Living with Covid-19

Information for men on Covid-19 (last updated 5 April 2022)
What is Covid-19?

It is a type of coronavirus that was first detected in China at the end of 2019.

Some coronaviruses are mild; some like SARS in 2002 are more serious. This is one of the more dangerous - worldwide well over six million people have officially died of Covid-19 and the real total is probably far more. The number of cases around the world is still rising in many places. Numbers of cases and deaths tend to fall when a 'lockdown' is introduced and rise again once it is lifted.

Some of us now have some immunity to Covid-19 having had one or more variants of the virus or been vaccinated against it. But with so many variants and different vaccines, we each have a different immunity profile.

Anyway, we don't really know how long any immunity lasts which is why it makes sense to get a vaccine and booster whenever they're offered. 

As well as the initial illness caused by the virus, there is evidence of long-term health problems afterwards - so-called Long Covid (or post-Covid-19 condition). 

What are the symptoms?

For most of the pandemic, the UK government has stressed three symptoms:

  • a high temperature,
  • a new, continuous cough,
  • loss or change to your sense of smell or taste.

It stuck doggedly to these despite evidence of many other symptoms until finally, in April 2022, it added nine new symptoms:

  • shortness of breath.
  • feeling tired or exhausted.
  • an aching body.
  • headache.
  • sore throat.
  • blocked or runny nose.
  • loss of appetite.
  • diarrhoea.
  • feeling sick or being sick.

As the NHS rightly points out these new symptoms are 'very similar to symptoms of other illnesses, such as colds and flu'. It is ironic therefore that the addition of these symptoms coincides with the government's removal of the testing system that would enable you to tell the difference. Do you have Covid or just a cold? Without testing you cannot tell.

From the care-home chaos to the track and trace fiasco, there have been many cock-ups in the Covid response. We don't yet know how serious the premature end to testing will turn out to be.

How is it passed on?

It's in our breath. Think about how cigarette smoke behaves and that's what's happening to the virus when people with Covid breathe. If someone smokes on one side of the room, you can smell it on the other so it's a good idea to open a window. Same applies to Covid.

Obviously if someone coughs or sneezes, the tiny, tiny water droplet particles in their breath travel even further. Some might get onto surfaces and Covid can be transmitted by touching those.

You can become infected when these particles are inhaled, or come into contact with the eyes, nose or mouth. So, the key thing is to avoid getting the virus on your face.

Is Covid-19 over?

No. This virus will be with us for many, many years to come. The thing we don’t know yet is how dangerous it will be.

The so-called Spanish flu of 1918 is still with us a century later. Bird flu is a variant of it. Swine flu is a variant of it. The deadly 1968 pandemic (so-called Hong Kong flu) was a variant of it. So was the 2009 flu.

What risks does Covid-19 pose in 2022?

It depends who you are and where you live.

In many parts of the world, death rates are still high. In the UK, your risk of catching it has perhaps never been higher but, because of vaccines and improved treatment, your risk of dying is lower. That doesn't mean the problem is easing. The high numbers of cases and hospitalisations are pummelling health services that are already struggling, leading to knock-on effects on care across the NHS.

For most people in the UK, the risk is of a mild to moderate short-term illness with possible hospitalisation. However, there are some other factors to take into account. Your having Covid-19 will:

  • expose you to the long-term risk of Long Covid including erection problems
  • expose the more vulnerable individuals around you to the virus which may have more serious, even deadly, outcomes for them
  • promote the virus’s evolution (so you’ll be playing a small part in the emergence of the next variant)
  • contribute to the swamping of the NHS meaning that if you or your family or friends need the NHS for some other reason, you may not get the quality of care you're expecting.
Who is 'more vulnerable'?

There are various factors that increase our vulnerability to Covid-19. Age is the main one but gender is very important too. You're more vulnerable because you are male.

Risks of serious outcomes increase if you’re:

  • older - in the pandemic in the UK so far, the mortality rate (deaths per 100,000 of population) is twelve times higher in those aged 70-79 (mortality rate = 254) compared to those aged 40-49 (21) and increases even more for the over 80s (971),
  • male - the mortality rate for men (120) is more than 50% higher than it is in women (78),
  • overweight,
  • have certain preexisting conditions (like diabetes and lung or heart disease),
  • have a weaker immune system for whatever reason (perhaps treatment for an illness like cancer), or,
  • come from certain ethnic groups - the mortality rates for black/black British people (211) and Asian/Asian British people (176) are more than twice the mortality rate for white people (87).
How do I avoid it?

Get vaccinated and boosted whenever you get the chance. Follow any official guidelines and take your own precautions if there aren’t any.

On a day to day basis, you need to avoid getting the tiny, tiny water droplet particles carrying the virus onto your face. Larger droplets fall to the ground or nearby surfaces but smaller ones can be blown around on the air for some time and over some distance. Wearing masks, staying outdoors, opening windows, keeping a distance from others, they’ll all help.

At any given age, men are at greater risk than women of more serious Covid-19 outcomes including death so basic precautions are a no brainer, really.

What will happen in the future?

Covid-19 has already been through several variants. Some, such the Alpha and Delta variants, were highly deadly. The current dominant variant, Omicron, is less so. But we don’t know what future variants will bring. Because these variants are not directly linked - it's not a case of one evolving into another - there's no guarantee the next variant will be a mild one.

We have stopped talking so much about a 'pandemic' and now sometimes hear the word 'endemic'. But Covid-19 is not endemic. Endemic diseases are predictable. Covid-19 is not. Not yet.

