency of vitamin D. Melanin in the skin is a superb sun-shield that blocks 80% or more of the UV light that is incident upon the skin. Vitamin D is produced from the action of UV on 7-dehydrocholesterol which is synthesised within the skin, and this process is reduced by the presence of melanin. UV is diminished not only by absorption by melanin, but also by distance from the equator, the low elevation of the sun in the winter, extensive skin cover by clothes, indoor work, indoor leisure, and sun-avoiding behaviour including excessive use of sunscreens.
The way to reduce the impact of Covid-19 is to correct the widespread vitamin D deficiency which leads to suboptimal defensive immunity. No doubt the 13 BAME doctors recorded here died without knowing their blood level of vitamin D and without any correction of likely deficiency.
Extensive vitamin D deficiency is being ignored. What I have demonstrated will no doubt be dismissed as mere uncontrolled observation. Medical-scientific explanations are unwelcome. No-one listens to clinical doctors but only to mathematicians and sociologists.
One conclusion that can be drawn from this study is that a melanin-rich skin and presumed vitamin D deficiency appears to be much more dangerous than the coronavirus. The virus might have caused death in the very elderly but ethnicity and vitamin D deficiency caused death to be 30 years premature.
To part-counter arguments that my numbers are incomplete, I would like to look at the deaths of BAME doctors in another way, as I have done in a previous Blog post on April 3rd. This information has been known for more than six months but still there is no relevant official action.
Although the deaths of 13 BAME doctors are recorded in the obituaries above, I am aware of 25 BAME working doctors who have died from Covid-19. The 25th death was Dr Krishnan Subramanian, consultant anaesthetist at the University Hospitals of Derby and Burton. He died on November 12th 2020.
|Dr Krishnan Subramanian|
The first BAME working doctors to die from Covid-19 were Dr Adil El Tatar and Dr Habib Zaidi, both of whom died on March 25th, early in the UK pandemic and just two days after lockdown.
To my knowledge, during the following six weeks a further 22 working doctors died from Covid-19. Only one of the 24 was white, Dr Craig Wakeham, from Dorset. The BAME:White ratio at 23:1 is as dramatic as that above in Figure 1,
The dates of the 23 deaths earlier in the year of BAME working doctors are illustrated in Figure 2.
|Figure 2. BAME doctors dying from Covid-19|
Professor Kamlesh Khunti FRCGP FRCP MD PhD FMed Sci professor of primary care diabetes and vascular medicine in Leicester is a member of SAGE, the scientific advisory group for emergencies.
On Saturday November 21st 2020 he addressed a meeting of BAPIO, British association of physicians of Indian origin.
Being an important person and presumed to be fully up-to-date and knowledgeable, a member of SAGE, his words were anticipated to be a revelation, words that would explain the intentions of the government to acknowledge the high number of deaths of BAME doctors in the UK (described above), and action to be taken. The audience was to be seriously disappointed.
All members of BAPIO packed into the room would have been well-aware of the importance of vitamin D supplements in correcting wide-spread vitamin D deficiency, and how this can bring deaths from Covid-19 to a halt. There was just one person in the room who was not aware of this: the guest speaker, Professor Kamlesh Khunti. His words can be summarised as:
"The official line is that there is no role for vitamin D.
No discussion, no debate, the words are carved in stone.
This level of ignorance at the centre of government advice is frightening.
We must be thankful for professors Parag Singhal and David Anderson for their direct well-informed action.