Experiences of South Asians in the COVID-19 pandemic in Hong Kong

ABSTRACT

This qualitative study aims to investigate how the COVID-19 pandemic has affected South Asians in Hong Kong. A total of 34 South Asian adults completed the interview. Data were analysed thematically and three broad themes emerged: the impact of the pandemic on daily life, discrimination experienced, coping with challenges. The impacts of COVID-19 have spanned across from individual, family, community, to societal domains. Future research using a longitudinal approach and the inclusion of those with quarantine or infection experiences would yield a more comprehensive understanding of the experiences of South Asian communities in Hong Kong.

KEYWORDS:

• South Asian
• ethnic minority
• COVID-19
• pandemic
• impact
• adjustment
• social-ecological model
• qualitative

Introduction

The outbreak and continued spread of the COVID-19 (coronavirus disease 2019) pandemic have infected over 760 million people and caused the causality of over 6 million people worldwide (World Health Organization 2023). Research has indicated that ethnic minorities tend to be particularly vulnerable to the pandemic (Chan et al. 2021). They are prone to poor living and working conditions, which account for disparities in healthcare and worse outcomes of COVID-19 infection (Tai et al. 2021).

Before the pandemic, the existing literature has consistently demonstrated that ethnic minorities are more likely to face difficulties in life due to racial discrimination, language barriers, and poverty (Ying, Lee, and Tsai 2004). Minority students and employees encounter prejudice in both the classroom and the workplace, which can have far-reaching effects on their development (Bhopal 2009). There remains widespread prejudice against ethnic minorities globally (Thapa and Adamson 2018).

Conceptually, the socio-ecological model is one perspective for explicating the experiences of ethnic minorities. It explains how an individual continually creates, restructures, and adapts to the environment as the environment affects their health and welfare (Van Den Broek et al. 2023). The four perspectives, covering the personal, interpersonal, community, and societal levels, can be applied to address the prevention of negative health outcomes (Mason et al. 2017). The individual level of the social-ecological model attends to an individual's characteristics and identities (Brown and Rounsevell 2021). The interpersonal level relates to social norms within social networks and social influence from friends and relatives (Van Den Broek et al. 2023). The community level refers to a relatively small, local ecological unit within a larger social system, and emphasises the networks connecting organisations and institutions that make up the community (Brown and Rounsevell 2021). The societal level includes laws, religious beliefs, and cultural norms, which encompasses multiple communities and other organisational structures, and has a more profound and complex impact on the environment (Goodwin, Jones, and Hunter 2022).

At the individual level, the personal traits and beliefs that an individual possesses are considered the most direct influences on the individual’s health development (Tannous-Haddad et al. 2022). Henderson and Baffour (2015) found that ethnic minorities with stereotypical or prejudiced beliefs and feelings about their minority identity are at a higher risk for cognitive impairment (Henderson and Baffour 2015). Understanding how one's racial socialisation and identity are shaped and influenced by one's life experiences and reflecting on the impact of living in a racist society is an important process to counteract the negative impact of racism at the individual level (El Hazzouri and Hamilton 2019).

At the interpersonal level, the social-ecological model argues that verbal and nonverbal prejudicial and discriminatory interactions between individuals, such as social exclusion, verbal or racial insults, and police brutality, can exacerbate discrimination against minorities (Mason et al. 2017). Racial discrimination can be mitigated by appreciating the unique experiences and perspectives of individuals, thereby improving patterns of verbal and nonverbal interactions between individuals (Murray and Ali 2017).

At the community level, discriminatory practices, procedures, and customs in community contexts can result in differential access to power, privilege, opportunity, and resources (Korn et al. 2021). For example, a US study showed that both structural and communal racism are root causes of health inequities and illnesses among ethnic minorities (Smith 2021).

At the societal level, the social-ecological model states that historic and current macro-level oppressive ideologies, policies, and practices against minorities have led to inequitable outcomes (Egede and Walker 2020). Studies argued that the situations of individuals harmed by racial discrimination can only be effectively improved by acknowledging that the legal, policy, and institutional roots of racism lead to different outcomes and by developing new policies and strategies (Egede and Walker 2020).

