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A GP whose ethnicity places him at greater risk of catching coronavirus fears he may pass it to his family, as he likened his role to a "protagonist in a war".
Dr Parag Pandya, a partner at Swanscombe & Bean Partnership, has been assessing patients both remotely and face to face during the pandemic.
His practice in Southfleet Road forms part of a medical practice group which cares for nearly 30,000 people across six sites in Dartford, Greenhithe and Gravesend – including the patient list of the recently-closed Elmdene surgeries.
The 46-year-old doctor says more than 60% of his colleagues at the healthcare centre where he works are of South Asian origin but the patients they treat are mostly white.
It follows a Public Health England report earlier this month which confirmed the Covid-19 death rate is disproportionately high among those from Black, Asian and minority ethnic (BAME) backgrounds.
The report found people of Bangladeshi ethnicity were twice as likely to die from the virus as those who are white.
Healthcare practitioners are among those designated under the government's terminology as key workers, tasked to carry out their day-to-day jobs on the coronavirus battlefield, dubbed the front line.
But unlike soldiers, Dr Pandya says doctors like him leave their practice each day with the anxiety of being asymptomatic carriers of the virus and taking it home to family members.
"I think it is difficult, it is not something we have been used to", he said.
"It is scary. It is war. But it does not resonate with the normal person because we are not seeing any weapons."
The continued presence of the virus is a very real concern for the doctor whose own uncle fell victim while working as a waiting list manager at a hospital.
"I'm at risk and I'm aware of that most of the time," he said.
"Every day, clinicians carry the risk of infection themselves as well as bringing the virus home to their family."
"Most clinicians do look at their own and patients' safety, but are more focused on getting the job done."
But Dr Pandya doesn't believe he or his BAME colleagues are necessarily being treated any differently despite their risk of worse outcomes.
"As far as I am aware, BAME doctors and nurses are being treated equally in the UK."
However, he said the number of deaths was staggering, even accounting for the overrepresentation of BAME workers in the NHS and other public-facing roles.
His practice in Swanscombe has undergone risk assessments to put in place a triage system and video conferencing to limit older BAME staff to the exposure of face-to-face meets for appointments, immunisations and home visits.
Another area of controversy throughout the pandemic has been the sourcing of personal protective equipment (PPE) for staff.
A study by the British Medical Association published in April found that “doctors with BAME backgrounds have been disproportionately affected by the chronic shortages of PPE across the NHS”.
It also found 64% of BAME doctors surveyed felt “pressured” to work with inadequate PPE compared with 33% among their white colleagues.
The doctors' union has been pressing for effective risk assessments to be made available to doctors and other NHS staff.
But Dr Pandya – who trained in Gujarat, India, prior to obtaining his post graduate qualifications in the UK, where he has practised for more than 20 years – says pressure of this sort is nothing new.
“Maybe black and brown doctors are less likely to complain,” he said by way of explanation.
“Many of us come from poor countries and so we are maybe more willing to work under extremely challenging circumstances.
“Maybe black and brown doctors are less likely to complain”
"We are shaped by our backgrounds. But I can’t imagine any hospital in the country would consciously be putting a particular subset of their staff in danger in order to protect another.”
Whatever the reason, he says, the fact remains that some people are more at risk than others.
People from BAME backgrounds are more likely to suffer from diabetes, high blood pressure and obesity, all of which have been identified as factors exposing people to greater risk of dying from Covid-19.
Some studies appear to indicate a lack of daily Vitamin D among those from BAME backgrounds who contract the disease could contribute to worse outcomes.
But there are no definite answers yet and the post-mortem will likely reveal several factors, says Dr Pandya.
"It could be cultural differences and what training they have. Also the density in which people live and work."
He added: "When we emerge from the other side of this tunnel strewn with lost souls and economies turned to rubble, perhaps we will blink our eyes open in a new world.
"But history does not encourage an easy optimism. Those with their hands on the levers of power are unlikely to be injected with a conscience for the downtrodden among us.
"Worse catastrophes than this have yet to break the walls that separate rich and poor, and divide a single humanity into racial hierarchies."
The GP praised his patients who he said had been "amazing" and "so understanding" in having to suspend certain services.
And while much uncertainty about the virus remains he said it is paramount those most at risk on the front line continue to get the "solidarity and support" they need.
