A-Z

Covid-19 in the community

Risk from exposure

In this section we share the concerns that people had about catching Covid that connected to the different ways they were exposed to the virus. Most people we spoke to recognised that some people were more likely to come into contact with Covid than others because of their jobs, gender and their race/ethnicity. The topics we cover are:

  • Recognition of inequality in Covid risk 
  • Risk because of occupation and socioeconomic position 
  • Risk because of race/ethnicity 
  • Risk because of gender 

 
There are a number of different ways that people we spoke to referred to their race and ethnicity. Some used labels like Black, Asian or White. Others used broader categories such as Black and Minority Ethnic (BME) or Black, Asian and Minority Ethnic (BAME). In this section we use the terms that people we spoke to use to describe themselves and others, and we also use the phrase ‘minority ethnic groups’ as a wider category. 

Recognition of inequality and Covid risk 

Some people we spoke to, like Matt, described the virus as having affected everyone equally. Others, like Cat, disagreed and said that the pandemic had actually shown very clearly that we’re not ‘all in this together’. This was because certain types of people were more likely to come into contact with the virus or experience severe complications as a result of illness.

 

Matt described feeling unsettled realising that the virus could affect anyone.

Matt described feeling unsettled realising that the virus could affect anyone.

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We were at a wedding about six weeks ago, got talking to, I’d not met before and it was a man about my age and his son who was 18. And we only worked out part way through the wedding, talking to someone else, his wife wasn’t there because his wife had died of Covid. And it’s almost when you make it, when you meet those. And so, it’s not just people you know well have been effected, it’s almost quite, I don’t know what the right word is, upsetting, disturbing, it has an impact when it’s, I suppose it’s people you think, well, there but for the grace of God go I, you know. It’s that element. People are totally, innocent you know, probably done, probably been washing their hands and doing whatever, they, it reminds you of the indiscriminate nature of it and that’s the thing that’s a little bit unsettling.

 

Cat described how the course of the pandemic had followed the lines of social injustice.

Cat described how the course of the pandemic had followed the lines of social injustice.

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I remember seeing a lot of, especially round by me, like nice little suburbia, people with their kids were doing like chalk drawings on their driveways of like, you know, thank you key workers or you know, rainbows and like we’re all in this together type thing. And then when it comes down to it we’re actually not necessarily as all in this together as we might think, because of all sorts of you know, social injustices and identity issues.

 

Esther felt that the pandemic had shone a light on multiple social inequalities.

Esther felt that the pandemic had shone a light on multiple social inequalities.

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You know, people, you know, like labour rights completely out the window. You know, people having, you know, people have to work because they’ve got to, you know, pay the bills and so, you know, some people don’t have the luxury of working from home. Some people don’t have the luxury of staying safe, you know. And I think that’s, I think that’s what really kind of spoke to me a lot during, during the pandemic is kind of, you know, how can we address these kind of social inequalities, which have really been exposed as a result of, of the pandemic.


 
People described becoming aware of social inequalities in risks of Covid infection from a number of sources: news and media coverage, their own observations on the basis of working in communities and, in healthcare settings, observations of the patients they were seeing.
 
 

Helen is a midwife working in a diverse area and noticed lots of deaths.

Helen is a midwife working in a diverse area and noticed lots of deaths.

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Because we’re in [city], we do quite a few ethnic groups. So we did have a few that were quite poorly and then we had to deliver them and they were sick in, and we’ve got different hospitals, from where maternity is to the main intensive care. So yeah we did have quite a few vulnerable women. But not extensively, the community I live in there was an awful lot of people really poorly and a lot of deaths.

 

Gulsoom saw from her community work that less White people were getting sick with Covid.

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Gulsoom saw from her community work that less White people were getting sick with Covid.

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When I sort of heard that on the news, and we started doing a lot of work in the community. We realised that majority of the people that were getting taken into hospital were from a BAME ethnic background. So black, African, Pakistani, Bangladeshi, whatever but from the BAME community and not many white people were getting Covid and, even if they were getting Covid, they weren’t… getting taken into intensive care and weren’t really dying with Covid.