Ethnic Minorities in the Hong Kong Context.

Cultural conflicts, language and cultural differences, play a role in immigrant families’ difficulties (Miyawaki 2016). Research in the UK also confirmed that religion, cultural beliefs, and lack of understanding of the health system are common barriers to accessing health services faced by ethnic minorities (Halliday et al. 2022). Limited English proficiency can exacerbate ethnic minorities’ mental stress and prevent them from accessing care of good quality due to a lack of information (Basri et al. 2022). Many South Asians in the United States reported higher suicide rates and risks of depression because health care systems do not recognise their language and cultural needs (Basri et al. 2022).

There is only limited research about ethnic minorities in non-Western communities, revealing an important research gap. There are a considerable number of studies on Chinese immigrants or locally born Chinese as ethnic minorities in Western societies, but research on ethnic minorities in Chinese societies is relatively scant. As a city striving to promote its international outlook and diversity, Hong Kong is home to people from different ethnic cultural backgrounds. The Hong Kong Government regards ‘ethnic minorities’ as members of the non-Chinese population, based on cultural origin, nationality, race, and language (Census and Statistics Department 2018). Between 2011 and 2021, the proportion of non-Chinese population in Hong Kong rose from 6.4% in 2011 to 8.4%, with the number of ethnic minorities increased by 37% (Census and Statistics Department 2021). Among the various ethnic minority groups, the major ones include South Asians, Mixed and Whites, while another largest group is foreign domestic helpers from the Philippines and Indonesia. During the British colonial period, many Indians, Pakistanis, and Nepalese came to Hong Kong for work and military services, resulting in a long settlement history of these South Asian communities. As one of the largest ethnic minority groups in Hong Kong, the number of South Asians increased from 0.9 to 1.4% in the past decade (Census and Statistics Department 2021). The proportion of people aged 65 and above is rising in various South Asian communities (i.e. in 2021, Indian-6.5%, Pakistani-4.3%, Nepalese-6%).

Not knowing the Chinese language, cultural differences, and not knowing how to communicate with health care professionals remain major challenges that hinder South Asian people from accessing formal services (Parial et al. 2022). In Hong Kong, the poverty rate of South Asians was approximately 25.7% in 2016, which was higher than the poverty rate in the whole population (19.9%) (Census and Statistics Department 2018). South Asians in Hong Kong also reported that social barriers, such as language barriers and cultural differences, affected their access to healthcare (Vandan et al. 2020). Due to a lack of health professionals who have cultural competency to understand the challenges faced by ethnic minority groups, South Asians face tremendous obstacles when seeking health information and support (Vandan et al. 2020).

Kwok (2022) has revealed that many ethnic minority students suffer from low Chinese language competence while having better educational and professional goals than their Chinese peers (Kwok 2022). Ethnic minorities in Hong Kong are subjected to negative stereotypes associated with crime, illicit labour, and refugees (Chan et al. 2021). Over one-third of local companies exclusively advertise in Chinese, and the majority of employers do not want to hire ethnic minority workers despite of what the government and NGO employment programmes have proposed (Cho, Chan, and Chan 2022). Research has also indicated that Chinese employees generally do not have a favourable attitude towards ethnic minority people (Kwok 2022). Given the discrimination faced by ethnic minorities in Hong Kong, further research would serve to expand understanding of their experiences in different circumstances and social contexts. Given the COVID-19 pandemic has dramatically intensified the difficulties, challenges and inequalities experienced by ethnic minorities in Western societies (Strassle et al. 2022), this study serves to contribute to ethnic minority research by investigating how COVID-19 has affected South Asian communities in Hong Kong, a socio-cultural context different from western ones. It examined South Asians’ perspectives on the impact of the pandemic on their personal lives, their attitudes toward healthcare initiatives and policies, and their experiences of challenges during the pandemic. This study will provide research evidence for healthcare professionals, educators, and policymakers for designing and improving policies and practices to better support this ethnic minority group.

