New insight into why more men are dying of COVID than women

According to the World Health Organization, 56 per cent of worldwide COVID-19 deaths have been in men

Diana Duong 4 minute read October 19, 2020
men coughing and looking at a tissue

COVID-19 has been killing more men than women. It could be anything from biological differences in their immune systems to behavioural norms. Getty Images

Since the start of COVID-19, more men have died from the novel coronavirus than women. In China, Italy, and in the U.S., reports of deaths were significantly higher in men. Even now, in the latest surveillance report from the World Health Organization, 56 per cent of worldwide COVID-19 deaths have been in men. While the exact reasons are still unclear, the reason could be linked to anything from biology to behaviours.

A new study published in the Proceedings of the National Academy of Sciences journal may give insight into the gender divide.

Earlier in the pandemic, Italian researchers surveyed 21,649 people in eight countries: Australia, Austria, France, Germany, Italy, New Zealand, the U.K. and the U.S. They found that women were more likely to adhere to COVID-19 public health guidelines, making them less vulnerable to the virus compared to men.

In fact, in March, 59 per cent of women versus 48.7 per cent of men were likely to consider COVID-19 a very serious health problem. In April, women were more inclined to agree with public health policies like physical distancing (39.6 per cent) than men (33 per cent). Over time, participants’ compliance with rules started to drop, with Germany seeing the largest gender divide, with 70.5 per cent of women continuing to follow virus prevention guidelines, compared to 63.7 per cent of men.

The study also found married couples who live together and communicate to each other about their views saw smaller differences. The gap closed further if men and women were both exposed to similar information about the pandemic.

Many men have been socialized to mask their fear

“Policy makers who promote a new normality made of reduced mobility, face masks and other behavioural changes should, therefore, design a gender-differentiated communication if they want to increase the compliance of men,” says Vincenzo Galasso, one of the authors of the study, in a statement.

“The biggest differences between men and women relate to behaviours that serve to protect others above all, such as coughing in the elbow, unlike those that can protect both themselves and others,” says Paola Profeta, another co-author of the study.

Men and women at equal risk of COVID-19 — but men have been more affected

While men and women are equally likely to be infected, men are at significantly higher risk than women for having worse outcomes and death, reports a study published in the Frontiers of Public Health. Researchers from China compared today’s coronavirus to the SARS outbreak in 2003 and found similar results.

Many men have been socialized to mask their fear

This may have to do with the biological differences between men and women’s immune responses. The X chromosome contains a high density of immune-related genes, and because women have two X chromosomes, they may be able to create a stronger immune response than men. The Washington Post also reported that women typically have stronger immune systems, and the T-cell response, which is responsible for killing infected host cells and activating other immune cells, in men is weaker. Our immune responses wane with age, Akiko Iwasaki, a professor and researcher of immunity to viruses and cancer, told the Post, but the T-cell response of men drops much quicker than in women; a man in his 30s and 40s could have the T-cell equivalent to that of a woman in her 90s.

Research has also shown men tend to have lower immune responses due to behaviours related to masculinity, like smoking and drinking, but also because they generally are less likely to take preventive public health measures, like hand-washing, mask-wearing, physical distancing, and seeking medical help.

An article published in the CDC reports:

“Many men have been socialized to mask their fear, and it is important to consider how hiding fear affects men’s response to COVID-19. It is particularly important to focus on men who respond to threats like COVID-19 with aggression and anger. Research shows that people with this response “tend to downplay risk and are resistant to risk reduction policies,” which is problematic during efforts to promote social distancing and other pandemic restrictions.” | @dianaduo
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