 
As described in ‘Sources of information about Covid-19’, many people said that they did not trust the government or the mainstream news. They disputed how social inequalities were being presented. For example, Emma felt that government messages about racial/ethnic inequalities related to the pandemic were being presented in ways that suggested that minority ethnic groups were responsible for the spread of the virus. She felt that news about social inequalities in the Covid-19 pandemic was therefore stigmatising.
 
 

Shirin and Mohammed said that BME people were being blamed for spreading Covid.

Shirin and Mohammed said that BME people were being blamed for spreading Covid.

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You remember they were really saying that black and minority Asian, but black and Asian and minority ethnic people are more at risk from Covid. What did you make sense of that then?
 
Shirin: I thought that was very negative. I don’t know why they had to say that in the news because you know like people.
 
Mohammed: Really scared and afraid.
 
Shirin: Not so afraid, it’s about you giving the wrong impression to other communities that we are more affected that shouldn’t be highlighted. That should be hidden agenda, confidential, isn’t it.
 
Mohammed: Yes, this was exaggerated. They’re not telling the true picture. Blaming the BME people. But Covid does not choose who is going to catch the disease [laughs].
 
Shirin: It’s for everybody. You can get it, anybody. It’s not like BME.
 

 


 
People described particular awareness of differences in risk due to:

  • Occupation (job) and socioeconomic* position
  • Race/ethnicity
  • Gender

Risk due to occupation and socio-economic position

As described in the section ‘Employment and Covid-19’, many people we spoke with worked in jobs that could not be carried out from home. People in keyworker occupations, especially those in health and social care, but also in other sectors, described fear about catching Covid through contact the public. Particularly in the early stages of the pandemic, their fears were increased due to a lack of appropriate PPE. 

 

Emdad describes wearing a mask to protect himself while working in public transport, but is aware of the risks faced by keyworkers.

Emdad describes wearing a mask to protect himself while working in public transport, but is aware of the risks faced by keyworkers.

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I had to continue my job because I am working at like another front worker, front line worker so I have to go but worried about myself that I have to go, if I can get the virus or not but I try to wear the mask all the time but it’s still so many closest thing like I followed, still I had like a positive like in December during the second wave.

 

And a bus driver died, thirty six around, bus driver died because of the Covid because they came to work. If they don’t come to work, they stay home, they not die because of our job, nature of our job. If it’s like, you know, the war time or something, you had to go to do our job because we need to run the service otherwise how people move from one place to another place. This is like backbone. [The transport system] is like a running service and like a backbone of the [city]. If they don’t run the service, no one can move from here to there.

 

Tun is a surgeon and felt unprotected by inadequate PPE.

Tun is a surgeon and felt unprotected by inadequate PPE.

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I think from just following the guidelines back then in terms of the personal protection of PPE, but I’ve been advised by my other colleagues that, you know, we are that we’re not really being provided enough or optimum PPE compared to the WHO guideline and back then it was just a simple face mask and a plastic apron and I kind of followed that precaution and also attended the training sessions in terms of what to do and how to wear the equipment and how to tick them off and from, in terms of what I tend to do differently is perhaps because I was leading the ward round, I was trying to minimise patient contact to my other colleagues so I tried to be, you know, be the only one who is in contact with patients and my other junior colleagues who did not need to be there, I kind of, you know, make sure that they are not with me when I see the patients but they’re more at a distance in terms of recording the outcome of the ward interaction with the patients so I did all the precautions. Having said that, even before I went to my on call my other colleagues from a different hospital mentioned that I should be wearing the FFP3 mask, which is the, you know, the highest protection but at, at that stage that wasn’t really the recommendation and I just continued with the normal face mask.


 
Alongside providing their workers with PPE, some employers were proactive in considering the different risks faced by their workers and considering other adaptations to their job roles.
 
 

Christina manages a care home and describes some staff feeling vulnerable even with risk assessment procedures put in place to protect workers.