Materials and methods

Research design. Semi-structured interviews were conducted with the assistance of an interview guide, which consisted of questions relevant to the research objective and existing literature. These questions included: the impacts of COVID-19 on daily life, their coping strategies, and personal experiences as South Asians in social, emotional, and health aspects during the pandemic. Also, participants were interviewed to express their views towards the initiatives made by different sectors to handle the pandemic.

This study received ethics approval from the Research Ethics Committee (Human Ethics-Non-Clinical) of the author’s university (REC/20-21/0299). Due to the use of telephone interview, verbal consent was provided prior to the interview. Each interview lasted for around 45–60 min. All the interviews were conducted in English by three trained interviewers with undergraduate degrees in social sciences.

Targets and recruitment of participants. Participants were South Asians aged between 18 and 54, residing in Hong Kong as residents. They were recruited from both online and offline sources. Online sources included social media platforms and direct email recruitment. Research staff searched social media platforms to identify community leaders from the various South Asian communities in Hong Kong as well as other South Asian participants through the referrals of NGOs and community groups. Offline sources included snowball sampling via referral from participants and personal networks of the research team, which consisted of staff having a good connection with the South Asian community in Hong Kong.

Data analysis. All the interviews were transcribed verbatim. The transcripts were checked against the recordings to ensure accuracy. Transcripts were coded using the comments and highlighting functions of Microsoft Word, following other researchers’ practice (Ose 2016). Initial codes were generated through careful reading of the whole dataset and then all the codes were sorted into potential themes. The codes and themes were created and analysed based on their connections to the research questions. Descriptive codes, such as ‘increased care duties’ and ‘more conflicts with family members,’ were created. These codes were then categorised into the sub-theme of ‘care duties and family relationships’ because they reflected a common meaningful pattern related to the impact of COVID-19 on family life. The research team then created other sub-themes, such as ‘social relationships’ and ‘changes in daily routines,’ based on common patterns of meaning around certain clusters of codes. These sub-themes were eventually categorised under the large theme of ‘Impact of the pandemic on daily life.’ This coding process was independently carried out by three researchers, and then further calibrated by the research team. Candidate themes and subthemes were reviewed by the research team to ensure that these themes were coherent and accurate. In addition, a table showing the initial codes, sub-themes, and final themes was produced so as to illustrate a clear structure and overall picture of common patterns of meaning (Table 1).

Table 1. Codes, sub-themes, and themes.

Initial codes	Sub-themes	Final-themes
Movement restrictions (stay home, cancelled visitation, lockdown), religious activities, dining, time management	Changes in daily routine	Impact of the pandemic on daily life
Work (home office, workload, cancelled flights)	Employment and work-related issues
Increased care duties, more interactions/more conflicts with family member/better relationship	Care duties and family relationships
Communication, social activities (distancing, communication, mask covering facial expression)	Social relationships
Less exercise, weight/fat gaining	Effects on physical health
Anxious/worried, scared/afraid/terrified Frustrated/annoyed/angry, sad/upset/disappointed/depressed	Effects on mental health
Perceived as someone carrying virus	Being discriminated against in the public	Discrimination emerged
Negatively impacted career development/lost jobs	Being discriminated in workplace
Be reported as the cause of virus by news reports and social media/ disappointment and hopelessness towards the biased views	Biased portraits by local media and government
Turning to religion, feel optimistic with faith	Reliance on religion	Coping with COVID-19 and associated challenges
Change of habit/ mode, distracting activities such as study, leisure, eat, sleep, exercise	Engaging in activities
Online teaching, online shopping	Use of technologies

Results

As shown in Table 2, a total of 34 South Asian adults completed the interview. Pakistanis were the largest group within the sample (56%), followed by Indians (29%) and Nepalese (15%). Amongst the 34 participants, 22 (65%) were female and 12 (35%) were male. The participants belonged to six different age groups. The 18–22 age group was the majority group within the sample (41%), followed by 23–27 (38%), 38–42 (12%), 28–32 (3%), 33–37 (3%) and 43–47 (3%). The majority (82%) reported having received tertiary education or above while 6 (18%) had received middle school education. Over half (53%) of the participants lived in public housing while another one-third (38%) resided in private housing.

