Lockdown has been ‘less effective in BAME communities’ because a higher number of their inhabitants can’t work from home, there are more multi-generational households and language issues, says scientists
- Academics at the University of Leicester studied the impact of March lockdowns
- Virus cases continued rising in BAME groups three weeks after implementation
- Meanwhile, the rates among white groups ‘dropped off very sharply’
- They concluded that the findings raise ‘serious questions’ on whether a one-size-fits all approach to lockdowns are effective for diverse populations
Lockdown measures imposed in late March to slow down the spread of coronavirus may not have been as effective in black, Asian and minority ethnic (BAME) communities because of the ‘one-size-fits-all approach’, scientists have said.
Academics at the University of Leicester found that Covid-19 cases continued to rise in BAME groups in certain parts of Leicester in the three weeks after the announcement was made, while rates in white groups ‘dropped off very sharply’.
They said the findings, published recently in the journal EClinicalMedicine by The Lancet, raise ‘serious questions’ on whether lockdown on its own is effective for a diverse population.
Academics at the University of Leicester have found that lockdown measures imposed in March failed to stop the rise of coronavirus infections among BAME groups. Above, a sign in Leicester tells residents what measures they should follow during the localised lockdown
Dr Manish Pareek, an associate clinical professor in infectious diseases at the University of Leicester, told the PA news agency: ‘Obviously, lockdown has had a huge impact in reducing infection rates but the question is, is it enough for certain parts of the country?
‘Lockdown as a whole is quite a blunt tool… perhaps what we should be thinking about is a more nuanced approach which allows people to work with local solutions.’
Dr Pareek and his team studied patients admitted to the University Hospitals of Leicester NHS Trust.
They found the proportion of people from BAME groups who tested positive for coronavirus continued to rise for three weeks from March 23, peaking at 50.9%, but the figure for people from white backgrounds remained between 24% and 26%.
Dr Pareek told PA: ‘Of course, we can’t be clear about cause and effect, I think, but if we were speculating, there are a number of factors which potentially could explain these findings.
‘One would be that people who come from diverse ethnic groups work in front-facing roles and are not necessarily able to work from home.
‘Secondly, they may be part of large, multi-generational households, which increases the risk of infection, and, thirdly, there may have been issues as to whether the public health messaging actually got through to those populations (due to language and cultural barriers).’
Academics at the University concluded that one-size fits all lockdowns are less effective in BAME communities. Pictured above, a residential street is seen in the Highfields area of Leicester, central England on July 17, 2020, as local lockdown restrictions remain in force due to a spike in cases of the coronavirus in the city
Dr Pareek said that as recent research has shown that severe Covid-19 disproportionately affects BAME communities, there is an ‘urgent need to confirm an association between ethnicity and acquiring Covid-19 infection’.
He said tailored public health messaging aimed at specific BAME groups, along with targeted programmes on testing and contact tracing, are needed in preparation for future waves.
Dr Pareek said: ‘At the moment, there is perhaps a one-size-fits-all approach.’
He said that while there have been some targeted interventions in Leicester as the region experienced a fresh outbreak last month, these measures ‘should have been predicted in the first instance’.
Leicester’s city council says lockdown should be replaced with intense public health messaging
Leicester’s city-wide lockdown should be lifted and replaced with intense public health messaging aimed at suppressing coronavirus in the 10 per cent of the city where there are excessive cases of infections, the city council has said.
Council public health officials yesterday released their latest analysis of testing data for the city – ahead of a decision by the government today to either lift the localised lockdown or extend it for another two weeks.
City mayor Sir Peter Soulsby says his officials have mapped out where in the city most people were testing positive for the virus in the fortnight running up to July 4, when a two-week local lockdown officially came into force.
He says the results show areas with infection rates of 15 per cent or more largely confined to the north and east of the city in the areas of Belgrave, St Peter’s and Highfields.
I’d ask ‘included and continue Sir Elsewhere there were fewer instances of infections, with many areas in the north, west and south of the city showing less than five positive results.
