Earlier this week, Public Health England published its report on Disparities in the risk and outcomes of COVID-19. This concluded that BAME groups have a much higher risk of dying if they contract the virus than those in white ethnic groups. People of Bangladeshi ethnicity were most at risk.
The report does not seek to reach a definitive conclusion on the cause, describing the relationship between ethnicity and health as 'complex and likely to be the result of a combination of factors'. But it does say that BAME communities are likely to be at increased risk of infection because they are more likely to live in urban areas, in overcrowded households, in deprived areas and have jobs that expose them to higher risk.
On the question of obesity, the report said it was a risk factor, but that more information was needed to understand the association between this and coronavirus.
Government’s clinically vulnerable group
BAME people are not included in the Government’s clinically vulnerable group which was recently updated to include anyone who is ‘seriously overweight (body mass index (BMI) of 40 or above). Government advice is that anyone in this group should ‘stay at home as much as possible, and, if you do go out, take particular care to minimise contact with others outside your household’. However, NHS guidance also says that this group can go to work if they can't work from home.
- identify what work activity or situations might cause transmission of the virus;
- think about who could be at risk
- decide how likely it is that someone could be exposed
- act to remove the activity or situation, or if this isn’t possible, control the risk.
Each of these steps must be carefully considered and documented. You'll need to separately consider those who are in the vulnerable group and also follow any relevant recommendations set out in sector specific guidance produced by the government and any other relevant approved trade/sector guidance. You may also have to consider how your staff travel to work as part of your overall risk assessment, particularly if they rely on public transport.
You will need to include obesity when considering who may be at risk in your workplace and then undertake individual risk assessments for anyone in that group - particularly as they may have other underlying health conditions that you may not be aware of.
You will need to make sure that your staff are aware of the steps you have taken to protect them. As part of this exercise, you could list the categories of people in the vulnerable group and explain that current advice is that they can return to work (if they can't work from home) and ask them to contact you so that you can consider their individual circumstances before you reach a decision about whether it's safe for them to do so.
We recommend that you include links to the NHS BMI calculator to help your staff determine if they are 'very obese'. Bear in mind that some people who may fall into this category, may be reluctant to talk to you about it. If you believe that a member of staff may be very obese, you may - depending on the nature of their work - ask them to work out their BMI and let you know if it's 40 or above. You'll need to be extremely tactful, but shouldn't shy away from the conversation simply because it a difficult one.
What about BAME groups?
You may need to include BAME groups in your overall risk assessment, particularly if the work undertaken by individuals in this group, potentially, increases their exposure to Covid-19. For example, people working in the transport, health and social care settings will have a much greater exposure to the virus, than say office workers. Therefore, the approach you take will depend on the nature of your business.
By way of example, the NHS Covid-19 Risk Reduction Framework for Health Care Workers includes four subgroups which require individual assessments. One of these is age and ethnicity and includes:
- BME ethnicity aged above 55 particularly in those with comorbidities; and
- White European aged 60 and over
It also includes sex as a category because males are at a higher risk than females - the report found that working age males were twice as likely to die as females. Of course, individuals may fall into more than one category which may increase their overall risk.
Once you have this information, you should put in place any steps to ensure that these individuals can safely return to work. If they can't and can't work from home, you will need to consider other options such as furlough, paid holiday or unpaid leave. However, we recommend that you take advice first because BAME people in particular will be protected under the Equality Act and may argue that your actions - in either forcing them to return to work or stay away from it - may indirectly discriminate against them. You therefore must keep notes to support your decisions as these will be helpful if you do have to justify them.
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