How does COVID-19 disproportionately affect gender?

Aaron_Denham

What might we expect to see in terms of the inequalities in gender data related to the disease and its associated direct or indirect burdens?

Shashi

Hi @Malinga, @LivLauren, @GB2020, @Eun, @ACislak, @rcuevas, @jennifercurtin, @ElsaMarie,
I'd like to ask for your input on this discussion, specifically who are the people suffering directly from data gaps in health? Who suffers indirectly?
Thanks.

shihei

Hi all, just joined and looking forward to the discussions. The gender implications of COVID19 are immense. There are obvious differences in disease incidence and mortality rates between men and women, but data are too limited and poorly disaggregated to see if this is true everywhere, across all age groups, and how these may be influenced by different factors. But there are also important gender implications in terms of the response to COVID19, including issues related to income loss, lack of safety net and social security and health insurance, disproportionate burden of domestic and childcare, and the greater viral load that the frontline healthcare workers, a majority of whom are women, are exposed to. We need to demand far better disaggregation of data (at a minimum by sex, for each age group) by all countries and international organizations, including by WHO and others.

Most importantly, I fear that development of vaccines and testing of drugs (even those to be repurposed) will not take into account the sex- and gender-based differences adequately. There are growing evidence about the differences in the immunity and drug metabolism between men and women, so development of vaccines and therapeutic products must pay better attention to these various factors.

shihei

Also, perhaps the question could be rephrased to:
What are the gender implications of COVID-19?
OR
How does COVID-19 disproportionately affect WOMEN (OR MEN)?

BarbaraDM

Hi, we are discussing on this as well and we have published on our web magazine an article for a well known Italian researcher commenting upon the fact hormones may play a role on differences (I post the article although it is in Italian since someone may be able it read it http://www.ingenere.it/articoli/perche-uomini-piu-vulnerabili-coronavirus). This Lancet article is the most interesting contribute I have read up to now https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30526-2/fulltext. On the different impact on women and men of pandemics I found very interesting also this https://www.unwomen.org/en/news/stories/2020/3/news-womens-needs-and-leadership-in-covid-19-response

stellunak

Hi, everyone! It's great to be reading your thoughts around this. Under the disproportionate impact theme, I would also add:
- The increase in cases of domestic violence and abuse and the decrease in the capacity of victims to ensure the safety of themselves and, possibly, their children
- The considerable consequences of uncertainty and social isolation for people with mental health issues, such as depression and eating disorders that especially affect women
- The consequences of COVID-19 and of our response to it for women struggling with fertility issues (delayed access to treatments and procedures), unwanted pregnancies (restricted access to abortion services), single motherhood (and/or pregnancy) etc.

Shashi

Thanks @shihei, @BarbaraDM and @stellunak for sharing these important insights on disproportionate affect. @Aaron_Denham would you be able to share inputs based on your research.
Thanks.

Shashi

Hello @Dockweiler, @katrinafalkner, @Gaelle, @areff2000, @Chakra,
You may have thoughts on this discussion. Please let us know what you think! Thanks.

WD_Research

UNFPA put out a very informative brief on this: https://www.unfpa.org/sites/default/files/resource-pdf/COVID-19_A_Gender_Lens_Guidance_Note.pdf

It covers differences in how disease affects men and women, protections needed for a predominantly female health workforce, and the disproportionate impact COVID-19 has on women’s health because sexual and reproductive health (SRH) needs don’t stop during emergencies. Safe pregnancy and delivery, and access to the broad range of SRH services, becomes limited as health systems are taxed with COVID-19. There is also a lot we just don’t fully know yet, such as the range of impacts the disease can have on maternal and infant health. Intimate-partner violence, and other forms of gender based violence also increase during crisis and must be addressed, particularly as women as are asked to stay home during this time.

Agreeing with @shihei women will also be affected by the increased burden of unpaid work (household, elderly and childcare) and loss of income, as many women work in the informal economy and/or hold part-time positions. We are also concerned with the historical lack of inclusion of women in clinical trials. Women must be involved in the design and development of solutions.

Shashi

Thanks @WD_Research for sharing this report. Its been an important read and gathered lots of insights on this issue.

@yasmeenhassan1, @Niki, @shruti, @barbara_mue, @mustafanaseem you may want to share your thoughts on this discussion.

sarahkhenry

Hi All,

Here is a list of articles that I have been keeping track of the intersection of gender and COVID-19 if they are at all helpful.

● COVID-19: the gendered impacts of the outbreak
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30526-2/fulltext

● Gender and the Coronavirus Outbreak
https://www.thinkglobalhealth.org/article/gender-and-coronavirus-outbreak

● Gender “Could be Coronavirus Key”
http://www.ipsnews.net/2020/03/gender-coronavirus-key/

● COVID-19 is not gender neutral
http://www.broadagenda.com.au/home/covid-19-is-not-gender-neutral/

● Coronavirus: A Look at Gender Differences in Awareness and Actions
https://www.kff.org/womens-health-policy/issue-brief/coronavirus-a-look-at-gender-differences-in-awareness-and-actions/

● COVID-19: Can A Health Crisis Become A Breeding Site For Gender Inequality?
https://feminisminindia.com/2020/03/24/covid-19-gender-should-matter-india/

● Sex, gender and COVID-19: Disaggregated data and health disparities
https://blogs.bmj.com/bmjgh/2020/03/24/

● A gender perspective: COVID and Public spaces
https://www.linkedin.com/pulse/gender-perspective-covid-public-spaces-lizzette-soria/

● The COVID-19 Outbreak and Gender: Key Advocacy Points from Asia and the Pacific
https://asiapacific.unwomen.org/en/digital-library/publications/2020/03/the-covid-19-outbreak-and-gender

● The Coronavirus Is a Disaster for Feminism: Pandemics affect men and women differently.
https://www.theatlantic.com/international/archive/2020/03/feminism-womens-rights-coronavirus-covid19/608302/

● Why gender matters in the impact and recovery from Covid-19
https://www.lowyinstitute.org/the-interpreter/why-gender-matters-impact-and-recovery-covid-19

● CALL FOR GLOBAL EVIDENCE ON GENDER AND COVID-19
https://www.menshealthforum.org.uk/news/call-global-evidence-gender-and-covid-19

● Briefing: Covid-19 – Gender and other Equality Issues (Women’s Budget Group)
https://wbg.org.uk/blog/briefing-covid-19-and-gender-issues/

Kathleen_Hamrick

@sarahkhenry amazing resources — thank you for sharing them with us here!

EVSwanson

A significant percentage of the world’s population, many of them pregnant women, will be infected over the next weeks or months. This editorial from the online journal of the American Medical Association warns that more evidence is needed on the possibility of transmission of COVID-19 in the womb. https://jamanetwork.com/journals/jama/fullarticle/2763851

Aaron_Denham

@WD_Research Thanks for the UNFPA report. It summarizes the key issues well. And thanks to @sarahkhenry, @stellunak, and @BarbaraDM for these resources. I passed these on to one of our other teams working in this space.

Kathleen_Hamrick

@EVSwanson thank you for sharing this important editorial piece about possible transmission of COVID-19 in the womb with us!

EVSwanson wrote: »

A significant percentage of the world’s population, many of them pregnant women, will be infected over the next weeks or months. This editorial from the online journal of the American Medical Association warns that more evidence is needed on the possibility of transmission of COVID-19 in the womb. https://jamanetwork.com/journals/jama/fullarticle/2763851

shihei

Thanks for sharing these great resources.

Here is also a Gender Alert for COVID19 in humanitarian settings, released by IASC Gender Reference Group: https://reliefweb.int/sites/reliefweb.int/files/resources/iasc_gender_reference_group_-_gender_alert_covid_19_final_24032020.pdf

May I also suggest if anyone knows of any reliable sources of country data disaggregated by sex and age to share those here?

The Global Health 50/50 has put out live tracking data only disaggregated by sex. While useful, the data are from a variety of sources: https://globalhealth5050.org/covid19/

DrLiliaGiugni

Hi everyone, just catching up with the discussion, and great to read all your comments. To the excellent points already made, I would also add the implications in terms of sexual and reproductive rights. Accessing reproductive services, in particular, is becoming even more difficult in several countries hit by the pandemic.