Changes in COVID-19 Morbidity in an Ethnic Minority Between First and Second Pandemic Waves

Abstract Background: During the COVID-19 pandemic, ethnic minorities have been more susceptible to infection and demonstrated poorer outcomes. In the first wave of disease, Israel’s Arab minority exhibited far lower morbidity and mortality rates, compared with the general population. However, this trend reversed completely during the second wave. We describe the rates of COVID-19 morbidity and mortality in Arab and Jewish localities during the first and second peaks of the outbreak and address socio-cultural aspects of the pandemic.Methods: A retrospective national archive study was conducted in Israel. Data were obtained from the Ministry of Health's database, including daily information on Arab, Jewish or mixed localities, from February to September 2020. Results: In April 2020, positive test rate was 3 times lower and death rate 10.7 times lower in the Arab compared to the Jewish population. During the second wave, morbidity and mortality rose dramatically in the Arab population, with 12% positive test rate in the Arab compared to 9% in the Jewish population and similar death rates in both populations. Conclusions: Following a promising start in the first wave, a surge in infections occurred in the Arab population during the second wave. The huge burden on the health system resulting from high morbidity across all population groups contributed to the decision to implement a second national lockdown. This unique pattern highlights the changing experience of a minority group during the second wave and demonstrates how COVID-19 exacerbates existing disparities.