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“Can you think of any groups most at risk of covid/infectious disease?”- Interview Question

Writer's picture: CamWAMS TeamCamWAMS Team

Updated: Sep 1, 2021

Food for Thought: an example interview question

In the last year, we have seen that different groups are more likely to get ill and die from coronavirus. For example, the elderly. Can you think of any other groups of people and why are they at an increased risk?


Ans -

This is a very broad question, which can be intimidating at first! Don’t worry, your interviewers will be able to guide you and give you some suggestions if your mind goes blank or you don’t know where to start. The good thing is that with a broad question like this (I got asked “what kills people” in my interview!), there is no right or wrong answer really. They’ve already said the easiest one - age - but there are other obvious ones too.


You could start by saying that people with underlying health conditions, such as any lung problems, are at greater risk. This could be because they have less functioning lung in the first place, so when covid affects one part, there is less healthy lung left to oxygenate the blood. Or, some people have conditions that affect the lungs’ own defences, so more virus might be able to enter and take hold in their lungs, such as in cystic fibrosis. You could also think outside the box, and say that some people may be in hospital because of both covid and their condition, which has worsened during the pandemic because they haven’t been able to see their GP or specialist and keep the treatment of their condition under control.


However, this question would actually be best answered by talking about health inequalities, because it’s sort of obvious that ill people are already more likely to die, generally. We now know that covid, just like many other diseases, has a greater impact on people who are more socially disadvantaged. There are lots of specific examples. We have picked a couple -


The first is race. Compared to white people, those from minority ethnic backgrounds are at greater risk. This is very complex and it is not completely clear what the main reason for this is. There are some biological reasons, such as black and south asian people are more likely to have diabetes and cardiovascular disease, or that black people often have a different version of one of the proteins that covid binds to when it first infects the lungs. People from BME backgrounds are also more likely to live in urban areas and have multigenerational households (children, parents, grandparents in one house), which both make covid spread more easily. Some BME communities are also, on average, more deprived, meaning they are affected worse by many health problems (see below). However, when we control for all these factors in statistics, people from BME backgrounds are still at greater risk. If ‘ethnicity’ (genetics), socioeconomic (deprivation) and ‘easy spread’ (dense population) factors don’t explain it, what else is going on? This has led some doctors to think there is an element of racism itself. We know this affects people’s access to healthcare, but also regular exposure to racism takes its toll on a person’s mental and physical health. This is the so-called ‘allosteric load’ hypothesis - if someone experiences a lot of stress, this will have a biological impact on their ability to fight disease, or may even lead to an over-reaction, as we see with many people on intensive care with covid.


Another could be housing. Like race, we know that housing status and deprivation are linked, so it is not surprising that they are at higher risk of covid: If you are homeless, you are usually living in a degree of poverty, which takes its toll on your health. Staying healthy with regular exercise and good nutrition can be expensive, and is not the priority when you don’t know where you’re sleeping for the night. Many homeless hostels, which house people in shared rooms, did not take people who had a positive covid test so they didn’t spread it to other people. But this meant covid positive people were left rough sleeping during the Winter, so they were not in a good place to fight the virus. They are also less likely to have family and friends to check in on them if they get worse.


This is obviously way too long an answer and you wouldn’t be expected to know this! But this at least gives you some food for thought, and maybe even gives you things you could talk about in your personal statement - if you read some more articles about it.

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