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Christina manages a care home and describes some staff feeling vulnerable even with risk assessment procedures put in place to protect workers.

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We put in place risk assessments for every everybody whether they were from ethnic backgrounds and you know, we went through everything that we could possibly do to keep them as safe as we could do but, obviously, it was with a caveat because I had a couple of care leaders that had to take medication round and I couldn’t avoid for them to go into the bedrooms where residents were positive. And I did say to them, I said, “I will do everything within my power to keep you as safe as I can but it is also your own responsibility. You know, I can’t mother everybody and we have the protection in place in order for you to stay as safe as we can possibly make you.” Luckily, those people, they were very understanding. They were very okay to do their job and to continue to do their job and, because of that support from them, they were able to talk to the other minority groups within the home and let them know that, you know, “This is what we’re having to do. Again, if you take responsibility for your own self and safety by using all the procedures that we’ve got, you should be safe.” And I believe that all of those that did follow all of the right procedures, certainly my two, the two care leaders, they were both safe throughout so.


 
People in less secure jobs, such as those working on ‘zero hours contracts’, felt they had to carry on working for economic reasons, even if this work involved lots of contact with the public. Mudasar described how his family were worried about his exposure to Covid as a taxi-driver and encouraged him to stop working, but how he needed to keep the family financially afloat.
 
 

Mudasar describes working as a ‘do or die situation’ because of his financial situation.

Mudasar describes working as a ‘do or die situation’ because of his financial situation.

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My sisters, everyone keep phoning me, finding out how am I doing every day. Still telling them, “Still sick, still sick.” Blah blah blah. So they was telling me, “We told you don’t go to work. Stay home.” But, at the same time, “You need to work. You need to pay your bills.” The government is saying stay home. Okay, I said, okay, I’d rather stay home. It’s no problem but I’ve got so many bills to pay. I got my rent to pay. Who’s going to cover my cost? So it’s not easy to stay home. Unless you’re financially well off, you can’t stay home. You have to, it’s a do or die situation [laughs].

 

Risk due to race/ethnicity

Most people we spoke with were aware of the additional risks faced by minority ethnic groups. Because of this, some White people expressed awareness of their relative privilege.
 

 

Genevieve describes feeling relatively fortunate facing infection as a White person.

Genevieve describes feeling relatively fortunate facing infection as a White person.

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It wasn’t really worrying for us. We, we knew that we were, you know, in the fortunate white background where our kids were probably gonna be fine with it so yeah it wasn’t, it wasn’t really a concern if the children caught it.


 
Whereas White people tended to focus on their occupational risks, people from minority ethnic groups described a sense of how any occupational or socioeconomic risks they faced connected with their racial/ethnic identity. Surindar noticed that the people she saw continuing to do public-facing work during the pandemic were all Black. Miura connected her risk as a Black woman to her job which, because of racialised discrimination against her overseas qualifications, was in low-paid social care.
 
 

Surindar noticed how the keyworkers who were facing most risk from Covid were all minorities.

Surindar noticed how the keyworkers who were facing most risk from Covid were all minorities.

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I, every time I go into Sainsbury’s or any other supermarket I notice it. I look at the people who are stacking the shelves. I look at the people who are on the tills. They’re all minorities. Very rarely do you get an indigenous person here. They’re all, literally they are you know, you see them and the guys are bringing in truckloads of stuff and people stacking the shelves. And bus drivers, I don’t think I’ve seen a bus driver, white bus driver here. That, it’s a job they do.


 
People we spoke to also recognised that some of the vulnerability to Covid minority ethnic groups faced was because of more of them lived in urban areas and sometimes in overcrowded and multi-generational housing.
 
 

Mr Eshaan wondered how much of the risk faced by minority ethnic communities was because they lived in areas hard-hit by Covid.

Mr Eshaan wondered how much of the risk faced by minority ethnic communities was because they lived in areas hard-hit by Covid.