Table 2. Socio-demographic characteristics of participants (n = 34).

Variables	n	Percent
Age
18–22	14	41
23–27	13	38
28–32	1	3
33–37	1	3
38–42	4	12
43–47	1	3
Gender
Male	12	35
Female	22	65
Education
Secondary level	6	18
Tertiary level & higher	28	82
Type of Housing
Private housing	13	38
Public Housing	18	53
Other (e.g. dormitory, workplace)	3	9
Ethnic Background
Pakistani	19	56
Indian	10	29
Nepalese	5	15

Impact of the pandemic on daily life

Participants reported that their everyday lives were affected by different government measures, such as social distancing policy, school lockdown, quarantine measures, and travel restrictions. The outbreak of COVID-19 affected the participants in six major aspects as follows.

Changes in daily routines. The social distancing restriction and travel ban affected the routines of the participants by disrupting their plans and schedules, as a lot of social activities were cancelled, and facilities were closed. The findings show gender differences in the experience of COVID-19. More female participants reported suffering from homebound lockdown, travel restrictions, and restrictions on dining outside. Male participants tended to encounter difficulties related to the suspension of physical activities, such as the closing of gym or sports centres.

Another issue concerning their daily routine change is time management. Participants reported staying at home more often. The division of work and responsibilities also changed, causing new challenges of time management and adaptation to the new norm of their lives. However, few participants mentioned that staying and studying at home was beneficial to them. For example, Participant SB (No.28), who was a homemaker and a student, said that she was used to staying at home before the pandemic and that taking classes at home provided her with more time to take care of the family. She said,

I would take care of my home. I have younger brothers. Actually it helps me a little bit. When I knew that the class would go online in the coming year, ok, stay at home and study. This has been beneficial to me … Of course I do help, I take care of the overall house thing, you know, cooking, laundry and everything … I wouldn’t be able to manage moth things if I need to go to the university in person.

Care duties and family relationships. Participants reported increased domestic duties as they stayed at home more often. Female participants tended to report experiencing increased family conflicts during the pandemic. 5 out of 22 female participants reported increased conflicts with family members, while only 1 out of 15 male participants reported similar situations.

The reasons for family conflicts included issues regarding vaccination, trivial matters, and domestic work. Participant IQ (No.22) shared her difficult time with her family members during the pandemic,

My mom is a housewife, she had to do even more stuff at home. Everybody at home is hard to deal with. Everybody is just kind of exhausted in a way that … the pandemic makes us feel, like we are tired of everything … We kind of feel stuck in a way, we can’t go out really and do our usual routine that we are supposed to do. We just feel exhausted and we have arguments sometimes.

Some participants reported having increased care duties, such as spending more time taking care of young family members and cleaning. Extra care duties took them a lot of time and distracted them from their work and study.

On the other hand, some participants believed that the pandemic brought positive impact on their family relationships because they could study online or work from home and enjoy more family time. Female participants were more likely to report increased interactions with family members. Participant 9 said,

Actually, the pandemic has been helpful in a way for me. Instead of having to leave my babies to a caregiver, I can just be there with my kids.

Employment and work-related issues. Due to the lockdown and other safety measures, some participants suffered from various kinds of work-related challenges. Participant VI (No.31) was a performer in the entertainment business, with a lot of his work involving doing live shows. Almost all his shows got cancelled due to COVID-19. 15 out of 37 participants reported that their job opportunities were affected, such as a lack of job opportunities and difficulties in finding a job. Some of them reported facing financial difficulties and mental health issues due to work-related issues. Participant ZU (No.11) said,

I do worry about getting a job. During the pandemic, it’s harder to get a job than before. A lot of companies are closing down, I guess, a lot of people don’t have work. So, I think that’s what makes me worry about not being able to get a proper job during the pandemic.

