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COVID-19 affects people differently, in terms of infection with the virus SARS-CoV-2 and mortality rates. In this Special Feature, we focus on some of the sex differences that characterize this pandemic. Share on Pinterest The data that are available so far indicate that there are significant differences between how the sexes respond to the new coronavirus.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date. Visit our coronavirus hub for the most recent information on the COVID-19 pandemic.Was this helpful?

There are many ways in which the pandemic itself affects peoples day-to-day lives, and gender understood as the ensemble of social expectations, norms, and roles we associate with being a man, woman, trans- or nonbinary person plays a massive part.

On a societal level, COVID-19 has affected cis- and transwomen, for example, differently to how it has cismen, transmen, and nonbinary people. Reproductive rights, decision making around the pandemic, and domestic violence are just some key areas where the pandemic has negatively impacted women.

However, sex differences understood as the biological characteristics we associate with the sex that one is assigned at birth also play an undeniable role in an epidemic or pandemic.

While sex and gender are, arguably, inextricably linked in healthcare, as in every other area of our lives, in this Special Feature, we will focus primarily on the infection rates of SARS-CoV-2 and the mortality rates that COVID-19 causes, broken down by sex.

In specialized literature, these effects fall under the umbrella term of primary effects of the pandemic, while the secondary impact of the pandemic has deeper social and political implications.

Throughout this feature, we use the binary terms man and woman to accurately reflect the studies and the data they use. Sex-disaggregated data lacking

Before delving deeper into the subject of sex differences in COVID-19, it is worth noting that the picture is bound to be incomplete, as not all countries have released their sex-disaggregated data.

A report appearing on the blog of the journal BMJ Global Health on March 24, 2020, reviewed data from 20 countries that had the highest number of confirmed cases of COVID-19 at the time.

Of these 20 countries, Belgium, Malaysia, Netherlands, Portugal, Spain, United Kingdom, and the United States of America did not provide data that was disaggregated, or broken down, by sex.

At the time, the authors of the BMJ report appealed to these countries and others to provide sex specific data.

Anna Purdie, from the University College London, United Kingdom, and her colleagues, noted: We applaud the decision by the Italian government to publish data that are fully sex- and age-disaggregated. Other countries [] are still not publishing national data in this way. We understand but regret this oversight.
At a minimum, we urgently call on countries to publicly report the numbers of diagnosed infections and deaths by sex. Ideally, countries would also disaggregate their data on testing by sex.

Anna Purdie et al.

Since then, countries that include Belgium, the Netherlands, Portugal, and Spain have made their data available.

The U.K. have made only a part of the sex-disaggregated data available for England and Wales, without covering Scotland and Northern Ireland while Malaysia and the U.S. have not made their sex-disaggregated data available at all.

At the time of writing this article, the U.S. still have not released their sex-disaggregated data despite the country having the highest number of COVID-19 cases in the world.

For more research-backed information and resources for mens health, please visit our dedicated hub.Was this helpful? Men more than twice as likely to die

Global Health 5050, an organization that promotes gender equality in healthcare, has rounded up the total and partial data that is available from the countries with the highest numbers of confirmed COVID-19 cases.

According to their data gathering, the highest ratio of male to female deaths, as a result of COVID-19, is in Denmark and Greece: 2.1 to 1.

In these countries, men are more than twice as likely to die from COVID-19 as women. In Denmark, 5.7% of the total number of cases confirmed among men have resulted in death, whereas 2.7% of women with confirmed COVID-19 have died.

In the Republic of Ireland, the male to female mortality ratio is 2 to 1, while Italy and Switzerland have a 1.9 to 1 ratio each.

The greatest parity between the genders from countries that have submitted a full set of data are Iran, with 1.1 to 1, and Norway, with 1.2 to 1.

In Iran, 5.4% of the women patients have died, compared with 5.9% of the men. In Norway, these numbers stand at 1.3% and 1.1%, respectively.

China has a ratio of 1.7, with 2.8% of women having died, compared with 4.7% of men.
Infection rates in womenand men

A side-by-side comparison of infection rates between the sexes does not explain the higher death rates in men, nor is there enough data available to draw a conclusion about infection rates broken down by sexes.

However, it is worth noting that in Denmark, where men are more than twice as likely to die of COVID-19 as women, the proportion of women who contracted the virus was 54%, while that of men was 46%.

By contrast, in Iran, where the ratio of deaths between men and women is less different (1.1 to 1), just 43% of cases are female compared with 57% cases in men.

Until we know the proportion of people from each sex that healthcare professionals are testing, it will be difficult to fully interpret these figures.

What we do know so far is that, overall, nine of the 18 countries that have provided complete sex-disaggregated data have more COVID-19 cases among women than they do among men. Six of the 18 countries have more cases among men than they do among women.

Norway, Sweden, and Germany have a 5050% case ratio.

