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Why are people of colour - ethnic minorities in Europe and North America - at greater risk of contracting and dying from COVID-19? There's not yet a definitive answer, but Devi Sridhar, Professor of Global Public Health at Edinburgh University, has some ideas.
"I don't think there's an agreed universal explanation for this," she tells this week's World Vs Virus podcast. "There are several hypotheses that have been suggested based on studies."
Among the most compelling hypotheses, Sridhar cites:
Social conditions: "Ethnic minorities are generally living in conditions where their housing conditions, which are in poor areas and more crowded areas, expose them to more risk daily."
Vitamin D deficiency: "There are increasing studies looking at vitamin D and the role of vitamin D deficiency. People who are darker require more vitamin D and are not getting it from sunlight, especially in northern countries."
Exposure of healthcare workers: Many people from what in the UK is known as the BAME community - Black, Asian and Minority Ethnic - work in healthcare. "Health workers have been put onto perhaps longer shifts, in riskier positions. The positions don't have as much access to PPE (personal protective equipment)."
"These are structural issues around discrimination and racism," Sridhar says.
"It makes people uncomfortable to talk about it, and is seen as being quite political, especially now with what's happening with the protests in the Black Lives movement.
"But I think we need to have these open discussions to get to the heart of what's happening, because there obviously is a big problem. We need to figure out why that is, and think about how we practically can start to address it."
Unconscious bias in health research might also play a role.
"When you have groups of individuals who all kind of look the same and approach problems the same, they tend to hire people, mentor people, support studies that fit with their world view," Sridhar says.
"We all need to reflect on our own biases, and...we all sometimes may not even think that we're making a choice. When we look at two CVs and we look at two studies we want to support, in terms of the validity of each, that actually reflects our bias."
She adds: "That's not only about ethnicity. It's also about gender. It's about class. It's about all the various bits that make people who they are. And making sure that you have people who often disagree with you in the room, that's the best way to actually make the decisions and fund studies that actually reflect what is really needed."
In the interview, Sridhar says why the (so far unknown) long-term consequences of the virus for survivors - the so-called "long-haulers" - could make COVID-19 "our generation’s polio", and why countries should not be looking to contain and manage the outbreak, but to eradicate it completely.
What is the World Economic Forum doing about the coronavirus outbreak?
Responding to the COVID-19 pandemic requires global cooperation among governments, international organizations and the business community, which is at the centre of the World Economic Forum’s mission as the International Organization for Public-Private Cooperation.
Since its launch on 11 March, the Forum’s COVID Action Platform has brought together 1,667 stakeholders from 1,106 businesses and organizations to mitigate the risk and impact of the unprecedented global health emergency that is COVID-19.
The platform is created with the support of the World Health Organization and is open to all businesses and industry groups, as well as other stakeholders, aiming to integrate and inform joint action.
As an organization, the Forum has a track record of supporting efforts to contain epidemics. In 2017, at our Annual Meeting, the Coalition for Epidemic Preparedness Innovations (CEPI) was launched – bringing together experts from government, business, health, academia and civil society to accelerate the development of vaccines. CEPI is currently supporting the race to develop a vaccine against this strand of the coronavirus.
Find all previous episodes of World Vs Virus here.