Few participants expressed difficulties in work associated with the travel ban and lockdown. For example, Participant SR (No.42) was an Indian involved in movie business in Hong Kong with his crew from India. His movie making plan got affected because of the travel ban and cancelled flight.

Once I booked the flight tickets, we fixed all the schedule and informed all the actors, teammates, everybody. And we booked locations and everything … Then once the flight got cancelled again, everything got cancelled, cancelled again … we have to do the whole process again.

Social relationships. Having less or no gatherings and interactions with friends due to COVID-19 was a common experience reported by at least half of the participants. Many participants’ daily communications were changed to online mode. Few participants believed that online communications made their relationships with their friends closer. For example, Participant KA (No.35) had been communicating with her friends online during the past year, but the online communication made their relationship closer.

I feel like it was pretty sad last year, since I was trying to avoid group gatherings. So that's kind of weird … I don't see my friends as often, it has made me feel closer to some of my friends.

Some participants reported that the pandemic had a negative impact on their social lives because their travel plans were affected by the travel ban and lockdown measures. Participant SN (No.18) was a teaching assistant and had lived in Hong Kong for 24 years with family members living in Pakistan. She expressed her struggles with cancelled flights, which greatly affected her travel plan and social and work life.

I went to Pakistan … I had a ticket for one month and I took leave for a month from my school. Then the tickets got cancelled, and every flight got delayed. And then I stayed there for almost two months. And then when I came back, I needed to stay in those estates … I remember that I was crying and wanting to come back to work and meet people in Hong Kong.

Effects on physical health. The pandemic had an adverse impact on participants’ physical health. Many participants reported having fewer physical exercises. Some participants said that it was harder to do exercise while wearing a mask. Participant SN (No.18), who used to walk around in her neighbourhood, spent more time sitting and lying, which negatively affected her health.

I like walking a lot. But now I will just sit in the sofa and I get used to idling, watching Netflix, and watching movies … It has affected my physical health the most. Because now, even if I walk for half an hour, I get tired … Because of this pandemic, I have become lazy.

In addition, one participant shared her experience of having difficulty in accessing medical services during the pandemic. Participant 9 shared,

There was a problem once for me and my kids. He was having a cough. When we went to the clinic, the doctor didn’t allow him to open his mouth, just checked his chest. So, he just did an ear checking, and gave us some medicine, for kids.

Effects on mental health. Feeling upset, isolated, disappointed, and depressed due to COVID-19 was reported by about one-third of the participants. 11 out of 22 female participants and 2 out of 15 male participants reported having these negative emotions. Participant SB (No.28) felt depressed and anxious about the COVID-19 situation, and expressed fear about the fact that there would be no cure for the disease:

When watching the news, there are so many people getting sick and other things around the world. It was also depressing. Overthinking is only going to make ourselves suffer overtime. At the beginning I was very anxious … we were very scared, like what’s going on.

Some participants felt scared because of the danger of infection and uncertainty of the future. Some felt upset or depressed because their schedule and plans were suspended. Moreover, participants felt stressed or worried because the pandemic brought an enormous financial burden to them, as many business activities were disrupted or cancelled and the job market was precarious. Also, the social distancing rules made some participants feel angry and annoyed, because it limited interactions between people. Being home-bounded made the participants feel isolated and stressed.

Discrimination emerged

Many participants not only reported personal experiences of verbal or behavioural racism, but they also witnessed biased news reports which accused ethnical minority people of the cause of the virus outbreak.

Being discriminated against in the public. Most (20 people) participants reported experiencing discrimination in public during the pandemic. Participant SI (No.4) shared her view about Chinese people’s general impression of South Asians,

I think Chinese people are discriminating against South Asians or ethnic minorities because they think that we are spreading the virus … I feel that there's discrimination when I go out in public … The issues the I think the public is trying to blame the situation on someone, and they're targeting South Asia as one of the groups to do so. That is why I'm saying that it has become worse … we should be treated unequally … I don't see the government making any effort to help ethnic minorities.