Other countries where more women have developed COVID-19 include:
Switzerland (53% of women to 47% of men)Spain (51% to 49%)The Netherlands (53% to 47%)Belgium (55% to 45%)South Korea (60% to 40%)Portugal (57% to 43%)Canada (52% to 48%)Republic of Ireland (52% to 45%)

Greece, Italy, Peru, China, and Australia all have a higher number of confirmed cases among men than women.Why are men more likely to die?

Part of the explanation for why the new coronavirus seems to cause more severe illness in men is down to biological sex differences.

Womens innate immune response plays a role. Experts agree that there are sex differences, such as sex chromosomes and sex hormones, that influence how a persons immunity responds to a pathogen.

As a result, women are in general able to mount a more vigorous immune response to infections [and] vaccinations. With previous coronaviruses, specifically, some studies in mice have suggested that the hormone estrogen may have a protective role.

For instance, in the study above, the authors note that in male mice there was an exuberant but ineffective cytokine response. Cytokines are responsible for tissue damage within the lungs and leakage from pulmonary blood vessels.

Estrogens suppress the escalation phase of the immune response that leads to increased cytokine release. The authors showed that female mice treated with an estrogen receptor antagonist died at close to the same rate as the male mice.

As some researchers have noted, lifestyle factors, such as smoking and alcohol consumption, which tend to occur more among men, may also explain the overall higher mortality rates among men.

Science has long linked such behaviors with conditions that we now know are likely to negatively influence the outcome of patients with COVID-19 cardiovascular disease, hypertension, and chronic lung conditions. Why women might be more at risk

On the other hand, the fact that societies have traditionally placed women in the role of caregivers a role which they continue to fulfill predominantly and the fact that the vast majority of healthcare workers are women cold place them at a higher risk of contracting the virus and might explain the higher infection rates in some countries.

An analysis of 104 countries by the World Health Organization (WHO) found that Women represent around 70% of the health workforce. In China, women make up more than 90% of healthcare workers in Hubei province.

These data emphasize the gendered nature of the health workforce and the risk that predominantly female health workers incur, write the authors of a report on the gendered impacts of the pandemic that appears in The Lancet.

Although we cannot yet draw definitive conclusions because sex-disaggregated data is not yet available from all the countries affected, The Lancet report looks at previous epidemics for clues.

During the 201416 west African outbreak of Ebola virus disease, the authors write, gendered norms meant that women were more likely to be infected by the virus, given their predominant roles as caregivers within families and as frontline healthcare workers.

The authors also call out for governments and health institutions to offer and analyze data on sex and gender differences in the pandemic.
Why sex-disaggregated data are urgent

The report in The Lancet reads, 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.

For instance, identifying the key difference that makes women more resilient to the infection could help create drugs that also strengthen mens immune response to the virus.

Devising policies and intervention strategies that consider the needs of women who work as frontline healthcare workers could help prevent the higher infection rates that we see among women.

Finally, men and women tend to react differently to potential vaccines and treatments, so having access to sex-disaggregated data is crucial for conducting safe clinical trials.

As Anna Purdie who also works for Global Health 5050 and her colleagues summarize in their article, Sex-disaggregated data are essential for understanding the distributions of risk, infection, and disease in the population, and the extent to which sex and gender affect clinical outcomes.
Understanding sex and gender in relation to global health should not be seen as an optional add-on but as a core component of ensuring effective and equitable national and global health systems that work for everyone. National governments and global health organizations must urgently face up to this reality.

Anna Purdie et al

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Gallagher brothers share a high-five and hug as Oasis reunite on stage after 16 years

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Gallagher brothers share a high-five and hug as Oasis reunite on stage after 16 years

Oasis have reunited on stage for the first time in almost 16 years – with brothers Liam and Noel Gallagher sharing a high five and the briefest of hugs as they closed a performance that for fans was more than worth the wait.

After the split in 2009, for many years Noel said he would never go back – and for a long time, as the brothers exchanged insults through separate interviews (and on social media, for Liam), it seemed pretty unlikely to ever happen.

But now, here they are. As they walked out on stage at Cardiff’s Principality Stadium, all eyes were on the Gallaghers for a sense of their relationship – dare we say it, friendship? – now after all these years.

There was no reference to their fall-out or making up, but the gestures were there – lifting hands together as they walked out for the first time.

The headline "OASIS REUNITED" was shown on stage at the gig. Pic: PA
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The headline “OASIS REUNITED” was shown on stage at the gig. Pic: PA

Fans at the Oasis gig. Pic: PA
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Fans at the Oasis gig. Pic: PA

Headlines and tweets of speculation and then confirmation of the reunion filled the screens as the show started. “This is happening,” said one, repeatedly.

In the end, it was all about the music.

