UK didn’t consider structural racism in pandemic planning, documents reveal

The UK government did not adequately consider health inequalities like structural racism in its emergency planning before the pandemic, leading scientists have found.

Speaking to the Covid-19 inquiry in London, Michael Marmot and Clare Bambra found that almost no emergency planning reports referred to health inequalities, with “certainly no mention of any of the causes of the health inequalities” such as structural racism.

The two leading epidemiologists speaking on Friday reviewed material generated by several government emergency exercises – including Exercise Cygnus from 2016, which intended to simulate a flu outbreak – to see whether these considered the impact of health inequalities.

It found no mentions of deprivation or other community characteristics, for example, “ethnic composition”.

“It is not discussed at all,” said Bambra, who is professor of public health at Newcastle University.

The inquiry had asked the two scientists to address the following question: “Did the specialist structures concerned with risk management and civil emergency planning allow for the proper consideration of structural racism and its impact?”

They found that the government’s consideration of this was absent from the multiple documents it reviewed.

“With some exceptions,” the scientists’ report found, the UK’s emergency planning “did not properly consider societal economic and health impact, in light of pre-existing inequalities”.

Bambra and Marmot – who is professor of epidemiology and public health at University College London – also concluded that the UK government, devolved government and public health bodies “did not systematically or comprehensively assess pre-existing social and economic inequalities and the vulnerabilities of different groups” during emergency planning before the pandemic.

During the pandemic, Black and Brown people were disproportionately impacted by coronavirus: they were more likely to be working in frontline jobs and living in cramped conditions, with higher levels of deprivation and worse health.

Belly Mujinga, a 47-year-old Congolese-born railway worker, died from a combination of coronavirus and a respiratory disease after she was spat on during a shift, despite requesting to be taken off frontline duties due to her clinical vulnerability.

Bambra told the inquiry that even with better data collection on racial disparities, it would be unlikely the government would have considered this in its emergency planning.

“I think if we had had [better data] with the caveats that I've outlined, then we certainly would have had more knowledge of who was most likely to be impacted,” said Bambra. “However, because of looking at the planning documents, I'm not sure that would have been taken into account in planning even if we had to have such a robust data capture system.”

Bamba and Marmot are amongst a selection of expert and civil servant witnesses speaking during the first module of the Covid-19 inquiry, which is seeking to explore the UK’s preparedness for the pandemic.

Next week will see former prime minister David Cameron, former chancellor George Osborne, current chancellor and former health secretary Jeremy Hunt, and other ministers give evidence during the inquiry.

The inquiry continues.