Being discriminated in the workplace. The ethnic identity of the participants affected their career more severely during the pandemic. Some participants shared their experience of being discriminated at work due to their ethnic background. As shared by Participant MA (No.3), being an ethnic minority person made her even harder to find a job during the pandemic, which caused an economic recession and layoff and consequently further limited her job opportunities.

I think a lot of times your ethnicity affect your opportunity to get a job … the job post prefers local Chinese or white people. I want to apply for English tutoring job, but they prefer native English, like white people, because their parents are willing to pay for that, but not us, even we speak English as well. We have fluent English, but they are like, ‘no, you don’t look like you are fluent’

Biased portraits by local media and government. Many participants mentioned that they were targeted in news reports and social media as the cause of the virus outbreak. They were angry about how the local media shaped public perceptions of ethnic minority people. Participant KA (No.35) mentioned that she read a biased article in a local newspaper targeting ethnic minority communities and that she and her friends felt angry about it.

Besides, some participants showed their disappointment towards government officials and the authorities responsible for public health. Participant 9 expressed her disappointment and hopelessness towards the biased views expressed towards South Asian people that she had observed from local media and the government.

There’re a lot of stereotypes. It’s a fact that the top officials and health department, I think they also spread this information. There are a lot of us, the younger ethnic minority people are very angry about that. We have written letters, but there wasn’t much … I guess, nobody has ever noticed it, except the south Asian communities … We did try to post it on social media to say, ‘hey, it’s not true, don’t judge us or don’t accept racism’. We tried to cope with the feelings of disappointment, that’s what we’re trying to do.

Coping with COVID-19 and associated challenges

To cope with the negative impact caused by the pandemic, female participants were more likely to turn to family, friends or their pets. None of the male participants reported using this strategy. For example, Participant MA (No.3) started to keep a cat to ease the tension among her family members and relax herself from the negative feelings during the pandemic,

We need to cope with each other and try not to be hostile towards each other … we are living in a small flat. In order to avoid any fights or arguments, we bought a pet, a cat. It’s very good to keep a cat, especially when you are very depressed. I think my attention is fully on the cat. It’s quite different, the emotional situation of the family is quite different now, because we have a pet now. We are quite happy.

Engaging in activities. Some participants reported engaging in activities to distract themselves from negative emotions, such as watching TV shows and playing video games. Others changed their habits to ease the negative influence of the pandemic on physical health, such as having home workout instead of going to the gym. More female participants (7 out of 22 people) coped with the challenges by engaging in activities that could distract them, whereas none of the male participants adopted this strategy. Participant RC (No.45), who was a make-up artist, started producing her own make-up videos and posting them online during the pandemic. She said,

Well, the only person I can do make-up for is myself during the pandemic. So I try to do different make-up looks on myself. I do some videos … and I'm planning to post a lot more videos on my social media about make-up so I can at least do something while I wait for my next step.

Use of technologies. Many participants reported relying on online services to solve their daily problems, such as online communication, online shopping, and delivery services. Participant 9 mentioned that she started to communicate with her friends online and use an online shopping app to buy groceries.

Yes, and we started to use the online shopping app. It is very helpful because we are able to just stay at home and get the delivery. Anything I need to buy, I would just order online, we are trying to avoid chance to infected as possible. So, everything is online now. For dinner, we do takeout or food delivery. If we are meeting friends, we are meeting through video calls, rather than meeting in person.

Reliance on religion. Some participants reported relying on their religion because they tended to feel more optimistic with their faith in their God. A few (4 out of 31) participants reported that turning to religion could help them to better face the challenges and cope with the negative impacts. Participant DH (No.33) shared his view,

We cannot control the things … When I lost my job, I was very down for maybe one or two days, then I thought that maybe something better is going to happen. So I forgot my past, tried to work on new things and things started getting better. I listened to some good religious speeches, which let me know things would get better, so that’s not an issue.

Religion was important to these participants because it served as a source of not just comfort but also empowerment, which enabled them to move on with a positive outlook.

Discussion

This qualitative study examined the impact of COVID-19 on South Asian people in Hong Kong. It provided health professionals, health educators, and health policymakers with research evidence to design and improve strategies and practices to better support this minority group.