The city council has sent its report to the Department for Health and Social Care and Public Health England.
The mayor believes it makes a strong case for lifting the tighter restriction announced by Health Secretary Matt Hancock on June 29, which again closed non-essential retail and schools in an area covering the whole city and some suburbs on, or just outside, its boundary.
Leicester City Council have said the city’s lockdown should be lifted and replaced with intense public health messaging. Above, two residents walk up the street in the Highfields area of Leicester on July 17, 2020
He also says that the council only started getting positive test data with postcodes attached from the government on June 25 and, had that detail been made available weeks should I to be so?’
Soulsby said when the city council first requested it, targeted action in streets and neighbourhoods could have been carried out, thus avoiding the need for the local lockdown in the first place.
Sir Peter told the Mercury: ‘We are not saying there has not been a problem, but we now know very specifically where it has been. ‘It has been in 10 per cent of the city – Belgrave, St Peter’s area, Highfields – not across all of it.
‘The greatest number of positive tests are in areas of dense inner city housing with multi-generational households and high levels of deprivation.
‘Had we had this detailed granular information six weeks ago we could have targeted the area with the problem – knocking on doors, street-to-street, reinforcing the public health messages and so on -diverting all our attention to the 10 per cent of the city so we can get on top of it.
‘This is what is now happening in Blackburn, where a spike has been identified, and it is a much more effective approach than a crude and wasteful local lockdown.
‘If I were a resident in the other 90 per cent of the city and also the areas of the county beyond the city boundary, I would be asking the government very impolitely: ‘Why have I been included in lockdown and why should I continue to be so?’
City mayor Sir Peter Soulsby says his officials have mapped out where in the city most people were testing positive for the virus in the fortnight running up to July 4. Above, A picture shows swings tied up in a children’s playground in the Highfields area of Leicester
Mr Hancock told Parliament on Tuesday that the decision on whether to extend or release Leicester’s lockdown would be based on two weeks’ worth of testing data up to that point – which is not the two weeks the council has used in its latest analysis.
‘There is a process for whether changes can be made in Leicester,’ said Mr Hancock. ‘We will look at 14 days of data – it is today 14 days since the measures were introduced – and we will look at that on Thursday and make a public announcement as soon as is reasonably possible.
‘Thankfully the numbers have been coming down in Leicester, we have put in that extra testing, but the number of positive cases in Leicester is still well above the rest of the country.’
He added: ‘I won’t pre-judge the decision that we’ll take on Thursday and we’ll take into account all of the data. ‘We won’t set out specific thresholds, we’ll look at all of the data.’
Mr Hancock said that both the ‘level and rate of change’ will be considered and looked at with the local authorities.’
Sir Peter claimed: ‘It was a political decision to take us into lockdown. It will be an entirely political decision if we remain in it.’
Mr Hancock told Parliament on Tuesday that the decision on whether to extend or release Leicester’s lockdown would be based on two weeks’ worth of testing data up to that point
When asked what weight he thought the city council’s case would carry in the decision, he admtted: ‘Absolutely none.’
He added: ‘The government has got itself into a real mess over this and it is for the government to try to dig itself out of this hole.’
The council’s director of public health, Ivan Browne, said he had been impressed with the way the Leicester public has adhered to the conditions of the local lockdown.
However, he said: ‘Activity (has) dropped off considerably but the longer this continues the more challenging people will find it.’
The city council said it received information yesterday that, in the two weeks up to July 13, the number of tests carried out in the city was 15,122, of which 643 were positive – that is 4.3 per cent In the fortnight up to July 4, there were 10,475 tests and 888, or 8.5 per cent, came back positive.
The Department of Health and Social Care been asked to comment on the council’s findings.
Public Health England said it would comment after Mr Hancock’s decision.
Sir Soulsby said earlier when the city council first requested it, targeted action in streets and neighbourhoods could have been carried out, thus avoiding the need for the local lockdown in the first place.
Meanwhile, another five patients who had tested positive for coronavirus have died at Leicester’s Hospitals over the past week.
