When Norwegian public health experts started investigating the history of people infected with the coronavirus, they made a surprising discovery: people born in Somalia have infection rates more than 10 times the national average.
The Scandinavian country has just over 7,500 cases of Covid-19, or 140 per 100,000 people, according to data released Tuesday. But 453 of these cases were part of the relatively small community living in Norway who were born in Somalia, a rate of 1,586 per 100,000.
“You would hear of an uncle who had been hospitalized and that this family was infected,” said Ayan Bashir Sheikh-Mohamed, a Somali-born doctor living in Oslo who was among the first to alert the authorities to the worrying death rate. . “It was like there were a lot of people.”
Norway is far from the only country where people from black and minority ethnic groups (Bame) have been disproportionately affected. Bame people make up around 13% of the UK population, but make up a third of patients with the virus admitted to intensive care units in hospitals. Black Americans make up about 14% of the American population, but 30% of those who have contracted the virus.
Investigations are underway into the reasons why racial minorities are so highly overrepresented among those who suffer from Covid-19, although few expect simple answers. Health experts and academics are currently looking for clues among the multiple medical, socio-economic, behavioral, cultural, environmental and biological factors that may be behind the association between Covid-19 and ethnicity.
“When we started sounding the alarm about four weeks ago, some people thought it was scary,” said Kamlesh Khunti, professor of primary care diabetes and vascular medicine at the University of Leicester in the UK. United. “We now find that over 70% of healthcare professionals who have died in the UK are from Bame backgrounds.”
Similar patterns showing a disproportionate number of victims of Bame virus have appeared in the United States and other European countries with large minority populations, although Professor Khunti said none had as strong evidence as the Kingdom – United on the general ethnic patterns of Covid-19. France, another country with a high proportion of Bame, prohibits the collection of statistics based on ethnicity.
“We in the UK are able to alert the world to what’s going on,” said Professor Khunti.
In the United States, data compiled by the Centers for Disease Control and Prevention is incomplete. But it shows that whites made up 51% of Covid cases of specified race, compared to 74% of the American population.
One of the factors studied is comorbidity. Jerome Adams, American general surgeon of African American descent, warned that the community is at greater risk because of the higher rates of underlying conditions such as diabetes, heart disease and obesity that make people more vulnerable to Covid-19.
African Americans also tend to be poorer and less able to distance themselves socially because of the type of work they do and where they live. Members of minority communities often live more closely together than in the general population, with extended families mixing in overcrowded conditions.
They are also more concentrated in public jobs such as transportation and delivery, as well as in health care and social services, where they risk greater exposure to the virus. “For many reasons, people from Bame backgrounds may find it difficult to maintain social distance,” said Professor Khunti.
Many of the same reasons are likely to explain the high rates of infection in the Somali community in Norway. They are generally poorer and live in close family units. Many work as taxi drivers and could have driven the skiers back from their Alpine holidays, which were behind most of the first cases in Norway.
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Trude Margrete Arnesen, a specialist at the Norwegian Institute of Public Health, noted the added difficulty of being able to provide advice. “Everyone is marinated in news about Covid-19 from morning to night, but not groups that don’t connect to mainstream media,” she said.
Oslo doctor Dr Sheikh-Mohamed admitted that the authorities had made a mistake based solely on written documents which many members of the Somali community could not understand. She and a friend had a YouTube channel they used for Somali public health videos and soon published several on the coronavirus, including one on handwashing that went viral, as well as a hotline.
In recent weeks, the number of infections has started to decrease among Norwegian-Somalis, which has led Dr. Sheikh-Mohamed to view his campaign as a success. “The severity of this disease has really hit people,” she said.
Although genetics has been mentioned as a possible contributing factor that makes certain ethnic groups more susceptible to the virus, this explanation was rejected by Ewan Birney, director of the European Institute of Bioinformatics, which is part of the European Molecular Biology Laboratory.
“After the big obvious differences in co-morbidities and socio-economic status between ethnic groups, genetic effects – which could have some effect between individuals – are very unlikely to contribute to the average effects between groups”, a- he says.
An international research effort is underway to examine the genetic differences that make some people more likely than others to be infected with the virus or to develop severe symptoms.
The British government has also commissioned several studies to investigate Covid-19 in ethnic minorities, but clear reasons have yet to emerge. “Since the first two or three, I haven’t seen much consistency in the analysis,” said Sir Patrick Vallance, the country’s chief scientist at a press conference this week. “I have no explanation. “
Additional reporting by Hannah Kuchler in New York