Connect with us

Published

on

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 Some information may be out of date.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

For live updates on the latest developments regarding the novel coronavirus and COVID-19, click here.

Continue Reading

Business

Council finances are becoming unsustainable and whole system overhaul is required, watchdog warns

Published

on

By

Council finances are becoming unsustainable and whole system overhaul is required, watchdog warns

From bin collections and parks to social care, it’s estimated local authorities in England provide more than 800 services for residents, touching on many different aspects of our lives all the way from childhood to elderly care.

A National Audit Office report found spending on services increased by £12.8bn – from £60bn to £72.8bn – between 2015-16 and 2023-24, a 21% increase in real terms.

Most of this increased spending – £10.3bn – has gone to adult and children’s social care, which represents councils’ biggest spend, increasing as a share of overall spending from 53% to 58% over the period.

Previous central funding cuts and an increasing population mean that spending power per person has largely stagnated, however, and remains 1% lower per person than in 2015/16, the report said.

This is a measure of the funding available to local authorities from central government grants, council tax and business rates. Though grant funding has increased in recent years, it has not yet made up for pre-2020 government cuts.

Complex needs

The population in England has increased by 5% over the period, accounting for some of this increased pressure, but it’s not the only driver.

In many areas, demand has outpaced population growth, as external events and the complexity of people’s needs has shifted over time.

The rapid increase in costs of temporary accommodation, for example, has been driven by the large increases in people facing homelessness because of inflationary pressures and housing shortages.

At the same time, demand for new adult social care plans has increased by 15%.

As life expectancies have increased, the length of time in people’s lives during which they suffer from health problems has also increased.

“We see that in adult social care that people have multiple conditions and need more and more support and often will be appearing as if they’re frailer at an earlier age. So that’s an important trend,” explained Melanie Williams, president of the Association of Directors of Adult Social Services.

“We’re constantly focusing on most urgent things at the expense of not doing the preventative work,” she added.

“When we’re just focusing on getting people home from hospital, we’re not doing that piece of work to enable them not to go there in the first place.”

Budget cliff edge over SEND spending

Meanwhile, demand for education, health and care (EHC) plans, for children with more complex special educational support needs has more than doubled, increasing by 140% to 576,000.

Budgets for special educational needs and disabilities (SEND) have not kept pace, meaning local authority spending has consistently outstripped government funding, leading to substantial deficits in council budgets.

Most authorities with responsibilities for SEND have overspent their budget as they have been allowed to until March 2026 on a temporary override, but they will need to draw on their own reserves to make these payments in a year.

One in three councils will have deficits that they can’t cover when the override ends.

Cuts to services

In the latest figures for 2023/24, the NAO found £3 in every £5 of services spending by English local authorities went towards social care and education, totalling £42.3bn.

This has left little headroom for other services, many of which have experienced real-terms financial cuts over the same time period, with councils forced to identify other services like libraries, parks and the arts to make savings.

But, Williams warned, cultural and environmental services like these can play a vital role in wellbeing and may actually exacerbate demand for social care.

“For us to be able to safeguard both adults and children – so people that need extra support – we do need that wider bit for councils to do,” said Williams, who also serves as corporate director of adult social care for Nottingham County Council.

“It’s no good me just providing care and support if somebody can’t go out and access a park, or go out and access leisure, or go out and have that wider support in the community.”

Commenting on the report, Cllr Tim Oliver, chairman of the County Councils Network, said: “As we have warned, councils have little choice but to spend more and more on the most demand-intensive services, at the expense of everything else – leaving them providing little more than care services.

“It is market-specific cost pressures, mainly in adult social care, children’s services, and special educational needs, that are driving councils’ costs rather than deprivation. Therefore government must recognise and address these pressures in its fair funding review, otherwise it will push many well-run councils to the brink.”

Fighting fires

The NAO report describes a vicious cycle where councils’ limited budgets have resulted in a focus on reactive care addressing the most urgent needs.

More efficient preventative care that could lower demand in the long term has fallen to the wayside.

In one example cited by the NAO, the Public Health Grant, which funds preventative health services, is expected to fall in real terms by £846m (20.1%) between 2015/16 and 2024/25.

Other areas have seen a switch in funding from prevention to late intervention.

Councils’ funding towards homelessness support services increased by £1.57bn between 2015/16 and 2013/24, while money for preventative and other housing services fell by £0.64bn.

Financing overhaul needed

Since 2018, seven councils have issued section 114 notices, which indicate that a council’s planned spending will breach the Local Government Finance Act when the local authority believes it’s become unable to balance its budget.

And 42 local authorities have received over £5bn of support through the Exceptional Financial Support (EFS) framework since its introduction in 2020.

According to a recent Local Government Association survey referenced in the NAO report, up to 44% of councils believe they’ll have to issue a section 114 notice within the next two years should the UK government cease providing exceptional financial support.

Read more:
Councils to get £68m to build thousands of homes
Council tax to rise to pay for police funding increase
Councils to receive £1bn boost to tackle homelessness

Looking ahead to upcoming funding settlements, and the government’s planned reforms of local government, the NAO warns that short-term measures to address acute funding shortfalls have not addressed the systemic weaknesses in the funding model, with a whole system overhaul required.

Sir Geoffrey Clifton-Brown, chair of the Committee of Public Accounts, said: “Short-term support is a sticking plaster to the underlying pressures facing local authorities. Delays in local audits are further undermining public confidence in local government finances.

“There needs to be a cross-government approach to local government finance reform, which must deliver effective accountability and value for money for taxpayers.”


The Data and Forensics team is a multi-skilled unit dedicated to providing transparent journalism from Sky News. We gather, analyse and visualise data to tell data-driven stories. We combine traditional reporting skills with advanced analysis of satellite images, social media and other open-source information. Through multimedia storytelling we aim to better explain the world while also showing how our journalism is done.

