Back in June 2020, research published by the University of Edinburgh found that south Asians are more likely to die from Coronavirus, than any other ethnicity.

The study on different ethnicities and their outcomes observed a cohort of 35,000 patients in 260 hospitals across England, Scotland and Wales, from February to May 2020, and found that, after being admitted to hospital for Covid19, the ethnic group were 20% more likely to die than white people. In particular, people of Bangladeshi ethnicity had around twice the risk of death than people of White British ethnicity. Furthermore, in an Office of National Statistics analysis of death certificates where Coronavirus was mentioned, from April to May 2020, it was found that Bangladeshi and Pakistani men were 1.8 times more likely to have a COVID-19-related death than white men. For women the figure was 1.6 times more likely.

With something like a global pandemic, it’s hard to compare how it has effected one group of people over another. After all, all around the world people have suffered from the virus and all around the world people have died from it. But as these statistics prove, in the UK, as in many other western countries, ethnic minorities have seen some of the highest infection and death rates. But it’s not entirely clear why.

This heightened risk of death for south Asians, found by the University of Edinburgh was thought to be partly because of the higher incidence of diabetes: south Asians are six times more likely than Europeans to develop type 2 diabetes. And research in conjunction between Diabetes UK and the University of Glasgow found that some contributing factors to this increased risk of diabetes could be a slower rate of fat metabolism, a culturally rich diet and typically low levels of exercise. And unfortunately, diabetes both increases the risk of infection and damages the body’s organs, making it harder to survive the Coronavirus.

However a number of other studies have identified other factors that could be contributing to the higher covid-related statistics found in the British south Asian communities. OpenSafely, a secure analytics platform for electronic health records in the NHS, created to deliver urgent results during the pandemic, facilitated a study between the London School of Hygiene and Tropical Medicine, the University of Oxford, TPP - a healthcare software company and the Intensive Care National Audit and Research Centre (ICNARC).

This collaboration looked at the factors associated with COVID-19-related hospital deaths in the linked electronic health records of 17 million adult NHS patients and found that those living in the most deprived areas are at around double the risk of death compared to those from the least deprived areas. UK government data collection in 2019, saw that most ethnic minority groups were more likely than White British people to live in the most overall deprived 10% of neighbourhoods in England.

There has also been a higher prevalence of cases in densely populated urban areas like London and Birmingham, both of which have large south Asian populations. In London, for example, the second largest ethnicity is Asian at 18.5%. South Asians also typically live in large, mixed and intergenerational households, where school children who can be easy carriers co-exist with elderly, and therefore vulnerable, members of the family.

Huge numbers of BAME individuals also work as frontline staff in the health sector and as key workers working in transport and delivery, as taxi drivers and as security guards and are therefore more exposed to the virus. Migrant individuals may also struggle to have access to healthcare.

But, OpenSafely, also found that adjusting for cardiometabolic factors like diabetes, socioeconomic considerations like home type and overcrowding and behavioural factors like smoking had little effect on the results. This means that the higher risk of death from Covid19, in south Asians is only partially explained by factors like the individual’s environment and pre-existing health conditions. The remaining part of the difference has not yet been explained.

Beyond health, the pandemic has resulted, perhaps unsurprisingly, in a rise in xenophobia and racism towards south Asians. This was particularly true in the summer of 2020 when certain parts of the north were put into lockdown just before Eid. Many south Asians and Muslims in particular suffered verbal racist attacks and slurs after being scapegoated for the rise in cases.

In fact on August 22nd of last year, which is the International Day Commemorating the Victims of Violence Based on Religious Belief, UN Secretary-General António Guterres said, that the pandemic has been accompanied by “a surge in stigma and racist discourse vilifying communities, spreading vile stereotypes and assigning blame.” There have also been cases of subconscious bias in the media, where images of Muslims and mosques have been used in articles about Coronavirus, further perpetuating negative stereotypes.

https://twitter.com/TheMuslimGuy/status/1238855208798760960

https://twitter.com/aayoub/status/1238662513086128128

One area of work that is markedly unique for south Asians and that has seen significant changes this year is the south Asian wedding industry in the UK. South Asians around the world are known to have large, loud and long festivities to celebrate weddings and often, many are expensive and elaborate affairs. But this year, more south Asian couples have chosen to postpone their weddings rather than cancel them altogether.

South Asian wedding planner Jyoti says that of those who have postponed their wedding, many have chosen to do away with the traditional ceremony and instead just have a civil service and postpone the reception until later because they have already bought a house together and need to begin their lives together.

Postponement has worked better for vendors too, who Jyoti says, have been very accommodating. In fact, she says, “even pre-Covid, I asked all couples to get wedding insurance. Those that did have seen their price held and most vendors have kindly offered new dates.” This is despite the pandemic not being covered by insurance because it is classed as a natural disaster. “I work on a deposit basis and by now most of the payment would be due but even I’ve had to hold it and extent time because you can’t expect people to pay the full amount now,” she says.

Having been a wedding planner for twenty years now, Jyoti has noticed that before, it was almost always the parents of the couple who paid for the wedding but now she says, the spending power is with the couples themselves who have saved up a lot for their big day. “It’s heartbreaking,” she says. “Most south Asian weddings don’t have an RSVP and today it’s really difficult to account for extended family members and the elderly in particular. For the larger weddings, they charge for the numbers, so this uncertainty can add more pressure on couples.” Still, she says, “because south Asian weddings are more about the family, cancelled weddings can be really difficult for parents even when the couple are ready to walk away.”

