When Amer Awan's father died of coronavirus, mourners congregated with little thought of social distancing. But cultural practices alone do not explain why Britain's ethnic minorities have been hardest hit by the outbreak.
"Visitors to the house were not wearing any masks or not wearing gloves. They wanted to hug me," the 44-year-old property developer from Birmingham, in central England, told AFP. "And I said, no, I'm sorry, I'm not gonna hug you. You know, you need to understand I've just lost my dad because of coronavirus and you are not taking this seriously."
His experience of the death of his father, Nazir, who moved here from Pakistan 56 years ago, makes him fear his community remains at risk of the deadly outbreak of COVID-19. Britain's black and minority ethnic communities appear to have been hardest hit by the virus sweeping the country.
Despite only making up 14 percent of the population of England and Wales, they represent a third of the patients in intensive care with coronavirus, according to the Intensive Care National Audit and Research Centre (ICNARC).
Chaand Nagpaul, head of the British Medical Association, said this was "extremely disturbing and worrying". "We have heard the virus does not discriminate between individuals, but there's no doubt there appears to be a manifest disproportionate severity of infection in BAME people and doctors," he told The Guardian newspaper.
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The first ten doctors who died with coronavirus in Britain were from ethnic minorities, including Alfa Sa'adu, Jitendra Rathod, Mohamed Sami Shousha and Syed Haider. In a letter to the government, several opposition Labour MPs said deaths represented "serious concerns" and called for an urgent investigation.
Sunder Katwala, the head of thinktank British Future, also said that a large number of Filippino nurses, hospital porters and other staff had been affected by coronavirus. "Tragically, a disproportionate number of those in the NHS who died are people who came to make their lives here and to work in the NHS," Health Secretary Matt Hancock said in a recent press conference.
'Viewed as outsiders'
Non-British staff make up 12 percent of the UK healthcare workforce, according to the Office for National Statistics (ONS). In London, the epicentre of the coronavirus outbreak in Britain, this rises to 23 percent.
Two nurses hailed by Prime Minister Boris Johnson following his admission to a London hospital with coronavirus were from overseas -- one from New Zealand, the other from Portugal.
But the letter from the Labour MPs suggested that "ethnic minority doctors have too often struggled for equal treatment" -- and says the fact they were among the first NHS deaths is "not a coincidence". "There have been suggestions that such barriers mean that BAME doctors feel less able to complain about inadequate personal protection equipment, thereby putting themselves at risk."
Key workers
In terms of patients, people from ethnic minorities are more likely to live in London or in the West Midlands -- another hard hit area -- and suffer more poverty and ill health. "South Asians live in more deprived areas and have more cardiovascular disease and diabetes," said Kamlesh Khunti, an expert in ethnic minority health who led the ICNARC study.
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They also often live in larger, multi-generational households and so "social isolation may not be as prevalent".
Zubaida Haque, deputy director of the race equality Runnymede, said ethnic minorities were also more likely to be in low-paid jobs or be key workers -- as transport and delivery staff, healthcare assistants, hospital cleaners and social care workers. "All of which bring them into more contact with coronavirus and so increase their risk to serious-illness and death," she told the BBC.
Back in Birmingham, a week after turning off his father's ventilator and letting the 68-year-old die, Awan fears other families will suffer like his. "Our community needs to take action. They need to take action because if they do not take actions, we will see the numbers rise," he said.