Bradford's main Muslim cemetery has been struggling to keep up with burials as

the second wave of the pandemic has gathered pace. It will take some medical
detective work to determine the cause of this increase in deaths, says Dr John
Wright of Bradford Royal Infirmary, but multi-generational homes could be a
factor.
My friend Zulfi Karim called me on Friday with news about a sharp surge in deaths
within Bradford's Muslim community.
"We've got three shifts of gravediggers and bereavement support people working
from six in the morning until 10pm, preparing graves. In the last 10 days we've had
38 burials, which would be the figure we'd normally have in a bad winter month," he
said.
"As fast as we're digging the graves we're filling them up with dead bodies. It's really
really concerning, and my staff are getting to the stage where we're at full capacity.
We're having to bring in a construction company to see if we can find new methods to
design and prepare for digging a grave."
By Saturday the figure had risen to 44.

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Zulfi is the chairman of Bradford's Council of Mosques and the head of the Muslim
Bereavement Service. He's attended every funeral, while also coping with long Covid
himself.
"From a personal point of view I've never seen anything like it," he told me. "I never
thought I'd experience this here in the UK in a non-war situation."
In the Muslim tradition, a person should be buried within 24 hours of death, but Zulfi
says it hasn't always been possible to keep up.
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It's going to take some work to fully understand what is going on.
According to the Office for National Statistics, Bradford is currently seeing about 100
deaths per week (from all causes), up from 60 or 70 in the summer, but this isn't
especially surprising; we expect this number to increase with the onset of winter.
In the hospital, Covid-19 admission rates have surpassed the first peak in April, but
the good news is that mortality remains considerably lower - less than a quarter of
the rate in spring - as we have become experts in caring for and treating Covid
patients. The average length of stay at Bradford Royal Infirmary has more than
halved - from 13 days to six.
Zulfi's hunch is that cases of Covid-19 may be going undiagnosed and that more
people are dying from it at home than the statistics show.

IMAGE COPYRIGHTPISHDAAD CHAHARDEHI

image captionAbout 30% of Bradford's population is from the South Asian community

Back in February when the pandemic was hurtling towards us from the other side of
the world, we watched how it devastated Italy and Spain and predicted that Bradford
would also be badly hit. The city has a high population density and overcrowded
housing, but also shares with Italy and Spain a pattern of multi-generational family
homes.
One of the notable features in modelling population spread of infectious diseases is
that the young have many more daily contacts than the old. The return to school and
university in September will have increased these contacts and the resulting viral
transmission, but the importance of maintaining education far outweighed the clinical
risk from the virus.
In cities like Bradford where school children and students (who often also live at
home) were mixing with grandparents, this risk equation was always going to be
different than in cities with fewer multi-generational homes. We now have a much
clearer understanding about the variables that increase the risk of death from Covid -
including ethnicity, gender and co-morbidities - but age is by far the greatest factor.
And when grandparents share a house with young people, this heightens the risk.
Over the last couple of weeks I have been hearing of more and more personal
tragedies that illustrate this problem.

Gulsoom Akhtar says her father, Akhtar Zaman, appeared at first to have an
ordinary cold, but was later diagnosed with Covid-19 and taken to hospital on his
GP's advice, with suspected pneumonia.
He was soon placed in intensive care, and died five days later, on 3 November. He
was buried the following day.
"It's absolutely awful how many people are dying. My dad was only 63. He'd had an
angina attack several years ago but he was well and he had nine beautiful kids. I was
just so overwhelmed and shocked," says Gulsoom, a neighbourhood engagement
worker, part of whose job is to spread information about Covid-19.
"Our youngest brother is only 17. We are all devastated and my mum has lost her
best friend after 35 years of marriage."
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image captionAs well as extra paving, floodlights will be brought in for late burials and the
evening gravedigging shift

Amjad Pervez and his wife did their best to isolate on the third floor of their house,
but continued to have some contact with their daughter, a university student, and with
their school-age grandchildren. Amjad became ill with Covid in mid-October.
"In the second wave the children are getting Covid and not showing symptoms and
particularly in the Asian community, where you have three generations living
together, it doesn't work in our favour," he says.
Amjad's mother, Hazran, was living with one of his brothers, in another multi-
generational household. Later she moved to stay in the home of a third brother,
where no-one was ill, and she could be better isolated. Nonetheless, the woman
whom Amjad describes as "fiercely independent" and "a fountain of wisdom" began
to show symptoms of Covid and was taken to hospital on Monday. She died on
Tuesday evening and was buried the following day.
"I think people know now about the number of deaths, and people are scared witless,
and they're being really careful about social distancing. People are petrified," says
Amjad, owner of the Seafresh/Adams food retailing and cash-and-carry group.
"I've lived in Bradford since 1969, I've grown up here, my business is here and my
social network is huge. I've never in my life seen our community under so much
mental stress and so scared."
Shadim Hussain, the father of four girls, had also taken measures to protect his
parents, but somehow his mother became infected and was taken into hospital on
Thursday. With pre-existing health problems, including chronic pulmonary obstructive
disease, she deteriorated quickly, and Shadim was called to the hospital that
evening.
"I could see it looked really difficult for Mum and instinctively we're taught as Muslims
to say a prayer - there's a special prayer that I said with Mum and she repeated it
after me. I could see her lips were still moving and I sensed she knew I was there,"
says Shadim, the founder of a fostering recruitment and training organisation, My
Foster Family.
She died that night and was buried on Friday.
"In the morning we picked up the body and we did the bathing of the body. By midday
we got the body prepared for burial and our slot at the cemetery was at 7pm that
night," says Shadim.
"It was in the dark and there was something special about it - it felt quite peaceful. I
got a call from Zulfi and he said, 'Whatever you need just let me know.' It was like
having an army of people around, who wanted to help us."

As we observed the two-minute silence on Remembrance Day the UK was becoming

the first country in Europe to surpass 50,000 deaths from Covid-19. There will be no
Last Post bugle call for these fallen souls.
The vaccines against coronavirus cannot come soon enough.

Front-line diary

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Prof John Wright, a doctor and epidemiologist, is head of the Bradford Institute for
Health Research, and a veteran of cholera, HIV and Ebola epidemics in sub-Saharan
Africa. He is writing this diary for BBC News and recording from the hospital wards
for BBC Radio.
• Listen to the new series of The NHS Front Line in November on BBC Sounds and the
BBC World Service
• Or read the previous online diary entry: 'We are first-hand witnesses of this
devastation'

Follow @docjohnwright and radio producer @SueM1tchell on Twitter