Liam has received criticism in the past for his voice not being what it once was during his solo or Beady Eye performances, but back on stage with his brother tonight he delivered exactly what fans would have hoped for – a raw, steely-eyed performance, snarling vocals, and the swagger that makes him arguably the greatest frontman of his day.

More on Oasis

This was Oasis sounding almost as good as they ever have.

Fans sang along and held up their phones to film as Oasis performed. Pic: PA
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Fans sang along and held up their phones to film as Oasis performed. Pic: PA

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Oasis: ‘It’s good to be back’

They opened with Hello, because of course, “it’s good to be back”. And then Acquiesce, and those lyrics: “Because we need each other/ We believe in one another.”

The song is said to be about friendship in the wider sense, rather than their brotherly bond and sibling rivalry, but you can’t help but feel like it means something here.

Over two hours, they played favourite after favourite – including Morning Glory, Some Might Say, Cigarettes & Alcohol, Supersonic and Roll With It.

Liam Gallagher as Oasis takes to the stage in Cardiff. Pic: PA
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Liam Gallagher as Oasis takes to the stage in Cardiff. Pic: PA

In the mid-section, Liam takes his break for Noel to sing Talk Tonight, Half The World Away and Little By Little; the tempo slows but there is by no means a lull, with the fans singing all his words back to him.

Liam returns for hits including Stand By Me, Slide Away, Whatever and Live Forever, before sending the crowd wild (or even wilder) with Rock And Roll Star.

Noel Gallagher performing on stage. Pic: PA
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Noel Gallagher performing on stage. Pic: PA

An Oasis fan is pointing at the stage during the gig. Pic: PA
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An Oasis fan is pointing at the stage during the gig. Pic: PA

When the reunion announcement was made last summer, it quickly became overshadowed by the controversy of dynamic pricing causing prices to rocket. As he has done on X before, Liam addressed the issue on stage with a joke.

“Was it worth the £4,000 you paid for the ticket?” he shouted at one point. “Yeah,” the crowd shouts back; seemingly all is forgiven.

After Rock And Roll Star, the dream that very quickly became a reality for this band, Noel introduced the rest of the group, calling Bonehead a “legend”.

Paul 'Bonehead' Arthurs of Oasis. Pic: PA
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Paul ‘Bonehead’ Arthurs of Oasis. Pic: PA

Liam Gallagher carried a tambourine in his mouth during the concert. Pic: PA
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Liam Gallagher carried a tambourine in his mouth during the concert. Pic: PA

Then he acknowledges all their young fans, some who maybe weren’t even born when they split. “This one is for all the people in their 20s who’ve never seen us before, who’ve kept this shit going,” he says before the encore starts with The Masterplan.

Noel follows with Don’t Look Back In Anger, and the screens fill with Manchester bees in reference to the arena bombing and how the song became the sound of hope and defiance for the city afterwards.

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‘I’d have paid £10,000 to see them’

Two fans sat on their friends' shoulders as Oasis performed. Pic: PA
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Two fans sat on their friends’ shoulders as Oasis performed. Pic: PA

During Wonderwall, there’s a nice touch as Liam sings to the crowd: “There are many things I would like to say to you, but I don’t speak Welsh.”

It is at the end of Champagne Supernova, which closes the set, that it happens; Noel puts down his guitar, and they come together for a high-five and a back-slap, a blink-and-you’d miss it hug.

Read more:
What you need to know about the Oasis tour
Liam Gallagher hits out at council after fans branded ‘rowdy’

“Right then, beautiful people, this is it,” Liam had told the crowd as he introduced the song just a few minutes earlier. “Nice one for putting up with us over the years.”

From the roar of the audience, it’s safe to say most people here would agree it’s been worth it.

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Sweden’s justice minister says to ‘turn up the pressure’ on crypto seizures

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Sweden’s justice minister says to ‘turn up the pressure’ on crypto seizures

Sweden’s justice minister says to ‘turn up the pressure’ on crypto seizures

Gunnar Strömmer reportedly said that Swedish authorities had confiscated more than $8.3 million worth of criminal profits since a law related to seizures was passed in 2024.

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At least 13 people confirmed dead and more than 20 missing from girls camp in Texas flooding

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At least 13 people confirmed dead and more than 20 missing from girls camp in Texas flooding

13 people have been killed in the US state of Texas after heavy rain caused flash flooding, according to local media reports.

Officials have also said more than 20 are missing from a girls’ camp in Texas.

As much as 10 inches (25 centimetres) of heavy rain fell in just a few hours overnight in central Kerr County, causing flash flooding of the Guadalupe River.

Judge Rob Kelly, the chief elected official in the county, confirmed fatalities from the flooding and dozens of water rescues so far.

A flood watch issued on Thursday afternoon estimated isolated amounts up to seven inches (17 centimetres) of rising water.

This breaking news story is being updated and more details will be published shortly.

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