A new points-based checklist could help keep healthcare workers safe by offering a way to calculate their risk of severe illness or death from Covid-19, researchers have said, stressing its usefulness for workers of black, Asian and ethnic minority heritage.
Covid-19 has been shown in multiple reports to disproportionately affect BAME communities, while in May it was revealed that more than 60% of healthcare workers who have died from Covid-19 were from BAME backgrounds.
Now researchers say they have come up with a simple points-based checklist to help identify healthcare workers most at risk of becoming severely ill or dying if they catch Covid-19; adding such information could flag which staff should be moved to roles with reduced risk of direct contact with Covid-19 positive patients.
The checklist, one of the tools that can be downloaded and printed out from the British Medical Association website, draws on a host of data collected during the Covid-19 outbreak and equates various factors such as age, ethnicity, and health problems with a set number of points: for example being male clocks up one point, and being of black African descent adds two points.
When added together, the final score reveals whether an individual is at low, medium or high risk of becoming severely ill or dying from Covid-19, relative to a white female, aged 40-49 with no co-morbidities.
Dr David Strain of University of Exeter Medical School, who led the work, said employers have a legal obligation to carry out risk assessments, but the tool would also be helpful for employees.
“Because it is an objective, simple tool, you can sit down with a line manager in order to have that conversation about what the right role for you to be working [is or] should you be working,” he said, adding the checklist should be used for all workers in healthcare settings ahead of a second wave of Covid-19 to reduce further loss of life, but could also be used by the wider community beyond the NHS.
Kamlesh Khunti, professor of primary care diabetes and vascular medicine at the University of Leicester, who was not involved in the work, said the new tool is one of many available, and that employers should use such approaches to keep staff safe. However he added a more sophisticated prediction model is soon to be launched by an Oxford-led team, of which he is a member.
Prof Rowland Kao, an expert in infectious disease dynamics at the University of Edinburgh, said the risk factors included in the checklist produced by Strain and colleagues are known to be important. But, he said, the tool has limitations, including the fact it does not look at the risk of an individual becoming infected with coronavirus.
Prof Nishi Chaturvedi, an expert in clinical epidemiology at University College London, also said the tool has drawbacks, including that risks may not be additive and that risk is given relative to that of white, 40-something women.
“The absolute risk of death from C-19 for women in this age group is vanishingly small, even a 4-fold relative risk compared to this group is still a small absolute risk,” she said.
Another problem, Chaturvedi said, is that the tool produces a single number that might give a false sense of precision, erroneously producing alarm or reassurance, when – as the team themselves note – there is a large degree of uncertainty around levels of risk.
“Numbers are incredibly powerful, even those with significant acknowledged uncertainty, and run the risk of overwhelming other considerations,” she said.