Continue Reading

Business

Victims of second Post Office scandal criticise ‘grinding wheels of bureaucracy’ as they try to get compensation

Published

on

By

Victims of second Post Office scandal criticise 'grinding wheels of bureaucracy' as they try to get compensation

Victims of ‘Capture’, a second faulty Post Office accounting system, say their redress scheme may not be in place until the autumn.

Former sub-postmasters and their relatives met with government representatives for an update on compensation.

While lawyers describe “positive steps”, some victims have told Sky News that they are disappointed with the timescale and described coming up against the “grinding wheels of bureaucracy”.

Capture software was an accounting system rolled out in Post Office branches between 1992 and 1999 and was likely to have caused false shortfalls.

It was the predecessor to Horizon, which led to hundreds of sub-postmasters being wrongly convicted of stealing between 1999 and 2015.

Former sub-postmaster Lee Bowerman, who was never accused of stealing but had to sell his Post Office business after using Capture, said the meeting was a “damp squib” and criticised “the grinding wheels of bureaucracy”.

He agreed that the proposed redress scheme would be “quicker than Horizon” but added “you can’t use them as a yardstick because at the end of the day …people still haven’t been paid out”.

Mr Bowerman added: “So don’t compare us to them when those schemes aren’t even fit for purpose.”

Around 100 Capture victims so far could be eligible for redress.

The scheme, however, would not apply to anyone currently convicted.

The Criminal Cases Review Commission (CCRC) have confirmed that they are now reviewing 27 Capture convictions.

Victims were told the government is considering a separate “fast track” redress scheme for anyone who has their conviction overturned in the future.

Lee Bowerman had to sell his Post Office business after using Capture
Image:
Lee Bowerman had to sell his Post Office business after using Capture

Steve Marston’s case is among those being considered after he was convicted of stealing from his branch in 1996 following shortfalls of nearly £80,000.

“I don’t think it would be human nature not to be disappointed that [the redress scheme] is not being sorted out in the next couple of days even,” he said.

“But we are talking about the government, aren’t we? They’ve got to fill in a form in triplicate, get it rubber stamped three times and that’s for a box of paper clips,” he added.

“I mean it is what it is, we have got to roll with it, stick in there and keep pushing as much as we can”.

Clare Brennan, daughter of Peter Lloyd-Halt, who was a sub-postmaster accused of stealing whilst using Capture, said she and her mother Agnes found the meeting “positive”.

She went on to describe a “weight being lifted” after they were told that it had been officially recognised that Mr Lloyd-Halt had worked for the Post Office.

The family say all Mr Lloyd-Halt’s documents and evidence have been lost and it’s been a challenge to their case.

Lawyers for victims also described “positive steps” towards a new compensation scheme, following the government meeting.

Read more:
Sub-postmasters ‘still going through hell’
What is the Horizon Post Office scandal?

Agnes Lloyd-Holt and Clare Brennan
Image:
Agnes Lloyd-Holt and Clare Brennan

Neil Hudgell, of Hudgell Solicitors, said that they were “reassured by the Department for Business and Trade today that good progress is being made with learnings taken from previous Post Office compensation schemes to form this one”.

He added that “there is a clear willingness to do right by those who have suffered at the hands of the Post Office in relation to Capture”.

“We always appreciate that redress can never come quick enough for these victims and we push as much as we can to take things forward.”

A spokesperson from the Department for Business and Trade said: “Officials met with postmasters today as part of the government’s commitment to develop an effective and fair redress process that takes into account the circumstances of those affected by Capture.

“Ensuring postmasters are treated with dignity and respect is our absolute priority and we will continue to update on the development of the redress mechanism as it progresses.”

The next meeting with Capture victims is due in April.

Continue Reading

World

Starmer was a charmer – but Zelenskyy meeting is the moment of truth

Published

on

By

Starmer was a charmer - but Zelenskyy meeting is the moment of truth

It feels like “the draft” has come six weeks early – the annual selection meeting in American football.

For three or four days, teams in the NFL attempt to woo players with the most lucrative contracts.

In a classic Emmanuel Macron manoeuvre, the French president deployed flattery in the Oval Office.

Three days later, Sir Keir Starmer the charmer upped the game, whipping out a letter from the King.

In their determination to entice the key player back onto Europe’s side, their tactical game was top-notch.

But President Volodymyr Zelenskyy’s arrival at the White House is the moment of truth for their charm offensive.

The Ukrainian leader has stressed the need for security guarantees before signing any agreement.

More on Donald Trump

President Donald Trump seems to be suggesting that a deal on rare earth minerals provides such security.

“Digging our hearts out,” as he put it, in an economic partnership, would certainly be ground-breaking diplomacy.

Please use Chrome browser for a more accessible video player

‘What a beautiful accent’

This week’s flurry in Washington reflects Europe’s concern about Trump’s push to end the war.

Ten days ago, his apparent concessions to Russia sounded alarm bells across the Atlantic.

But his meetings with Macron and Starmer were more amicable than France and the UK dared hope.

Both fact-checked him in real time when he claimed European aid for Ukraine had been given as a loan.

Read more:
As it happened: Trump-Starmer visit
Starmer contradicts Vance over free speech claim
Read some of Trump’s letter from the King

Please use Chrome browser for a more accessible video player

An ‘intense session’ but ‘pretty good outing’

But rather than retaliate, he appeared to have heard their concerns about his U-turn towards Moscow.

Asked by one journalist if he still thought Zelenskyy was a “dictator”, he replied: “Did I really say that?”

Don’t underestimate that joke.

It is the closest Donald J Trump would ever come to a climb-down.

The publication of the detail is a pivotal moment in assessing which team he has opted to play for.

Continue Reading

Trending