A new (novel) coronavirus was identified in China causing severe respiratory disease, including pneumonia. The World Health Organization named the virus responsible as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the disease it causes COVID-19. COVID-19 is bringing to the fore many inequities in health, which includes men's experiences. It has been acknowledged that COVID-19 discriminates by age and by underlying health conditions (Office for National Statistics (ONS), 2020a).
In 2003, men were also disproportionately affected during the SARS and Middle East Respiratory Syndrome (MERS) outbreaks, both caused by coronaviruses. In Hong Kong, more women than men were infected by SARS, but the death rate among men was 50% higher (Leung et al, 2014). With regards to respiratory tract infections generally, men can have worse outcomes. Data from the ONS (2020b) reveal that in each age group there have been more deaths involving COVID-19 in males than in females. In the week ending 10 April the largest difference was in the age group 75–84 years: there were 2346 deaths involving COVID-19 in males versus 1315 in females. This gender difference has been noted globally.
Gender disaggregated data and gender analysis of the outbreak by global health institutions and governments is now occurring, as we all begin to try to understand the extent to which disease outbreaks affect women and men differently. This is an essential step to understanding the effects of a health emergency on individuals and communities. It could also offer an opportunity for creating effective, equitable policies and interventions (Wenham et al, 2020).
A number of issues could be working against men in the current pandemic, including biological factors (men tend to struggle to mount an effective immune response to infections) and some that are ingrained in lifestyle. Women's immune systems respond more energetically than men's, producing a stronger response when they have been vaccinated, and they have better memory immune responses, protecting adults from pathogens they were exposed to as children. However, women are more susceptible to autoimmune diseases, such as rheumatoid arthritis and lupus, where the immune system moves into overdrive attacking the body's own organs and tissues. Most people with autoimmune disease are women.
Baker (2020) notes that men's risk of death from COVID-19 seems to be greater than that of women. He suggests that key factor could be that men, as opposed to their female counterparts, are more likely to be affected by one of the underlying non-communicable diseases known to increase mortality, for example, hypertension, diabetes, cardiovascular disease and chronic obstructive pulmonary disease.
Policies and public health efforts have year-on-year failed to address the impact of disease outbreaks on gender. Baker (2020), once again, makes it clear that the health problems affecting men can no longer be overlooked locally, nationally and internationally. The response to coronavirus means that this gross inequality can no longer continue. Lifestyle, biology and behaviour are all playing a part in the COVID-19 trend that is emerging across the world. A gendered response to non-communicable diseases is essential if men's vulnerability is to be addressed and inequality is to be tackled.