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German doctors broach ‘taboo’ subject of Covid toll on minority groups
Anecdotal evidence suggests Muslims over-represented in ICUs, but Germany has no official data
German doctors are reportedly concerned about the large proportion of people from minority ethnic backgrounds among coronavirus patients in intensive care, citing a lack of proper communication with Muslim communities in particular about the dangers of the disease.
Lothar Wieler, the head of the Robert Koch Institute, Germany’s disease control agency, confirmed that the issue was discussed with senior medical consultants last month, though he stressed the meeting was informal.
Wieler has been quoted by German media as saying the topic was “taboo” for the German government, which feared the debate could be seen as racist. He reportedly called it a “huge problem” that had “massive implications” for the government.
Wieler is quoted as saying at the meeting, which took place on 14 February, that he had tried “to approach certain people to discuss it”. He said it was necessary to speak to the heads of religious communities in the hope they could relay the concerns to their congregations.
He is reported to have told the meeting: “These are parallel societies in the heart of our country. If you want to get a message through, it only works with on-the-ground social work in mosques. And we can’t get in there, and that’s bad.”
He is quoted as saying Muslims make up 4.8% of Germany’s population, “but amongst those lying on the intensive care wards, this group makes up considerably more than 50%”.
Muslims make up about 6% of the population. The majority trace their origins to Turkey, while the rest come from Arab countries, followed by the Balkans, Afghanistan and Iran.
There has been very little public debate in Germany about the extent to which people from minority ethnic groups might be affected more by the virus.
The Organisation for Economic Co-operation and Development (OECD) said last autumn that in almost all member countries, people from minority ethnic groups were “systematically overrepresented” in cases of Covid-19 and in resulting deaths.
It said the reasons included poverty, cramped living conditions, more frequent use of public transport, and jobs in which keeping physical distance was impossible, such as in the hotel and catering or meat processing industries.
Germany collects statistics about the number of intensive beds occupied by coronavirus patients, including details of their sex and age, but there is no official statistical data on patients’ ethnic backgrounds. It has not been a topic during regular government briefings with the media, and politicians have been accused of neglecting or downplaying the issue.
A leading pulmonary specialist, Thomas Voshaar, was quoted as having told the German meeting that the large proportion of patients he was seeing with coronavirus in intensive care “shows very clearly that there is obviously a group that politicians are not managing to reach with their coronavirus warnings, who have a migrant background”.
He said a straw poll of intensive care doctors had been carried out by phone that reflected this. According to the poll and anecdotes from the doctors who took part in the telephone conference, 50-90% of the most severely ill patients they were treating were from ethnic minorities. Voshaar said his team had decided to refer to the patients internally as “people with a communication barrier”.
Wieler told the Bild newspaper, which first reported on the conference, that the meeting had not been a “public discussion between experts, but a personal, informal sharing of information”. He said the participants had “not come to any concrete conclusions” but had just “considered ideas”.
The news magazine Focus reported on Wednesday that it had approached intensive care doctors across Germany in the past few days and had found that their experiences widely backed up the concerns discussed at the meeting.
One doctor who wished to remain anonymous told the magazine: “It is the case that patients with an ethnic minority background are hugely overrepresented.” He said it had been especially evident during the second wave of the virus, when “they made up by far the largest proportion of patients who required therapy”.
The German government is expected to announce on Wednesday the next stages in its plan for how the country could emerge from the strict lockdown that has been in place since November.
The government is under huge pressure from businesses, but Angela Merkel has previously insisted the national infection rate must fall below 35 per 100,000 people over a seven-day period – it is currently at 64 – and she is widely expected to announce that the restrictions will stay in place until the end of March.
Germany’s infection rate has been rising steadily in recent days, with the more infectious B117 mutation first detected in the UK now making up about half of all new infections, compared with 6% three weeks ago.
A sluggish vaccine programme – by Wednesday just over 6.6 million people had received one jab, and less than 2% of the population was fully vaccinated – is being seen as a hindrance to any relaxation plans.
