Covid-19: letter to Scottish government 03/04/20

The Forum's letter to the Chief Medical Officer of Scotland

Dr Catherine Calderwood
Chief Medical Officer
The Scottish Government

Dear Dr Calderwood,

Excess COVID-19 deaths amongst men – implications for action

Thank you for everything you and your colleagues are doing to fight COVID-19.

One emerging trend which is causing us concern is the excess mortality from COVID-19 amongst men. We are keen to know what is being done to understand this and reflect it in the national programme. 

Following the early results from China, mortality statistics from Italy (via WHO Europe) and Denmark and, based on initial INARC and ONS reports, the UK suggest that, to date, 60-70% of deaths from COVID-19 are male – at a younger average age – despite men being a minority of the older age group most at risk.

Factors for this – reflected in the latest research and opinion polling – include:

  • Men are biologically more susceptible to respiratory diseases and COVID-19
  • Men’s health behaviours are overall more risky
    • Men in Scotland smoke more than women
    • Men, especially working age men, generally seek medical help later
    • Men generally wash hands less
    • Gender difference in self-isolation, complacency about COVID-19 and compliance with advice

    Historic smoking levels may mean that this effect is stronger in Scotland than the rest of the UK.

    Our strong belief is that taking proper account of sex and gender (and other health inequalities) will lead to better, more effective policy and interventions. Ignoring sex and gender 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:

    • Sex-disaggregated data from Scotland on incidence, outcomes and intervention effectiveness​.
      The sex-disaggregated data from ICNARC (which excludes Scotland) covers 79 deaths and from ONS (also excluding Scotland) 103 deaths – lagging a long way behind the UK total reported to date by DHSC of 2,921 deaths. Neither provides a gendered view on the 76 deaths to date in Scotland.
    • Gender-targeted communication
      to tackle complacency on COVID-19. Wider availability of disaggregated data is likely to help with this.

    Separately, to support the government’s efforts, the Men’s Health Forum remains keen to support any work in other critical areas – such as the mental health issues caused by isolation.  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 across Scotland, Wales and England to create a list of virtual men’s mental health support services that are available to men who are self-isolating

    We are a small charity, but if there is anything else you think we could usefully do, we would be very interested to help where we can.

    Thank you again for everything you are doing.

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

LETTER to CMO Scotland (03/04/20) (PDF, 73kb)