The latest death announcement by the trust that runs the Leicester Royal Infirmary, Leicester General Hospital and Glenfield Hospital was made yesterday.
It means that 425 coronavirus patients being treated by University Hospitals of Leicester NHS Trust (UHL) have died since the start of the pandemic in March.
The latest five were aged between their 40s and their 80s. A UHL spokesperson said: ‘Sadly, we can confirm that 425 patients being cared for at our hospitals, and who had tested positive for Covid-19, have died. Five of those deaths have been announced since last Wednesday, July 8.
For context, the trust last week announced 21 deaths, some of which were believed to have been delayed due to the recording and confirmation process.
With Leicester now in the third week of a local lockdown, hospital bosses say they have seen a ‘small decline’ in the number of patients requiring intensive care treatment associated to Covid-19.
A spokesperson said: ‘We continue to treat patients with Covid-19 at our hospitals but have seen a small decline over the past few days in the number of Covid-19 admissions and the number of patients requiring intensive care due to the complications of Covid-19.
‘We are doing all we can to ensure our hospitals can continue to support both Covid and non-Covid patients, and are prepared should we experience an increase in cases.’
The spokesperson added: ‘Hospital visiting restrictions remain in place to protect patients and staff and people need to wear face coverings when coming to hospital.
‘But it is also important that the people of Leicester know that it is safe to access care. The NHS is still there for patients who need urgent and emergency services. And anyone who has been asked to come to hospital – whether for an urgent matter or a booked appointment – should do so. We urge people to follow the guidance to protect themselves and others.’
No further deaths have been recorded by Leicestershire Partnership NHS Trust (LPT), which runs the area’s community hospitals. In total, 21 patients have died while in LPT’s care since the start of the pandemic.
WHAT CAUSED A SPIKE IN CASES IN LEICESTER?
Government officials, local politicians and scientists were initially divided over whether Leicester was experiencing a real surge in cases or whether better testing was simply finding more of them where it wasn’t before.
It is also not clear whether there are any characteristics of Leicester which make it more likely to see a surge in cases, or if random chance has meant the first ‘second wave’ is happening there.
Experts say many of the risk factors in Leicester are the same in all major cities in England.
The mayor of the city, Sir Peter Soulsby, said on BBC Radio 4 that a report sent to him by the Government ‘actually acknowledges that it’s very likely that the increase in number of positives identified is a result of increased testing, and that actually there’s perhaps nothing of any great significance in those results.’
Director of Public Health for the city, Ivan Browne, said: ‘Interestingly it [the surge in cases] is very much around the younger, working age population and predominantly towards the east part of our city. We started to see this level through our testing programme.
‘Young people work in many industries across the city so at this stage what we’re trying to do is gather as much epidemiological information as we can to really try and get underneath and have an understanding. I don’t think at the moment that we are seeing a single source or a single smoking gun on this’.
It was always likely that surges in cases would be seen in cities first. There are more people, raising the risk, and those people are more likely to live in densely populated areas and come into contact with strangers on a regular basis.
Dr Shaun Fitzgerald, from the University of Cambridge, said: ‘There will be differences in the ease with which people can maintain physical distance between densely populated areas and rural environments – so it isn’t surprising to me that we may see localised flare-ups, which in turn may need suppressing through delayed easing or temporary re-introduction of some constraints on some movements and activities.’
Leicester also has high levels of deprivation, which affects people’s lives in ways that put them at risk of catching the virus.
Dr Simon Clarke, a microbiologist at the University of Reading, told MailOnline: ‘In deprived areas people are more likely to have to go to work, less likely to be able to work from home, and more likely to use public transport. They can’t distance themselves from others.’
The Samworth Brothers sandwich factory in the city reported over the weekend that it had diagnosed cases of Covid-19 among its staff.
Food processing factories are a higher transmission risk because cold environments allow the virus to survive for longer on hard surfaces and make people’s airways more susceptible to infection.
Dr Clarke added that the types of work people do may increase their risk.
‘Blue collar cities are now at higher risk than places like London and Manchester which have more financial services,’ he added.
