A rapid literature review on inequalities and ethnicity in healthcare workers’ experiences of delivering care during the COVID-19 pandemic

A rapid literature review was conducted regarding inequalities faced by frontline BAME healthcare workers (HCWs) responding to the COVID-19 pandemic within the United Kingdom. A number of key themes and sub-themes were identified within the literature. Firstly, in relation to viral exposure. BAME HCWs are more likely to be exposed to COVID-19 on account of: frontline prevalence (driven by pre-existing systemic racism pre-pandemic, disproportionate redeployment and location of redeployment compared to White counterparts); complications with Personal Protective Equipment (PPE) (driven by lack of access, training and fit-testing compared to White counterparts); and, being afraid to speak up in a ‘bully’ culture (redeployment and PPE access worse for minoritized groups due to lack of ability to say ‘no’, fearful of repercussions). Secondly, in relation to emotional impact. BAME HCWs may experience heightened and unique emotional strain on account of: increased anxiety (due to their increased mortality risk, a greater ‘tear’ between personal risk and sense of duty, and through risk posed to family due to intergenerational living); and, due to racial abuse (experience of racially motivated verbal abuse from patients or patient families, and in some instances even peers, can dramatically change experience of providing care). There is a clear wealth of evidence which exemplifies inequalities in BAME HCWs’ experiences of care provision during COVID-19. Steps should be taken not only to prioritise physical BAME HCWs’ wellbeing but also their emotional and mental health needs. There is greater need for primary research, in particular qualitative data to narrate and capture the lived experiences of BAME HCWs during this pandemic.