Gendered impact of the 2019–20 coronavirus pandemic

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Coronavirus disease 2019 is known to affect both men and women, but the impact of the pandemic and mortality rates are different for men and women. [1] From a purely medical perspective: mortality due to COVID-19 is higher in men in studies conducted in China and Italy. [2] [3] [4] A higher percentage of health workers, particularly nurses, are women, [5] which may give them a higher chance of being exposed to the virus. [6]

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However, when looking at the larger socio-cultural impacts of the pandemic: School closures, lockdowns and reduced access to healthcare following the 2019–20 coronavirus pandemic may differentially affect the genders and possibly exaggerate the existing gender disparity. [1] [7]

Sex differences in mortality

As of April 2020, men die more often than women after being affected with COVID-19 infection. [1] [4] [2] The highest risk for men is in their 50s, with the gap between men and women closing only at 90. [4] In China, the death rate was 2.8 percent for men and 1.7 percent for women. [4]

The exact reasons for this sex-difference is not known, but genetic and behavioural factors could be a reason for this difference. [1] Sex-based immunological differences, lesser prevalence of smoking in women and men developing co-morbid conditions such as hypertension at a younger age than women could have contributed to the higher mortality in men. [4] In Europe, 57% of the infected individuals were men and 72% of those died with COVID-19 were men. [8] As of April 2020, the US government is not tracking sex-related data of COVID-19 infections. [9] Research has shown that viral illnesses like Ebola, HIV, influenza and SARS affect men and women differently. [9]

Impact on health

During public health emergencies, women are at an increased risk of malnutrition. [10]

Women as caretakers

Evidence from past disease outbreaks show that women are more likely to be caregivers for the sick individuals in the family, making them more vulnerable to infection. [1] [11] [6] A majority of healthcare workers, particularly nurses, are women. They are on the frontline to combat the disease, which makes women vulnerable to exposure. 90% of the healthcare workers in China's Hubei province (where the disease originated) were women and 78% of the healthcare workers in USA are women. [6]

Reproductive health

During an outbreak, healthcare resources are diverted to combat the disease, which results in down-prioritizing reproductive health of women. [12] The physiological changes in pregnancy puts women at an increased risk for some infections, although evidence is lacking particularly about COVID-19. Women had a higher risk of developing severe illness when affected with influenza virus (which belongs to the same family as COVID-19), so it is important to protect pregnant women from being infected with COVID-19. [13] Women nurses were reported to have decreased access to tampons and sanitary pads while also working overtime without adequate personal protective equipment during the 2019-20 coronavirus pandemic in mainland China. [14] In addition, access to abortion was severely restricted in areas of the United States.

Abortion policies

The government of Argentina was planning to submit a bill to the Congress to grant abortion rights to women in March, after the official announcement of president Alberto Fernández in his speech opening the Congress sessions on March, 1. [15] However, the submission of the bill was postponed due to the coronavirus crisis and the lock down of the country. [16] Provision of abortion services under the current law is still being granted in the country, [17] albeit with challenges due to some provinces that have historically opposed abortion. The Ministry of Women of Argentina is working to facilitate abortion through the establishment of a helpline that women can call to obtain information. [18]

Clinical trials

Women are underrepresented in clinical trials for vaccines and drugs, as a result of which sex-differences in disease response could be ignored in scientific studies. [9]

Socio-economic impact

Women constitute a larger part of informal and part-time workers around the world. During periods of uncertainty, such as during a pandemic, women are at a greater risk of being unemployed and being unable to return to work after the pandemic is over. [6] Quarantine experience can be different for men and women, considering the difference in physical, cultural, security and sanitary needs for both genders. [19]

Domestic workers

Domestic workers is largely dominated by women and has important levels of informality. [20] In particular, migrant domestic workers are in a more vulnerable situation, with unclear immigration status and lack of legal protection. In situations where those migrant domestic workers come from less-developed countries, their families back home are dependent of their remittance to survive in the country of origin of the worker. In Philippines, those remittances account for 9% of their GDP, therefore impacting their country of origin's economy. [21] In Argentina, they have established a unique-payment for all domestic workers, and childcare and elderly care is deemed an essential activity so they are allowed to circulate even with the lock down. [22]

