Biology is unlikely to cause ethnic differences in COVID-19 risk for healthcare workers

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Differences in risk of COVID-19 infection between ethnic minority healthcare workers and their white colleagues are likely due to domestic and work factors rather than biology, according to the largest and most recent study detailed on the subject, co-edited by researchers at University College London (UCL).

Previous research has shown that healthcare workers from ethnic minority groups are at a disproportionately higher risk of contracting COVID-19 than their white colleagues. Baseline data from the UK-REACH study confirms this. Of 10,772 healthcare workers participating in the study, black healthcare workers were significantly more likely to have evidence of COVID-19 infection than white healthcare workers.

However, after work-related factors, such as position and place of work, the number of COVID-19 patients they have treated, and lifestyle factors, such as living with other healthcare workers and age are taken into account, this difference in risk is no longer seen. This implies that these home and lifestyle factors, rather than anything innate / biological, are responsible for the disproportionate risk of COVID-19 among ethnic minority healthcare workers.

The study, posted on the MedRxiv pre-print server and carried out with the University of Leicester and the University of Nottingham found that a higher risk of COVID-19 infection among healthcare workers was associated nursing or midwifery work, exposure to increasing numbers of COVID-19 patients, lack of access to PPE, living with another key worker, and working in hospitals or ambulances.

Additionally, those working in Scotland and the South West of England have a lower risk of infection than healthcare workers in the West Midlands, as are those working in intensive care units (ICUs). .

Co-author Professor Katherine Woolf (UCL Medical School) said: “There is concern that black healthcare workers are at greater risk of reporting COVID-19 infection. Our study suggests that this higher risk was due to the fact that black healthcare workers were more exposed to the virus at work and / or outside of work, rather than because of inherent biological or genetic factors. reduce their chances of catching COVID-19, in particular by being supported to take booster vaccines. This is especially important now, as the Omicron variant of the virus is much easier to catch than previous variants. “

Dr Manish Pareek, associate professor of infectious diseases at the Biomedical Research Center at the National Institute for Health Research (NIHR) Leicester and lead investigator of the UK-REACH study, said: ‘Our study shows the importance of occupational risk and life at home. For example, it shows a strong association between the number of COVID-19 patients followed by a healthcare professional and the healthcare professional’s risk of infection. This is not in all situations: times their risk of infection was higher than those who had not reported access problems.

“On the other hand, those who worked in intensive care units, where long-sleeved gowns and respiratory masks are recommended at all times, were at less risk than those who did not work in this environment. This supports the idea of ​​improving PPE standards for all healthcare workers. Managing COVID-19 patients, regardless of location or type of procedure performed, can have a beneficial impact in reducing infection rates among staff. “

Dr Christopher Martin, academic researcher in infectious diseases at the University Hospitals of Leicester NHS Trust and first author of the study, said: “We have identified the main risk factors associated with COVID-19 infection among role workers and living with other key workers.Healthcare workers from black ethnic groups in our study were younger, more likely to work in environments such as inpatient care, more likely to see a number more COVID-19 patients and less likely to report having access to appropriate PPE at all times than their white colleagues. They were also more likely to live with other key workers and in more disadvantaged areas.

“All of these factors increase their risk of COVID-19. However, once these factors are taken into account, the difference in risk of infection between black and white healthcare workers was negligible, suggesting that the differences in life occupational and family health workers from ethnic minorities – some of which are linked to inequalities more generally – lead to different infection rates. These important findings should inform policies, including targeted vaccination strategies and health assessments. risks aimed at protecting healthcare workers during future waves of the COVID-19 pandemic. ”

The results are particularly timely, given the emergence of the highly infectious Omicron variant of the coronavirus, which may be better able to evade vaccination-induced protection against infection, which could lead to more numbers. high number of healthcare workers contracting the disease.

The authors acknowledge that the study has limitations, such as the potential for self-selection bias, meaning that healthcare workers might be more inclined to complete the survey if they felt they were running greater risk of infection, for example. However, the study is the largest and most detailed to date, focusing specifically on the risks to healthcare workers. The sample of 10,772 people is broadly representative of the NHS workforce, albeit with fewer support staff, and the infection rates reported in the study are consistent with those reported in other studies British.

The results were posted on MedRxiv as a pre-print, meaning the results have yet to be peer reviewed.

Long-term COVID impact on ethnic minority healthcare workers investigated

More information:
Christopher A. Martin et al, Predictors of SARS-CoV-2 infection in a multiethnic cohort of UK healthcare workers: a nationwide prospective cohort study (UK-REACH), ( 2021). DOI: 10.1101 / 2021.12.16.21267934

Provided by University College London

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