But she notes, “some individual suppliers and sole traders are surviving on this and if couples start cancelling on this, then they suffer greatly. It’s a very dark industry at the moment; it’s put the shutters down on people and many have had to re-train.” Jyoti believes the government simply haven’t done enough. In fact, she says, the wedding industry is the part of the hospitality industry that’s been completely ignored. As a sole trader, she’s thankful therefore, for her day job in the NHS.

“In the future I can see smaller weddings,” she says. “I think its the parents that say we didn’t invite so-and-so and Covid has given couples the courage to say no we want something small so we can save for things like a house and honeymoon but the big blowout wedding will not change until the next generation become parents.” For now she’s advising couples that want large destination weddings not to put deposits down. “You can fight not getting your money back here but not abroad.”

Communicating clearly, like Jyoti does, is especially necessary during the pandemic for the south Asian community which is considered one of the ‘hard to reach’ groups by the government. Misinformation has been rampant, especially over Whatsapp, about the way the virus spreads, the severity of the infection and the necessity of precautions like wearing a mask to cover both the nose and mouth, and not just the mouth. In particular, there has been significant misinformation and lack of understanding over the vaccine and how it works.

Dinesh Sejpal, is an elderly, deaf south Asian man who has experienced some of the worst misinformation. “I worry about the Coronavirus vaccine because it might have meat in it,” he says. “I didn’t have much information and spoke to people about it and then I saw on BBC with an interpreter, news about the vaccine but it wasn’t enough information and I wanted more so I can be more clear.”

He has many concerns. “I’m vegetarian so that’s how my body is, does that mean the vaccine [if not vegetarian] will affect me differently?” he asks. “I also think that the person who takes the vaccine can die because I’m not sure if it works or not,” he says. And because of how widespread the misinformation within the community is, when he tried seeking help, he got varied responses. “First I received a message from my brother and he told me the vaccine is not vegetarian and then I texted my friend’s daughter and she said that’s rubbish so now I’m confused.”

He hasn’t received any information from the government. As a deaf person, he says, “I need a letter to explain how the vaccine works and if its vegetarian or not and how long it will last. I need facts. The interpreter on TV is not giving facts, its just talk. I even went to the GP to ask for information and they didn’t give me any. For me it’s important to have the facts, even if it’s just basic details because if I have that then I will be satisfied,” he pleads.

For now he says, all he can do is ask friends who’ve had the vaccine, try asking his GP again and ask other deaf people. “Its difficult being deaf,” he says. “because people who are not deaf can make a phone call and get information but we can’t”.

As was the case for everyone, festivals were deeply affected too. Diwali, for example, was markedly different. For 27-year old Londoner Saahil Lakhani “it was strange because normally we would go to my aunt’s and have a massive puja which she would lead followed by a large meal and there would be 25 to 30 of us. This year we did a zoom call, and she showed the puja online. She still made the full dinner, we just all went round and picked it up and ate it at home in our own time so [the celebration] really only lasted about half an hour.”

But like most people he understands why it had to happen. “I wouldn’t say fair was the right word because I don’t think it was unfair - it was circumstantial. I don’t think lockdown was strictly necessary because of the economy and mental health but I don’t think the government thought about those things and considered Diwali. I think they were just unprepared.” In this unpreparedness, religious institutions like temples and mosques have tried to step in and help their local communities. For Dr Al Duabayan, the Director General of London Central Mosque in Regent’s Park, this was providing food to the poor.

One of the central pillars of Islam, is the giving of charity and is known Zakat. “We collected this and sent it to organisations helping the poor. We asked people to speak to us online about their issues and then we sent them relief,” Dr Al Duabayan said. “During Ramadan and especially after Eid, people donate to help so we focused on giving food to poor people and old people.”

“We also started collaborating with a food bank in Westminster and we sent food baskets and meals to people’s homes, enough for one week. This year we reached many Muslims and non-Muslims because this pandemic is a general issue that has affected everybody so it is our duty as a charity to help everybody. We extended our hand as this is what Islam asks us to do,” he explained.

But it hasn’t been easy. “The hardest thing was to close the mosque because the London Central Mosque hasn’t been closed since 1964. It was so hard on our hearts to close prayers and when we announced this to people, they had tears in their eyes,” he said. “Psychologically it was so hard but we had to explain to people that it’s dangerous and that Allah doesn’t want us to harm our lives."

The mosque in Regent’s Park by Asim Saleem under CC by 3.0

“When we wanted to close many people asked us if we’re sure because they thought it was fake. But I said if it’s fake, why would the government ask everything to close? We have to follow the rules and regulations and then after one week when people started to see the news and see that people were dying they realised that we have to take it seriously.”

He acknowledges though that “it’s no wonder that people resisted initially because few living people have gone through this so it’s a new experience. That’s why some people didn’t follow the regulations so we had to monitor them and advise them to wear a mask when they came and use hand sanitiser and bring their own prayer mat. If you continue to be strict, then people will start to follow.”

Although the mosque, just like everyone else, struggled to move everything online, Dr Al Duabayan worries that some of the smaller mosques around the country, may not have been able to do so because they lacked the manpower. Today all of the mosque’s classes and seminars have moved online and they now have 12,000 students. Like most religious institutions, “we’ve asked people to take the opportunity where they can and do their prayers and religious activities at home,” he says.

“I believe in one principle,” Dr Al Duabayan says. “If everybody shares and does the best in their area, things will improve. The pandemic has also shown us that we are all connected. In hard times like this we should help each other.”

How has the pandemic affected the south Asian community in the UK?

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