Increase in unpaid care work

Activities of care rely heavily on women. The isolation and lock down measures will increase the inequality of the care work, burdening women more than men, including looking after children, elderly and sick members of the family. [23]

Gender based violence

Due to increased tension in the household during a pandemic, women and girls are likely to experience higher risk of intimate partner violence and other forms of domestic violence. [19] [24] [25] In Kosovo, there has been a 17% increase in gender based violence during the pandemic. [26] During periods of lockdown, women experiencing domestic violence have limited access to protective services. [10] [27] In the Netherlands, the number of calls to child abuse centers rose by 76% in February 2020 compared to the previous year. [28] In Sint Maarten, the sale of alcohol was temporarily halted to prevent more domestic violence from occurring. [29]

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2019–20 coronavirus pandemic Ongoing pandemic of coronavirus disease 2019 (COVID-19)

The 2019–20 coronavirus pandemic is an ongoing pandemic of coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). The outbreak was identified in Wuhan, China, in December 2019. The World Health Organization declared the outbreak a Public Health Emergency of International Concern on 30 January, and a pandemic on 11 March. As of 3 May 2020, more than 3.46 million cases of COVID-19 have been reported in 187 countries and territories, resulting in more than 244,000 deaths. More than 1.11 million people have recovered.

Coronavirus disease Human diseases caused by coronaviruses

A coronavirus disease, coronavirus respiratory syndrome, coronavirus pneumonia, coronavirus flu, or any other variant, is a disease caused by members of the coronavirus (CoV) family.

Coronavirus disease 2019 zoonotic respiratory syndrome and infectious disease in humans, caused by SARS coronavirus 2

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Neil Ferguson (epidemiologist) British epidemiologist and researcher

Neil Morris Ferguson is a British epidemiologist and professor of mathematical biology, who specialises in the patterns of spread of infectious disease in humans and animals. He is the director of the Abdul Latif Jameel Institute for Disease and Emergency Analytics (J-IDEA), head of the Department of Infectious Disease Epidemiology in the School of Public Health and Vice-Dean for Academic Development in the Faculty of Medicine, all at Imperial College, London.

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The 2019–20 coronavirus pandemic was confirmed to have reached Bahrain in February 2020.

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Syra Madad is American pathogen preparedness expert. Madad is the Senior Director of the System-wide Special Pathogens Program at NYC Health + Hospitals where she is oversees New York City's response to the Coronavirus disease 2019 pandemic in the city's 11 public hospitals. She was featured in the Netflix documentary series Pandemic: How to Prevent an Outbreak.

Michael Joseph Ryan is an Irish former trauma surgeon and epidemiologist specialising in infectious disease and public health. He is Executive Director of the World Health Organization's Health Emergencies Programme where he leads the team responsible for the international containment and treatment of COVID-19. Ryan has held leadership positions and has worked on various outbreak response teams in the field to eradicate the spread of diseases including bacillary dysentery, cholera, Crimean–Congo hemorrhagic fever, Ebola, Marburg virus disease, measles, meningitis, relapsing fever, Rift Valley fever, SARS, and Shigellosis.

Flatten the curve Public health strategy

Flattening the curve is a public health strategy introduced during the 2019–20 COVID-19 pandemic. The curve being flattened is the epidemic curve, a visual representation of the number of infected people needing health care over time. During an epidemic, a health care system can break down when the number of people infected exceeds the capability of the health care system to take care of them. Flattening the curve means slowing the spread of the epidemic so that the peak number of people requiring care at a time is reduced, and the health care system is not overwhelmed. Flattening the curve relies on mitigation techniques such as social distancing.

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Maria D. Van Kerkhove is an American infectious disease epidemiologist. With a background in high threat pathogens, Van Kerkhove specializes in emerging infectious diseases and is based in the Health Emergencies Program at the World Health Organization (WHO). She is the technical lead of COVID-19 response and the head of emerging diseases and zoonosis unit at WHO.

2019–20 coronavirus pandemic on social media Impact of COVID-19

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World Health Organizations response to the 2019–20 coronavirus pandemic overview about World Health Organizations response to the 2019–20 coronavirus pandemic

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Impact of the 2019–20 coronavirus pandemic on domestic violence Aspect of viral outbreak

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Mortality due to COVID-19

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