The Response So Far To Those Covid19 Petitions and Letters

You would think they all went to bed, right? All those Covid-19 Petitions and Letters from March 2020?

Its great to know all this gathered a lot of conversation nationwide and perhaps, change is really coming... thanks to all those (especially non BAME friends and colleagues) who went over and above clapping for the NHS, writing personal and public letters via newspapers/change.org/petitions.parliament/to MPs/etc.

A few that I'm aware of (i.e. not exhaustive):

1. NHS frontline workers visas extended so they can focus on fighting coronavirus. 

2. Attempted review of the Immigration Health Surcharge. Unfortunately, the Home Office has vested interest in maintaining the status quo. Oh wait, a U-turn?

3. Inquiry announced into disproportionate impact of coronavirus on BAME communities being led by Prof Kevin Fenton, Public Health Regional Director for London. This will address questions like are there differential impacts on testing, on diagnosis, on severity of the disease and on death?  Are there ethnic variations in the clinical stages of covid-19 and can these variations be explained by other factors (Age, Male gender, co-morbidities like Heart disease, Diabetes, Obesity, Kidney disease, Smoking). 

Result expected end of May? Delayed due to #BlackLivesMatter protests.... Don't #BAMELivesMatter? Released but a whole new conversation on this.

4. A number of trusts identifying BAME staff for risk assessment (vulnerable and at risk) and added to priority list for testing and ensuring they are fit tested for appropriate PPE. Including reassurances.

5. Free automatic visa extension for those working on the frontlines for 1 year with no fee and will not pay Immigration Health Surcharge (for that year).

6. Family members and dependents of "essential front line" staff who die as a result of the coronavirus will be offered Indefinite Leave to Remain. Another U-turn, now extended to low paid workers.

7. Families of health staff who die of covid19 to get £60K payout. (if there is evidence you were at the "frontline"... weird right?). Waiting for a U-turn on this one!

8. NHS warning that BAME staff could be at potentially greater risk and recommendation to Trusts and GP practices for risk assessment of BAME staff.

9. Labour Party announced its own review into coronavirus impact on BAME communities, headed by Baroness Lawrence.

I know there may be a concern by some in enacting issues like "risk assessment" of BAME staff without unconsciously promoting discrimination. 

If done properly, risk assessment should cover:

• thorough and comprehensive (confidential) conversations, 
• identification of underlying health conditions (like Diabetes, Hypertension, Heart Diseases, obesity, etc) and 
• feelings and understandings about safety and mental health.
• the rest like age, sex, disability, pregnancy, living with vulnerable persons.
• possibility of relocation to alternative accommodation for the duration of the pandemic if large vulnerable families. 
• possibility of redeployment to green areas/presumed non-covid areas if staffing can allow.
• possibility of provision of appropriate PPE (FFP3 - not surgical face mask; gowns - not apron; etc)

Jankowski's group has suggested a risk stratification tool. 

This I think is great guidance which can be modified to suit your local trust/practice and staffing needs. It only lacks pregnancy and living with vulnerable people... perhaps omitted on purpose, given the context.