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I think we got to be careful there because sometimes you be because they are concentrated in one area. It might not be, it might not be a direct discrimination itself, you know, it could be because they’re all clustered together in one area, you know, as opposed to them being not looked at, but if it was in more than others, you know. Obviously the people researching it and monitoring those numbers would see what happened there.

 

 

Abdul saw multi-generational housing as an important source of Covid risk in minority ethnic communities.

Abdul saw multi-generational housing as an important source of Covid risk in minority ethnic communities.

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I think we have a lot of different generations living within one property, whereas you probably won’t see that in the more Caucasian aspect. Where you know, in some houses you’d have sort of the grandparents, the parents, the kids, and possibly even the grandkids, all under one roof. Which probably makes it much more easier for the virus to pass especially between people. Whereas if you think from most Caucasian families, you’d probably have you know the mum and dad living in one house, the grandparents in another, kids in another with their kids. So, so it’s three different houses so you know for a fact it’s not going to pass, whereas as soon as one person gets it in that in that household it tends to spread like wildfire.


 
As described in the section ‘Fears about being admitted to hospital’, some people we spoke to suspected that racial discrimination in healthcare settings was why there were more deaths among minority ethnic communities. They felt this was made worse because family members were not allowed to accompany patients to translate or advocate for their needs (this expectation of racial discrimination was also reflected in vaccine hesitancy, see ‘Vaccination’). Claudia also suspected that people from minority ethnic communities not following social distancing rules was a cause of greater Covid risk. Many people echoed this talk about less strict rule-following, although others, such as Fahmida, disagreed strongly.
 
 

Claudia said that fear of racial discrimination in healthcare stopped people from minority ethnic groups from seeking help.

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Claudia said that fear of racial discrimination in healthcare stopped people from minority ethnic groups from seeking help.

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I think there is, I think we’ve got a long way to go in terms of educating Black and Asian people about their health and wellbeing and when to go and seek and get help, you know and I think because of, I don’t, I can’t, I can’t say why that is. I do know that from my previous career in terms of mental health you’d often hear that, you know, Black and minority ethnics were, ethnics are treated with, more severely with medication and things like that but parts of me has to wonder, ‘do they, are they seeking help and support at the beginning of noticing symptoms?’ and I suspect, my theory is I suspect not. So, by the time they enter the healthcare system they’re in crisis, you know, in terms of physical health and mental health. If they either listen to somebody or won’t seek support, you know, I think there’s a lot of education that’s still needed but the healthcare is there and it’s there for everybody.

 

Fahmida disagreed that a lack of social distancing was a cause of minority ethnic groups being hard hit by Covid.

Fahmida disagreed that a lack of social distancing was a cause of minority ethnic groups being hard hit by Covid.

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Yeah, lots of, but people like Asian people are very careful, some people said, “Oh Asian people go there, oh they went to their friends house or sister house” but they’re not. I think in my area is I like nearly six or seven months my friend are not coming to my house. We are not going to their house we just sitting outside because we are very careful. We just go for shopping in Tesco or grocery shopping, but we are careful, but some people because is, sometimes they got from their husband because their husband going to work or like restaurant or some, lots of people taking from that another place to home.


 
Many people we spoke to offered biological explanations of racial/ethnic differences in Covid risk. They thought differences were because of genes or not having enough Vitamin D. Again however, other people we spoke to challenged these explanations and highlighted the broader social inequalities faced by people from minority ethnic groups.
 
 

Goutam thought that genetics played a big role in racial/ethnic differences in Covid risk.

Goutam thought that genetics played a big role in racial/ethnic differences in Covid risk.

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Obviously the gene sequences are different, you know, like in ethnic minority whether it’s because black or its different in a white man and a white woman as well and whether that plays a part that must have some part really because when you see the news there was a lot of like, you know, black men and women passed away and a lot of Asian men and women as well and I think something must be I, in that which is more attractive or some way it impacts the Covid virus really and compared to a white man or woman’s genes like in some way, so that, there must be a sequence of these or something in the body which is more kind of like, you know, it’s more towards like more prone to this like I think minority people are compared to other people.

