Sex differences in COVID-19

Published

2 years ago

September 29, 2023

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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 Some information may be out of date.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 COVID-19.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 could place the 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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US

Menendez brothers denied parole – but they could still taste freedom

Published

2 hours ago

August 23, 2025

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Menendez brothers denied parole - but they could still taste freedom

The Menendez brothers, who were sentenced to life for killing their parents in their Beverly Hills mansion in 1989, have both been denied parole.

Lyle Menendez, 56, and his 53-year-old brother Erik have spent 35 years behind bars for the shotgun murders of their father and mother, Jose and Kitty Menendez.

The brothers have claimed that their parents abused them and have argued that the killings were an act of self-defence.

A Netflix drama series about the brothers called Monsters, which aired in September 2024, thrust them back into the spotlight and led to renewed calls for their release, including from their family.

A long-delayed resentencing hearing offered them a path to freedom for the first time since their incarceration.

However, their release from prison is still a long way off – and far from guaranteed.

Parole denied but still possible

Lyle Menendez was denied parole on 22 August after making his first appeal for release. A judge recently reduced both his and his brother’s sentences, making them eligible for parole.

The decision came a day after his brother Erik Menendez was also denied parole by a panel of California commissioners.

A panel of two commissioners recommended that Lyle not be released for three years, after which he will be eligible to apply for parole again.

The panel concluded there were still signs that Menendez would pose a risk to the public if released from custody, despite noting that a psychologist found that he is at “very low” risk for violence upon release.

During the hearing, Menendez cried and took sole responsibility for the murders, saying in his closing remarks: “I will never be able to make up for the harm and grief I caused everyone in my family.”

While speaking to the panel on Friday, Menendez said his father physically abused him by choking, punching and hurting him using a belt.

“I was the special son in my family,” he said. “My brother was the castaway. The physical abuse was focused on me because I was more important to him, I felt.”

He also said his mother sexually abused him, but appeared uncomfortable discussing this when asked by the panel why he did not disclose it during a risk assessment earlier this year.

When asked whether the murders were planned, Menendez said: “There was zero planning. There was no way to know it was going to happen Sunday.”

He also described buying the guns used in the murder as “the biggest mistake”, and told the panel: “I no longer believe that they were going to kill us in that moment. At the time, I had that honest belief.”

What does the resentencing mean?

Before leaving his role in December, former Los Angeles district attorney (DA) George Gascon asked LA County Superior Court Judge Michael Jesic to review the brothers’ convictions.

During the resentencing on 13 May, he gave them a revised sentence of 50 years to life, making them immediately eligible for youth parole under California’s youthful offender law because they committed the crime while under the age of 26.

The judgment was based on whether the pair had been rehabilitated based on their behaviour in prison.

The brothers’ case highlighted some of their achievements behind bars: attaining several degrees and contributing to the community.

It listed a prison “beautification programme” Lyle Menendez started called GreenSpace as one example, and added that both brothers had received low-risk assessment scores, with Lyle apparently not being involved in a single fight during his time in jail.

The brothers’ attorneys pushed for the judge to resentence the brothers to manslaughter, which would have allowed them to be immediately released, but he gave them a revised murder sentence instead.

Handing them the new sentence, Judge Jesic said: “I do believe they’ve done enough in the past 35 years, that they should get that chance.”

The resentencing hearing had faced lengthy delays due to the judge needing to review a large number of files, as well as the LA wildfires in January.

There was also a turnover in the DA’s office, with liberal leaning Gascon replaced by the more conservative Nathan Hochman, who repeatedly attempted to have the resentencing hearing thrown out.

Emotional testimony in court from brothers and family members

The brothers appeared at the proceedings in Los Angeles County Superior Court via video feed from prison in San Diego.

“I killed my mum and dad. I make no excuses and also no justification,” Lyle said in a statement to the court. “The impact of my violent actions on my family… is unfathomable.”

