**1. Introduction**

The Corona virus (COVID-19) was declared a pandemic by the WHO in March 2020. COVID-19 and its subsequent variants (mainly Delta & Omicron) spread exponentially across the World and globally infected over 375 million people with 5.7 million deaths as on 31st January 2022 [1]. COVID-19 has affected some population groups and countries much more than others in terms of infection rate, hospitalisation admissions and discharge, and premature mortality. Globally, the seventh highest deaths due to COVID-19 (>155,000) has been experienced by the

UK; however, in terms of fatality rate per million population the UK ranks at 30th. Both government statistics and media in the UK has pinpointed that the Pandemic has had wider and differential impacts on people from low socio-economic status and those having minority ethnic/cultural background. One in five people in the UK belongs to Black, Asia and Ethnic Minorities (BAME) groups; and they are in majority in London and Birmingham, followed by high concentration in Manchester, Leeds and some other major cities of the England.

According to the report released by the Public Health England on 2nd June 2020 [2], the COVID-19 diagnosis rate, admission to Intensive Care Units and resultant deaths are disproportionately higher among BAME. Age-standardised certified deaths rate due to Coronavirus was more than four times for Black and three times for Asian people when compared with their White British counterparts during the 1st Wave (beginning with 23rd March 2020 Lockdown). There is very limited official release of evidence to explain underlying reasons for such massive differentials in infection, hospitalisation and fatality rates across ethnic and socio-economic groups and resultant health and wellbeing inequalities emerged due to coronavirus pandemic.

This paper explores underlying reasons of differential impacts of COVID-19 on BAME's health and wellbeing. These include demographics, socioeconomic condition, health estate and long-term conditions, as well as diet and lifestyle factors. BAME people have much higher prevalence of long-term conditions/diseases, obesity, low level of health literacy, and living in most deprivation areas and above all working in low-paid occupations. These factors are pivotal in order to plan for short- and long-term impact mitigation strategies as well as to recoup BAME peoples' health and quality of life they enjoyed before the pandemic. The paper also highlights health inequalities for BAME community through two case studies depicting how the Pandemic affected their specialist health services (organ transplants) and how much and type of BAME nursing and allied staff have faced racism whilst working for the National Health Services (NHS) before and during the Pandemic. explores.

#### **2. Underlying reasons for differential impact**

In fact, due to high infection and spread rate, the coronavirus has not discriminated in terms of providing differential exposure to people with diverse socioeconomic and ethnic/cultural backgrounds. In principle the BAME people are not disproportionately affected because they are BAME in some kind of biological sense, but because of socio-economic and cultural factors which create conditions whereby they are more likely to be exposed to infection and lack the physiological infrastructure to be able to deal with it as effectively as more privileged people. These multiple disadvantageous factors, which triggered and became outrageous when BAME people got exposed to coronavirus, are related at their underlying health issues; lack of physical activity; deprived living conditions; poor hygiene practices; and being engaged in high-risk occupations including low-paid gig sector.

To begin with, the most critical one is the low immunity levels among BAME people to fight against the infection due to unbalanced diet lacking micronutrients, widespread prevalence of anaemia and Vitamin D deficiency prevalence, and predominance of long-term conditions and early onsets of CVD, Type 2 Diabetes and Hypertension (a decade earlier in BAME compared to White British) [3]. COVID-19 affected disproportionately older people and men in the UK [4]; the median age for White British admitted due to coronavirus was above 60 as compared to 55 for BAME people during the 1st Wave. It is found that a majority of BAME people after *Perspective Chapter: Impact of COVID-19 on the Health of Ethnic Minorities in the UK… DOI: http://dx.doi.org/10.5772/intechopen.104871*

reaching age 55 milestone, develop a long-term condition (LTC). Among South Asians it was noticed that by age 55 most of them have been on medications for CVD and diabetes for more than 15 years [3]. The high rate of prevalence of LTCs and medications among BAME people, in turn has reduced their immunity levels and thus are unable to fight against infections (most of them even receive every year free winter flu jab from the NHS thus vouching on the prevalence of low level of immunity).