Impact of the pandemic on daily life. The impacts of COVID-19 on South Asian participants were manifested in six aspects, including daily life, caregiving responsibilities and family relationships, employment, social relationships, physical health, and mental health. They were linked to the social distancing constraints that affected the daily lives of participants, as many social events were cancelled and facilities were closed. These policies have directly led to a significant increase in the amount of time people spend at home, which may enhance individuals’ chances of having interpersonal relationship conflicts with their family members, especially for women who take key responsibilities of housework and childcare. This may be related to the fact that, in traditional Asian cultures, women are generally subjected to the gendered cultural expectation to take up more household chores (Tanaka and Okamoto 2021). Our findings about women’s experiences during the COVID-19 are consistent with previous studies on the impact of the Ebola and SARS virus pandemics on women's lives and health, indicating that women tend to be more vulnerable to negative impacts of the pandemic (Yoosefi Lebni et al. 2021). Previous studies suggest that women teleworking from home has the potential to become an ongoing approach when buffer mechanisms such as grandmother-sitting, nursery, babysitting care and cleaning services are not available due to the pandemic (Mahamid, Veronese, and Bdier 2022). Through public policies and interventions, women may be able to achieve work-life balance through teleworking. Moreover, creating social work and guidance units in family courts for women can benefit women in high-risk regions by alleviating negative emotions, reducing domestic violence, and enhancing women’s health (Azizi et al. 2021).

The findings also show that many ethnic minority participants had financial difficulties and mental health concerns due to work-related issues during COVID-19. The increasing unemployment risk and difficulties in job-seeking can be viewed as a consequence of the unprecedented global travel restrictions and stay-at-home orders that have severely disrupted the global economy. COVID-19 clearly demonstrates the vulnerabilities faced by workers and employers (Kniffin et al. 2021). As the pandemic has led to the restructuring or closure of many companies, many workers have been retrained or made redundant, and the economic, psychosocial and health costs can be enormous (Achdut and Refaeli 2020). Understanding how such radical changes may unfold is important for those involved in planning ways to meet the needs of vulnerable employees, including those of ethnic minorities.

Discrimination against ethnic minorities. COVID-19 has made the long-term problem of discrimination against ethnic minorities worse. Participants felt that others feared them because they belonged to an ethnic group that was misunderstood to be more frequently infected with COVID-19 in Hong Kong. This is consistent with the findings in studies conducted in the United States, where ethnic minorities experienced more COVID-19-related discriminatory behaviours (Strassle et al. 2022). While the pandemic was only a trigger, the fundamental issue is to address discrimination as a prevailing challenge for minorities. This study demonstrates that public health messages need to be carefully and responsibly crafted to prevent and address discrimination against marginalised groups. A study in England demonstrated that communities can provide local training and education through social media and other means to help promote public understanding about how to control local outbreaks and to reduce stigmatising attitudes towards ethnic minorities (Khunti et al. 2021).

Coping with challenges. Previous studies indicated that, during the pandemic, people mainly adopt two types of coping strategies, including problem-focused coping and emotion-focused coping (Halliday et al. 2022). As noted by some scholars, problem-focused coping involves handling challenges by facing it head-on and taking action to resolve the underlying cause (Probst and Jiang 2016). In this study, the participants’ behaviours of using online services to solve their daily problems can be viewed as problem-focused coping that help them to adapt to changes and challenges caused by the pandemic. Emotion-focused coping involves regulating feelings and emotional responses to the problem instead of addressing the problem (Perlick et al. 2017). Our participants’ emotion-focused coping strategies were related to religious beliefs and interactions with significant others, such as engaging in more activities with their friends and families, so as to reduce their negative feelings by keeping a positive thinking pattern. Providing services in convenient community locations (e.g. shopping plazas, community centres, and places of worship), increasing the number of South Asian mental health professionals, and increasing the representation of South Asian immigrants in mental health promotion materials are important initiatives to effectively enhance the mental health and positive coping strategies of South Asian people (Anyon, Ong, and Whitaker 2014).