Erik also spoke about taking responsibility for his actions and apologising to his family.

He said: “You did not deserve what I did to you, but you inspire me to do better.”

The brothers chuckled when one of their cousins, Diane Hernandez, told the court that Erik received A+ grades in all of his classes during his most recent semester in college.

Anamaria Baralt, another cousin of the brothers, told the court they had repeatedly expressed remorse for their actions.

“We all, on both sides of the family, believe that 35 years is enough. They are universally forgiven by our family,” she said.

The defence also called a former judge and a former fellow inmate to the witness stand to testify that the brothers were not only rehabilitated, but also helped others. Prosecutors cross-examined the witnesses but didn’t call any of their own.

Former judge Jonathan Colby, who said he considered himself tough on crime, told the court that spending time with the brothers and witnessing their growth made him believe in rehabilitation.

Anerae Brown, who previously served time in prison alongside the brothers, cried as he testified about how they helped him heal and eventually be released through parole.

“I have children now,” he said. “Without Lyle and Erik I might still be sitting in there doing stupid things.”

The judge said he was particularly moved by a letter from a prison official who supported resentencing, something the official had never done for any incarcerated person in his 25-year career.

Los Angeles County prosecutors argued against the resentencing, saying the brothers have not taken complete responsibility for the crime.

The current DA Mr Hochman said he believed the brothers were not ready for resentencing because “they have not come clean” about their crimes.

His office has also said it does not believe they were sexually abused.

“Our position is not ‘no’. It’s not ‘never’. It’s ‘not yet’,” Mr Hochman said. “They have not fully accepted responsibility for all their criminal conduct.”

What happens now?

The reduced sentencing made the brothers immediately eligible for parole, but they must still appear before a state parole board, which decides on whether or not to release them from prison.

While this decision is made, the brothers will remain behind bars.

Their first hearing had to take place no later than six months from their eligibility date, according to board policy.

After their first appeal was denied, the brothers will continue to receive subsequent hearings until they are granted release.

But the brothers have another potential avenue to freedom, having appealed to California governor Gavin Newsom for clemency before they were resentenced.

Mr Newsom has the power to free them himself through clemency, and in February, he ordered the state parole board to investigate whether the brothers would pose a risk to the public.

They already have a hearing before the board scheduled for 13 June, but that one was set as part of the clemency petition.

It’s not yet clear if that hearing will serve as their formal parole hearing or if a separate one will be scheduled.

Mr Newsom can override any decision the board makes.

Anne Bremner, a trial lawyer in Seattle, said the brothers will be preparing for the parole board and aiming to impress upon them that they should be let out, but suggested the board members will already have a clear view.

“My guess is the parole board has been watching this and of course they’ve done these risk assessments already,” she said, adding they will know “who these two are, what their alleged crimes were and what they’ve done since the time that they were incarcerated until today.”

Potential new evidence

The brothers’ lawyers have also submitted a letter Erik wrote to his cousin as new evidence, saying it was not seen by the jury when the brothers were sentenced in 1996 and could have influenced their decision.

The letter is dated months before the murders, which they say alludes to him being abused by his father, Jose Menendez.

In the handwritten letter, Erik wrote: “I’ve been trying to avoid dad… every night, I stay up thinking he might come in.”

He also said he was “afraid” and that he needed to “put it out of my mind” and “stop thinking about it”.

More new evidence submitted comes from Roy Rossello, a former member of the band Menudo, who alleges he was sexually assaulted by Jose Menendez as a teenager in the 1980s.

He has provided a signed declaration of his alleged rape by Jose Menendez to the brothers’ lawyers, which the lawyers say is further proof of his supposed abusive nature.

LA prosecutors filed a motion opposing the petition, but its status is unclear, and appears to have been halted while the brothers have pursued their resentencing and clemency.

What happened in the original Menendez trials?

On 20 August 1989, Lyle and Erik Menendez shot their parents, Jose and Mary Louise “Kitty” Menendez, multiple times at close range.

