Gendered impact of the COVID-19 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 significantly higher in men in studies conducted in China and Italy.[2][3][4] A higher percentage of nurses are women,[5] which may give them a higher chance of being exposed to the virus.[6]

However, when looking at the larger socio-cultural impacts of the pandemic: School closures, lockdowns and reduced access to healthcare following the COVID-19 pandemic may differentially affect the genders and possibly exaggerate the existing gender disparity.[1][7]

Sex differences in mortality[edit]

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[edit]

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

Women as carers[edit]

Evidence from past disease outbreaks show that women are more likely to be carers 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[edit]

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 COVID-19 pandemic in mainland China.[14] In addition, access to abortion was severely restricted in areas of the United States.[citation needed]

Abortion policies[edit]

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[edit]

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[edit]

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[edit]

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]

The U.S. Congress included $3.5 billion in grants for childcare providers in the CARES Act in March 2020. However, this is insufficient to sustain most childcare providers who have lost work. The Center for Law And Policy estimated that childcare providers in the United States will need $9.6 billion per month to economically survive the effects of a hypothetical six-month period of reduced activity.[23]

Increase in unpaid care work[edit]

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.[24]

Gender based violence[edit]

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][25][26] In Kosovo, there has been a 17% increase in gender based violence during the pandemic.[27] During periods of lockdown, women experiencing domestic violence have limited access to protective services.[10][28] In Sint Maarten, the sale of alcohol was temporarily halted to prevent more domestic violence from occurring.[29]

References[edit]

  1. ^ a b c d e Wenham, Clare; Smith, Julia; Morgan, Rosemary (14 March 2020). "COVID-19: the gendered impacts of the outbreak". The Lancet. 395 (10227): 846–848. doi:10.1016/S0140-6736(20)30526-2. ISSN 0140-6736. PMC 7124625. PMID 32151325.
  2. ^ a b Chen, Nanshan; Zhou, Min; Dong, Xuan; Qu, Jieming; Gong, Fengyun; Han, Yang; Qiu, Yang; Wang, Jingli; Liu, Ying; Wei, Yuan; Xia, Jia'an; Yu, Ting; Zhang, Xinxin; Zhang, Li (15 February 2020). "Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study". The Lancet. 395 (10223): 507–513. doi:10.1016/S0140-6736(20)30211-7. ISSN 0140-6736. PMC 7135076. PMID 32007143. Retrieved 7 April 2020.
  3. ^ Team, The Novel Coronavirus Pneumonia Emergency Response Epidemiology (17 February 2020). "The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China". Chinese Journal of Epidemiology (in Chamorro). 41 (2): 145–151. doi:10.3760/cma.j.issn.0254-6450.2020.02.003. ISSN 0254-6450. PMID 32064853. Retrieved 7 April 2020.
  4. ^ a b c d e Rabin, Roni Caryn (20 March 2020). "In Italy, Coronavirus Takes a Higher Toll on Men". The New York Times. Retrieved 7 April 2020.
  5. ^ "Gender equity in the health workforce: Analysis of 104 countries" (PDF). World Health Organization. Retrieved 7 April 2020.
  6. ^ a b c d Gupta, Alisha Haridasani (12 March 2020). "Why Women May Face a Greater Risk of Catching Coronavirus". The New York Times. Retrieved 7 April 2020.
  7. ^ "Gender and the Coronavirus Outbreak: Think Global Health". Council on Foreign Relations. Retrieved 7 April 2020.
  8. ^ "COVID-19 weekly surveillance report". www.euro.who.int. Retrieved 7 April 2020.
  9. ^ a b c Gupta, Alisha Haridasani (3 April 2020). "Does Covid-19 Hit Women and Men Differently? U.S. Isn't Keeping Track". The New York Times. Retrieved 7 April 2020.
  10. ^ a b "Cross-post: An Intersectional Approach to a Pandemic? Gender Data, Disaggregation, and COVID-19". Digital Impact Alliance. Retrieved 7 April 2020.
  11. ^ Davies, Sara E.; Bennett, Belinda (2016). A gendered human rights analysis of Ebola and Zika: locating gender in global health emergencies. pp. 1041–1060. Retrieved 7 April 2020.
  12. ^ Sochas, Laura; Channon, Andrew Amos; Nam, Sara (2017). Counting indirect crisis-related deaths in the context of a low-resilience health system: the case of maternal and neonatal health during the Ebola epidemic in Sierra Leone. pp. iii32–iii39. Retrieved 7 April 2020.
  13. ^ "Coronavirus Disease 2019 (COVID-19)". Centers for Disease Control and Prevention. 11 February 2020. Retrieved 7 April 2020.
  14. ^ Stevenson, Alexandra (26 February 2020). "Shaved Heads, Adult Diapers: Life as a Nurse in the Coronavirus Outbreak". The New York Times. Retrieved 7 April 2020.
  15. ^ Página12. "Aborto y otras definiciones centrales de Alberto Fernández en la apertura de sesiones ordinarias 2020 | Lo principal del discurso del Presidente en el Congreso". PAGINA12. Retrieved 2020-04-14.
  16. ^ Clarín.com. "Por el coronavirus, el Gobierno analiza dilatar el envío al Congreso de dos proyectos clave: aborto legal y reforma judicial". www.clarin.com (in Spanish). Retrieved 2020-04-14.
  17. ^ Página12. "¿Cómo abortar en época de cuarentena por coronavirus? | Otras urgencias de la salud pública". PAGINA12. Retrieved 2020-04-14.
  18. ^ Beck, Ingrid. "Abortar en tiempos de coronavirus". Letra P (in Spanish). Retrieved 2020-04-14.
  19. ^ a b "COVID-19: A Gender Lens". www.unfpa.org. Retrieved 7 April 2020.
  20. ^ "New strategies to reduce informality in domestic work". www.ilo.org. 2016-12-05. Retrieved 2020-04-14.
  21. ^ Owen, Lara (2020-03-08). "Five ways the coronavirus is hitting women in Asia". BBC News. Retrieved 2020-04-14.
  22. ^ "Coronavirus: qué pasa con las niñeras y trabajadoras domésticas en la cuarentena total". El Cronista (in Spanish). Retrieved 2020-04-14.
  23. ^ Peck, Emily (2020-05-15). "The Child Care Industry Is About To Collapse. There's No Bailout Coming". HuffPost. Retrieved 2020-05-15.
  24. ^ "Coronavirus puts women in the frontline". European Institute for Gender Equality. Retrieved 2020-04-14.
  25. ^ "Gender Equality and Addressing Gender-based Violence (GBV) and Coronavirus Disease (COVID-19) Prevention, Protection and Response". www.unfpa.org. Retrieved 7 April 2020.
  26. ^ "UN chief calls for domestic violence 'ceasefire' amid 'horrifying global surge'". UN News. 2020-04-05. Retrieved 2020-04-07.
  27. ^ "Gender-based violence spikes amid pandemic, shelters need support". www.unfpa.org. