Monday, April 27, 2020

Why are more men than women dying from COVID-19 - except in Canada?

There have been many articles highlighting the fact that significantly more men than women are dying from COVID-19. And my initial theory, that more men (who are probably more cavalier in their attitudes, and less careful and fastidious than women) were also being infected more, appears to be completely incorrect: men and women are being infected about equally.
But it certainly seems to be the case that substantially more men than women are dying from the virus worldwide, and data from individual countries really underlines it: China reported a fatality rate of 2.8% for men versus 1.7% for women; in South Korea, this is 1.19% for men and 0.52% for women; in Spain, men are twice as likely as women to end up in intensive care as women, and twice as likely to die; in hard-hit northern Italy, these statistics are 82% and 70%; New York reported 39 deaths per 100,000 people among women, and 71 per 100,000 among men; etc, etc. This disparity applies in all different age ranges.
Various theories have been put forward to explain this imbalance, from women's stronger immune system and the protective effects of estrogen to the poorer heart and lung health of men to the prevalence of male smokers in the populations, none of them definitive.
But it may also be something to do with those cavalier, devil-may-care attitudes I mentioned earlier: for one thing, men are less likely to get themselves tested than women. In the USA, 56% of people tested were women, and 16% of those tested positive, while 44% were men, but 23% of them were positive. That suggests that men are less likely to get tested, and are more likely to wait until the disease is further progressed (or perhaps that women are more likely to exaggerate or self-diagnose symptoms!) An early diagnosis gives a better chance of dealing with the disease, thus giving women a natural advantage.
As so often, the truth behind the disproportionate mumber of men dying may be a complex combination of all these genetic, immunological, medical, societal and psychological reasons.

UPDATE
On the other hand, Canada is one of very few countries to buck the trend, and Canada has the world's highest proportion of female deaths from COVID-19. Overall, 53% of Canadian deaths are women (54.4% in Ontario and 54.9% in Quebec).
The reason for that appears to be related to the number of deaths that occur in long-term care homes (about 80% of Canada's total). Given that over 70% of care home residents are female, and upwards of 80% of nurses and personal support workers, then it makes sense that the toll on women as a whole be so much higher in Canada.
Of course, the reason why Canadian long-term care homes have been hit so hard is the subject of much agonizing and ongoing debate, and I'm sure it will continue to be discussed for years afterwards.

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