The brothers, who were 21 and 18 at the time, initially told police they found them dead when they got home, but were eventually tried for their murder.

During the original trial, prosecutors accused the brothers of killing their parents for a multimillion-dollar inheritance, although their defence team argued they acted out of self-defence after years of sexual abuse by their father.

An initial attempt to try each brother individually in front of separate juries ended in a mistrial after both juries failed to reach a verdict.

In their second trial, which saw the brothers tried together, the defence claimed the brothers committed the murders in self-defence after many years of alleged physical, emotional and sexual abuse at the hands of their father, with no protection from their mother.

They said they had feared for their lives after threatening to expose their father.

The prosecution argued the murders were motivated by greed, and they killed their parents to avoid disinheritance.

Evidence of alleged abuse from their defence case was largely excluded from the joint trial by the judge.

In 1996, seven years after the killings, a jury found the brothers guilty, and they were convicted of first-degree murder and conspiracy to murder.

They were sentenced to life imprisonment without the possibility of parole.

But the brothers and many of their family members have continued to fight for their freedom ever since.

Although their focus of late has shifted towards the brothers’ rehabilitation in prison, their main argument in recent years has been that more evidence of Jose Menendez’s alleged abuse has come out since the last trial, and that a modern jury would have a better understanding of the impact of abuse than one 30 years ago.

UK

Police separate anti-immigration and anti-racism protesters across the country

Published

3 hours ago

August 23, 2025

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Police separate anti-immigration and anti-racism protesters across the country

Protesters have gathered across the country as groups demonstrated against asylum seeker housing and were met by anti-racism campaigners.

Demonstrations under the Abolish Asylum System slogan were held in England, Scotland and Wales, including in Bristol, Exeter, Tamworth, Cannock, Aberdeen, Mold, Perth, Nuneaton, Liverpool, Wakefield, Newcastle, Horley and Canary Wharf.

Counter-protests were also organised by campaign group Stand Up to Racism.

In Bristol, mounted police separated the two groups in the Castle Park, with officers scuffling with protesters.

Police kept around 200 anti-immigration protesters draped in English flags away from roughly 50 Stand Up to Racism protesters in Horley, Surrey.

One man, wearing a West Ham United football shirt, was held by police as he yelled: “You’re not welcome here, you’re not welcome here, you’re not welcome here” at anti-racism protesters.

Anti-immigration protesters also chanted: “Tommy, Tommy, Tommy, Tommy Robinson” in support of the far-right activist, whose real name is Stephen Yaxley-Lennon.

The anti-racism protesters chanted “say it loud, say it clear, refugees are welcome here” and held signs calling for solidarity and to “stop deportations”.

The Stand Up to Racism protesters were shepherded into a smaller area as they continued to chant: “No hate, no fear, refugees are welcome here”, which was met with “No they’re f****** not” from the other side of the street.

In Perth, protesters gathered outside the Radisson Hotel.

The anti-migration protesters held up signs with slogans such as “Perth is full – empty the hotels” and “get them out”.

Stand Up to Racism Scotland said it had achieved “victory” in Perth, with more than 200 gathering to oppose the Abolish Asylum System demonstration.

In Liverpool, a dispersal order was issued to try and contain the protests.

Saturday’s events come amid continued tension around the use of the hotels for asylum seekers.

Regular protests had been held outside the Bell Hotel in Epping, Essex, which started after an asylum seeker housed there was charged with sexually assaulting a 14-year-old girl on 10 July.

Hadush Gerberslasie Kebatu, 38, was charged with trying to kiss a teenage girl and denies the allegations. He is due to stand trial later this month.

In the wake of those protests, Epping Forest District Council sought and won an interim High Court injunction to stop migrants from being accommodated there – a decision which the government is seeking permission to appeal.