The less data we collect on Covid-19, the less we’ll know about what is happening and the less we’ll be able to predict the future. That is why the government has been heavily criticised for winding down free testing and the collection and publication of data. 

Ideally, we’d be trying to keep ahead of the virus by testing the population and our waste water to spot new variants. Instead, we have the end of free-testing and the scaling back of surveillance by the ONS and the UK Health Security Agency (UKHSA) - described as a 'walk in the dark' by the British Medical Journal. (Ironically, surveillance is perhaps the one area in which the UK has genuinely been a world leader.)

What is Long Covid?

Most Covid infections resolve within a month. But some do not. Long Covid is an informal term used to describe signs and symptoms that continue or develop after an acute infection of Covid-19. As of January 2022, well over a million people in the UK had Long Covid symptoms.

Doctors are in the early stages of understanding this condition and there are a variety of different symptoms affecting may parts of the body. These include:

  • Breathlessness
  • Cough
  • Sore throat
  • Heart symptoms like chest tightness, chest pain or palpitations
  • Fatigue and tiredness
  • Fever
  • Pain
  • Cognitive impairment (or 'brain fog', loss of concentration or memory issues)
  • Confusion
  • Headache
  • Sleep disturbance
  • Pins and needles and numbness
  • Dizziness
  • Abdominal pain
  • Sickness
  • Diarrhoea
  • Reduced appetite (in older people)
  • Joint and muscle pain
  • Depression and anxiety
  • Tinnitus (ringing in the ears) and earache
  • Loss of taste and/or smell
  • Skin rashes

According to the Royal College of Nursing, patients are also reporting mental health issues. But the four most common physical symptoms are:

  • fatigue – reported by 55%
  • shortness of breath – 39%
  • loss of smell – 33%
  • difficulty concentrating (brain fog) – 30%. 

This is a long list of varied symptoms. Many of them could be caused by other conditions, of course, and doctors will try to rule these out. There is an NHS Covid recovery website.

You mentioned erection problems?

Yes. Research suggests that men who have had Covid-19 experience erection problems (EPs), both in the long-term and short term. One study, from Italy, says the risk of EPs increases by nearly six times when you have Covid-19. A detailed analysis of the penile tissue in men with ED following Covid-19 found remnants of the virus six to eight months after infection. Indeed, a paper published in the UK goes so far as to describe EPs as 'a likely consequence of Covid-19 for survivors'.

Doctors are not entirely sure what causes the link. Erection problems are linked to poor heart health. So is Covid-19. Or perhaps it is linked to testosterone - low-levels are seen in men with Covid-19. Or the depression and anxiety around having Covid-19 or Long Covid could also cause EPs. 

Whatever the reason, it makes sense for men to avoid catching Covid-19. That’s why the Forum ran a campaign in 2021 called: Don't be soft… Get the vaccine

Should we have tried to get rid of Covid completely?

If we had we wouldn’t need to worry about future variants but eliminating a disease is easier said than done.

For example, the UK was measles-free. But in 2017, partly thanks to low vaccine uptake, it came back.

How did the UK do?

Not great. It is in the top ten total death list with approaching 200,000 deaths. Even if you look at deaths per head of population, the USA and Italy are the only G7 countries with worse records. Given that the UK has been lucky enough to have the vaccine for longer than most countries, it’s a poor show.  In the UK, the excess death rate during 2020 and 2021 was nearly 90% higher than France and Germany.

Despite the head start, fewer people (72%) have been vaccinated in the UK than in countries like France and Germany, Australia and New Zealand, Cuba and China. Portugal is the best-vaccinated European country (93%).

What about the rest of the world?

Officially, over six million people have died worldwide. Some experts suggest that looking at the excess deaths data - the number of deaths above typical levels for recent years - the real Covid-19 death toll could be three times higher - nearer 18 million.

Deaths are still rising in some countries. In many countries in Africa and Asia, very few people have been vaccinated - fewer than 20%. High levels of infection across the world massively increase the likelihood of more variants with the associated dangers.

Will we see another pandemic like Covid-19?

Yes. They come round every so often and as the global population increases and world gets smaller, it is likely they’ll happen more often.

We learned from cholera epidemics in the nineteenth century that clean water would be a good idea. If we learn from this epidemic that, say, clean air is a good idea, we might do better next time. Basic sick pay (to enable infected people to take time off work) would help too.

Who can you trust when it comes to Covid-19?

It’s not easy. We all want things to be better and some of us let this desire dominate reason.

Understanding bias might help. Most people mouthing off on social media have an agenda and your health is not on it. Their bias is easy to see.

The unconscious bias of politicians and employers may be less obvious.

Politicians are, of course, concerned about public health but, in difficult situations, some have a tendency to tell us what they think we want to hear (such as ‘eat out’ or ‘it will be over by Christmas’), rather than share uncomfortable facts. Bear this in mind when considering what politicians say, especially when scientists and public health experts appear to be saying something different.

Employers too are concerned about public health but some may understandably be more concerned about keeping their businesses going. This means you will have to make your own decisions about how safe your workplace is.

Health researchers, scientists and public health organisations like the World Health Organisation will be more reliable. This is what they do for a living.

If you find or hear about interesting research, check who carried it out, which media is reporting it, whether it’s been published in a serious health journal and whether any other research supports it. Anything that is genuinely a game-changer will be reported on mainstream news programmes (BBC, ITV, Channel 4 etc) or in the serious newspapers.

Date published 30/03/22
Date of last review 05/04/22
Date of next review 13/04/22

References

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