Conceptual alignment. Our findings further support the conceptualisations of the social-ecological model (Krug et al. 2002) as an approach to explain the socio-cultural pandemic experiences and responses of South Asians in the context of the pandemic at four levels. The individual level is concerned with the biological and personal factors that increase the likelihood of experiencing diminished health (Siglock 2021). These factors at the individual level include the individual’s age, gender, education, beliefs, and history of disease (Mengesha et al. 2017). Our research revealed how South Asian immigrants’ religion belief can potentially give people a sense of faith and create groups of people who relate to each other because of similar beliefs (Magyar-Russell et al. 2022). These factors have a significant positive impact on South Asian immigrants’ mental health.

The relationship level is concerned with the individuals’ family members, friends, and social networks (Cummings et al. 2010). In this research, at the relational level, family members and friends are encouraged to support South Asian migrants in their daily lives, such as chatting with friends through video calls and helping with domestic chores of which female family members are traditionally expected to bear the burden.

The community level of the social ecological model is concerned with the relationship between the social and physical environment in which individuals live and their risk and protective factors (Yu et al. 2019). A good community environment is associated with a range of health benefits for residents, including reduced premature mortality, increased life expectancy, and reduced mental health problems (Doyle et al. 2006). In this research, participants who engaged in fewer outdoor activities and had limited access to medical services in their communities due to the COVID-19 measures reported worse physical and mental health outcomes. These findings suggest that more online health services should be provided to improve people’s living experiences.

At the societal level, laws and regulations proposed by the local and central government affect individuals’ connections with the environment (Gruenewald, Remer, and LaScala 2014). In this study, early extreme risk prevention regulations and quarantine measures towards COVID-19 were developed based on the high infectiousness of COVID-19 as well as its severe complications and high mortality rates (Ferreira et al. 2021). However, for current COVID-19 policies, it is critical to understand whether a quarantine of less than 14 days can be as effective as judiciously deploying testing, considering the increasing unemployment rate and people’s increasing anxiety about finding a job caused by economic recession during the pandemic (Wells et al. 2021). Policies related to quarantine measures and health promotion messages transferred by governmental departments should be adjusted according to the current COVID-19 situation.

Limitations

A few limitations of this research warrant attention. Most of the participants had received tertiary education and were able to speak English. Hence, the impacts identified in this study could not represent other South Asians with less education. Another issue is that the participants in this study were not infected with COVID-19, did not have any members being infected, and never experienced any compulsory quarantine. Thus the impacts and issues identified were mainly related to the impacts of general preventive practices and policy measures. Finally, as data were collected only within one time point period, changes in views and perspectives according to the changes of the pandemic status and corresponding government policies were unable to be captured. Future research using a longitudinal approach and the expansion of the sample to include those who have the experiences of being in quarantine or infected would be useful to provide a more comprehensive picture of the experiences of South Asian communities in Hong Kong.

Geolocation information

This study was conducted in Hong Kong, China. Hong Kong Special Administrative Region lies between Latitude 22°08’ North and 22°35’ North, Longitude 113°49’ East and 114°31’ East.

Disclosure statement

No potential conflict of interest was reported by the author(s).

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Notes on contributors

Daniel W. L. Lai

Daniel W. L. Lai is Chair Professor and Dean of Faculty of Social Sciences in the Hong Kong Baptist University. His expertise includes health and aging, culture and immigration, and outcome evaluation. Other than conducting research in the area of gerontology, he is also Vice-President of the Hong Kong Association of Gerontology.

Wenqing Yu

Wenqing Yu is a PhD student of the Department of Social Work, Hong Kong Baptist University. Her research interests include older people and their mental health issues.

Chenxi Lian

Chenxi Lian is working as a Senior Research Assistant in the Faculty of Social Sciences, Hong Kong Baptist University. Her research area includes behavioural economics, social psychology, and applied psychology.

Rebecca Y. K. Lam

Rebecca Y. K. Lam is a Research Assistant at the Faculty of Social Sciences, Hong Kong Baptist University. She has participated in research projects related to gerontology and intergenerational relationship.