Environment

Want EV charging at your apartment, as an owner or a renter? Click here

Published

3 hours ago

August 23, 2025

admin

Want EV charging at your apartment, as an owner or a renter? Click here

California apartment EV chargers — Photo: ChargePoint

EVs are great, and can unlock more transportation convenience with the ease of charging at home. But for apartment-dwellers, this can be a complicated conversation. So a nonprofit called Forth is here to help, through its Charge at Home program.

One of the main benefits of an electric vehicle is in the convenience of owning and charging the car in the place it spends most of its time. Instead of having to go out of your way to fuel it, you just park it at home, in the same place it spends at least 8 hours a day, and you leave the house every day with a full charge.

But this benefit only applies to those with a consistent parking space which they can easily install charging at. When talking about owners who live in apartment buildings, it can sometimes get more complicated.

While certain states have passed “right to charge” laws to give apartment-dwellers a solution for home charging, apartment charging is nevertheless a bit of a patchwork solution so far.

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And as a result of this, EV ownership among apartment renters lags behind that of single-family homeowners. It’s clear that apartments are holding back people from buying EVs, and that’s bad – lots of people live in apartments, and the gas those cars use pollutes the air just as much as any other.

Certain areas where EVs have hit a point of critical mass (namely, the large California cities) have pretty good EV ownership among renters, but it could still be better. And residents are clamoring more and more for easy EV charging in apartment communities.

So, Forth, a nonprofit advocating for equitable access to clean transportation, set up a program called Charge at Home, which is meant to connect renters, apartment building owners or other decisionmakers with resources to help install chargers at multifamily properties.

The site lets you select your situation – a resident or a decisionmaker for a new or existing multifamily development – and then gives you access to tools for your specific situation, whether you be a resident and developer.

The site houses links to help design a multifamily project, find electricians, inform you about right to charge laws or available incentives, and provide case studies, among others.

Charge at Home also hosts roundtable webinars periodically, and includes a library of past webinars with the information you need.

There are a lot of considerations for each of these projects, so it can be helpful to have someone with experience to help you go over it all. Personally, when talking to friends about getting an EV, charging considerations are usually the thing that takes up the bulk of the conversation.

So if the toolkits are still too daunting for you, Charge at Home is offering free charging consultations for multifamily developers, owners, property managers and HOAs.

The charging consultations have been made possible by funding from the Department of Energy, though that funding only runs through the end of September – so get your requests in soon. Forth may still offer consultations afterwards, but is still uncertain about funding so doesn’t want to promise anything – but the website will remain up for people to submit questions and find information, whether or not free consultations stick around.

But at the very least, as Forth points out, whether a multifamily development is interested in having EV charging at this moment or not, any developer should think about having the infrastructure, conduit and capacity ready to go for future install of EV chargers, and should consider the needs of current residents who are likely already considering EVs today.

It’s going to be necessary to install this capacity at some point, and doing so earlier can help save money down the line, make your development more attractive to renters today, and allow more renters to make the switch to cleaner transportation which helps air quality and to reduce climate change, both of which harm everyone on the planet.

Electrek’s Take

I’ve long said that the only real problem with EVs is the problem of access to consistent charging for people who don’t have their own garage. Whether this be apartment-dwellers, street-parkers or the like, the electric car charging experience is often less-than-ideal outside of single family homes, at least in North America.

There are workarounds available, like charging at work, or using Superchargers in “third places” where you often spend time, but these still aren’t optimal. The best thing is just to charge your car wherever it spends most of its time, which is your home. When you do that, EVs outshine everything in convenience.

We’ve highlighted some projects before which showed how reasonable it can be to install charging for developments. Every project is going to have its complexities, but when you see projects like this condo complex that managed to install chargers for just $405 per parking spot, all of a sudden it becomes a no-brainer not to have EV charging.

But the fact is, there just aren’t enough apartment complexes out there which have EV charging. So if Forth’s program can help residents or landlords with that, it can go a long way towards solving the only real problem with EVs.

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