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We have already seen evidence from China suggesting that mortality rates from COVID-19 in men were almost twice as high as in women. According to The Lancet, the proportion of male deaths from the virus in Italy has been even higher: of the 827 deaths recorded by 11 March, 80% were male.
This pattern, if confirmed over a longer time period, would be consistent with what epidemiologists observed during the SARS and MERS outbreaks. In the 2003 SARS outbreak in Hong Kong, for instance, nearly 22% of infected men died, compared to around 13% of women. In an analysis of MERS infections between 2017 and 2018, around 32% of men died, and nearly 26% of women.
The mortality 'gap' could be caused by sex-based immunological or gendered differences, such as patterns and prevalence of smoking. The sex disparity also holds true in SARS-infected mice and it may be that the hormone oestrogen has a protective effect: removing the ovaries of infected female mice or blocking the oestrogen receptor makes the animals more likely to die compared to infected control mice.
The recently-established Gender and COVID-19 Working Group has observed that 'Policies and public health efforts have not addressed the gendered impacts of disease outbreaks. The response to COVID-19 appears no different. We are not aware of any gender analysis of the outbreak by global health institutions or governments in affected countries or in preparedness phases. Recognising the extent to which disease outbreaks affect women and men differently is a fundamental step to understanding the primary and secondary effects of a health emergency on different individuals and communities, and for creating effective, equitable policies and interventions.
The Men's Health Forum (Great Britain) has called for a gender-sensitive approach to COVID-19 and also published a 'Toolbox Talk' on the virus. This is mainly aimed at men in the workplace but can be used as a health education tool with any group of men. GAMH would welcome any information about male-targeted work on COVID-19 in other countries.
In the meantime: keep well.
Director, Global Action on Men's Health (GAMH)
It’s tough for men to ask for help but if you don’t ask when you need it, things generally only get worse. So we’re asking.
In the UK, one man in five dies before the age of 65. If we had health policies and services that better reflected the needs of the whole population, it might not be like that. But it is. Policies and services and indeed men have been like this for a long time and they don’t change overnight just because we want them to.
It’s true that the UK’s men don’t have it bad compared to some other groups. We’re not asking you to ‘feel sorry’ for men or put them first. We’re talking here about something more complicated, something that falls outside the traditional charity fund-raising model of ‘doing something for those less fortunate than ourselves’. That model raises money but it seldom changes much. We’re talking about changing the way we look at the world. There is nothing inevitable about premature male death. Services accessible to all, a population better informed. These would benefit everyone - rich and poor, young and old, male and female - and that’s what we’re campaigning for.
We’re not asking you to look at images of pity, we’re just asking you to look around at the society you live in, at the men you know and at the families with sons, fathers and grandads missing.
Here’s our fund-raising page - please chip in if you can.