The reason why Black and South Asian healthcare workers are at a higher risk for SARS-CoV-2 infection remain unclear. We aimed to quantify the risk for SARS-CoV-2 infection among healthcare staff who belong to the ethnic minority and elucidate pathways of infection.

A one-year follow-up retrospective cohort study has been conducted among National Health Service employees who were working at 123 facilities in Lincolnshire, UK.

Overall, 13,366 professionals were included. SARS-CoV-2 incidence per person-year was 5.2% (95% CI: 3.6–7.6%) during the first COVID-19 wave (January–August 2020) and 17.2% (13.5–22.0%) during the second wave (September 2020–February 2021). Compared with White staff, Black and South Asian employees were at higher risk for SARS-CoV-2 infection during both the first wave (hazard ratio, HR 1.58 [0.91–2.75] and 1.69 [1.07–2.66], respectively) and the second wave (HR 2.09 [1.57–2.76] and 1.46 [1.24–1.71]). Higher risk for SARS-CoV-2 infection persisted even after controlling for age, sex, pay grade, residence environment, type of work, and time exposure at work. Higher adjusted risk for SARS-CoV-2 infection were also found among lower-paid health professionals.

Black and South Asian health workers continue to be at higher risk for SARS-CoV-2 infection than their White counterparts. Urgent interventions are required to reduce SARS-CoV-2 infection in these ethnic groups.


University of Lincoln, College of Social Science Research

Maxime Inghels, University of Lincoln, Lincoln International Institute for Rural Health
Ros Kane, University of Lincoln, School of Health and Social Care
Priya Lall, University of Lincoln, Lincoln International Institute for Rural Health
David Nelson, University of Lincoln, Lincoln International Institute for Rural Health
Agnes Nanyonjo, University of Lincoln, Lincoln International Institute for Rural Health
Zahid Asghar, University of Lincoln, School of Health and Social Care
Derek Ward, Lincolnshire County Council
Tracy McCranor, Lincolnshire Partnership NHS Foundation Trust
Tony Kavanagh, Lincolnshire Partnership NHS Foundation Trust
Todd Hogue, University of Lincoln, School of Psychology
Jaspreet Phull, Lincolnshire Partnership NHS Foundation Trust
Frank Tanser, University of Lincoln, Lincoln International Institute for Rural Health