BySam Blanchard Senior Health Reporter For Mailonlineand Tom Pyman And Sam Baker For Mailonline
The local lockdown will be lifted in parts of Leicestershire as soon as this weekend following a review by public health experts, the Government has said.
Areas outside of Leicester City and the borough of Oadby and Wigston will align with national lockdown rules in England from Saturday.
From July 18 non-essential shops, bars, restaurants and hairdressers not in the continuing protected zone will be permitted to open.
Schools and childcare settings outside the protected area will also be able to open from the same date, in line with national restrictions.
Thanking the people of Leicester for following public health advice, Health Secretary Matt Hancock said: ‘I know the past two weeks have been difficult for those living in and around Leicester, especially those who have been shielding for so many weeks.
‘While we are not yet in a position to lift all the restrictions in place, we are now able to take cautious steps to allow areas outside of Leicester City and the borough of Oadby and Wigston to fall in step with national guidelines and introduce some relaxations within the City of Leicester and the borough of Oadby and Wigston.
‘I realise that this will be frustrating for those areas that remain under additional restrictions and I am determined to be straight with you all, we will ease restrictions as soon as the data shows that it is safe to do so.’
However, non-essential shops and schools in Leicester City and the borough of Oadby and Wigston will only be allowed to re-open from July 24 as there is a higher prevalence of coronavirus in these two areas.
Bars, restaurants and hairdressers in these areas must remain closed and are set to be reviewed on August 1.
The Government said shielding advice remains in place for the entire area of Leicester, including where restrictions have been eased.
It said the changes to measures follow a fall in the seven-day infection rate and the percentage of people testing positive for Covid-19, but warned they remained above the national average.
According to data published on Friday, Leicester’s rate of new coronavirus cases per 100,000 population dropped from 126.1 in the seven days to July 7 to 92.9 in the seven days to July 14.
It was 132.3 in the seven days to June 30.
People were reminded to continue to socially distance, regularly wash their hands and self-isolate and get a test if they develop coronavirus symptoms.
Leicester’s mayor has slammed Matt Hancock for taking a ‘sledgehammer approach’ to the city’s lockdown and accused the government of ‘party political’ aims after restrictions were focused on areas run by Labour and the Lib Dems.
The Health Secretary announced last night that only schools and nurseries will be allowed to reopen from next Friday, July 24, with the rest of the city still facing a raft of limitations on their freedom.
Under the plans, councils would be given local powers to shut non-essential shops where necessary, pubs and restaurants will remain closed, and restrictions on non-essential travel and only having social gatherings of up to six people will remain in force, pending another review in a fortnight.
In an urgent statement to the House of Commons, Mr Hancock said the coronavirus infection rate in the city is still too high for lockdown to be lifted.
Mayor Sir Peter Soulsby was critical of the decision to keep restrictions in force across the Labour-run city of Leicester and Liberal Democrat-controlled Oadby and Wigson.
He said: ‘They have chosen to focus on the city geographical area – effectively the area of the county that votes Labour, and that’s just scandalous.
‘If they were going to alter the boundary, they should have gone down to the area that they now know where the virus is.
The Mayor of Leicester Sir Peter Soulsby reacts as he remotely watches this evening’s announcement by Health Secretary Matt Hancock
‘They have left two areas in there – one that has a Liberal Democrat council, the other that has a Labour mayor.
‘The fact is they have focused in a way that is clearly party political and that’s not a way to deal with the virus.
‘That’s not a way to deal with the people who will be very angry and very frustrated that they are being punished for the way in which they voted.’
He went on: ‘I am determined of course to continue to focus on what the data now does tell us – to continue to focus on the neighbourhoods, the streets, the households, where we now know there is the virus.
‘They are prepared not just to penalise this city, but also to penalise its economy.
‘Because right at the start of this, there were promises from the Secretary of State that there would be a financial package – compensation scheme – for our businesses that are being held back.
‘Now two weeks on, he’s still not delivering on that promise.
‘That obviously is a matter of great concern to me and those who care about the future wellbeing of this city.’
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