 

Gertrude thought Vitamin D had a role in why ethnic minorities were more affected by Covid.

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Gertrude thought Vitamin D had a role in why ethnic minorities were more affected by Covid.

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After Covid I did go and check them, they were very low, very, very low and so I had to load myself on Vitamin D and I would say especially ethnic minority people who don’t like taking tablets like that, taking supplements and all they’d rather just go, and I think that is one of the reasons why ethnic minority, we suffered more from Covid because of Vitamin D levels so that has to do, it strengthens your immunity if your Vitamin D levels are good so when it comes to you it would be like ahh that was the bad flu, when yours lower like mine were oh yeah [laughs].

 

Milembe wondered why more Black people were dying in the UK than in African countries.

Milembe wondered why more Black people were dying in the UK than in African countries.

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So, I, you know, I just, I was just following up and asking myself questions. “Is it, why is it worse for the black? Is it because of the sheer skin, what is it anything else because that does this virus doesn’t like, black?” You know, you just felt like, “oh this black people, they have to get it worse for everything, you know, you get discriminated for, you know, just being the shade, even the virus does that” [laughs].
 
I felt like, “mm?” I’ve never felt like being black was such an issue until, until the virus came [laughs]. I was like, “even the virus doesn’t like you” [laughs]. So that, yeah that was quite interesting but I try to follow it up in a, looking at it in a scientific way and that was, “Why black? Is it just because of being black? Is there anything else apart from being black? What are the other factors that are perhaps unlikely to be impacting the black and then the virus makes is just, you know, a like, a catalyst to that?” or so I started thinking obviously I didn’t have the answers but I was just rejecting it can’t just be just because you’re black?

And then I started comparing because the virus went on to hit the African where, you know, where the population is all black and then “how come it doesn’t, they don’t, they’re not dying at the same rate as we feel in here?”.

 

 

Risk due to gender norms

A minority of people we spoke to thought that gender norms led to differences in Covid risks. Similar to what people said about race/ethnicity, some people talked about gender norms connected with occupational risks, in that people working in low-paid social care roles were often women facing job market discrimination.
 

 

Miura saw similarities between the discrimination faced by older women and migrants in access to good jobs.

Miura saw similarities between the discrimination faced by older women and migrants in access to good jobs.

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In my service, the majority of my colleagues are Scottish. The majority. But they are Scottish and a middle age, okay. Okay, maybe people who did not have access to a higher education. People who are not from a higher class of course they are from a low income class and majority of them you can see that they are from the area [place names] and in [City] like East End. None of them are from West End [laughs]. Or you know like, I don’t know I think there is a relationship you know between the job that they do and their class let’s say like in the society and their age as well because majority of them were like 40 and above. And then, no I would say majority is 50 and above. Yeah 50 and above and now doing this job you know. And they have been doing it for life like they are going to retire in this job and I feel like the youngest person in there. But yeah it’s either people like that in this Scottish category or migrant people.


 
As well as in the job market, where women are disproportionately found in paid care roles, some highlighted how gender norms surrounding the provision of informal care within households would lead to women doing more caring for others when they were ill and saw this as responsible for gender differences in the risk of long Covid. Sindhu reflected on how mothers of young children ask for less help from other people.
 
 

Susanne saw women’s informal care responsibilities as contributing to their risk of Long Covid.

Susanne saw women’s informal care responsibilities as contributing to their risk of Long Covid.

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Long Covid is it because, you know, when somebody starts Covid they are, they’ve got a kind of long Covid strain or is it because they’ve got Covid and sadly then they’ve, life’s been busy, they’re looking after family whatever, you know, they haven’t had the time to rest. I think more women are prone to long Covid than men, you know, women to be honest are much more likely to care aren’t they for their family and put their energy into that rather than looking after their selves. That’s a generalisation but it’s often the way isn’t it.


 
* Socioeconomic: The position or status of a person or group in a society as defined by a combination of social and economic factors that affect access to education and other resources important to a person’s upward mobility.

 

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