Duncan Selbie
Public Health England (by email)
March 31, 2020 

Dear Duncan,

Thank you for your helpful email, for your reassurance about PHE surveillance systems and for your continued commitment to tackling health inequalities – including on COVID-19.

We’ve been looking at publicly available information and the sex gap is more serious than we thought. The initial UK (excl. Scotland) data on mortality by sex from ICNARC shows that 73.4% of hospital deaths are men – and ONS’s figures for deaths up until March 20 show 62.0% of England & Wales deaths are men.
Available research on UK men’s attitudes from YouGov (including the study commissioned by the Imperial College COVID-19 Response Team) is also concerning, showing that, despite this higher death rate::

• A lower proportion of men than women claim to be worried about COVID-19 (71% vs 83%)
• A lower proportion of men believe in the seriousness of COVID-19 (24% of men believe it is ‘just like the flu’ vs. 16% of women)
• A lower proportion of men say have improved their personal hygiene (e.g. by washing their hands frequently or using a hand sanitiser) - 67% of men vs 74% of women
• A higher proportion of men say disbelieve Government advice such as staying at home to stop the virus from spreading, with 10% saying this is false compared with 2% of women.

This is in addition to historical gender issues such as the impact of differing smoking and drinking levels amongst men – and men’s different susceptibility to viral infection.

This suggests that ignoring sex and gender in the Government’s response risks having a direct and negative effect on the incidence and outcomes of COVID-19.

To address this, we believe it is critical to see:

• Quicker availability of sex-disaggregated data. The sex-disaggregated data from ICNARC covers 79 deaths and from ONS 103 deaths – lagging a long way behind the total reported to date by DHSC of 1,789 deaths.
• Gender-targeted communication to tackle complacency on COVID-19. Wider availability of disaggregated data is likely to help with this.

On the issues I highlighted previously, the Men’s Health Forum remains keen to support any work in these areas.  To this end, we:

• Have pulled together global gendered-research into COVID-19 looking at the biological and behavioural factors associated with higher male mortality
• Have continued to work on gendered COVID-19 communication to help employers and men access relevant information in an effective form
• Are contacting our voluntary sector partners to create a list of virtual men’s mental health support services that are available to men who are self-isolating

Aside from the list of support services, these are available to view online at menshealthforum.org.uk/covid-19-and-men and any extra support or priority you could give to these areas would be appreciated.
Thank you again for everything you are doing.

Martin Tod,
​Chief Executive, Men’s Health Forum

• Forum's letter of 19/03/20 (original letter)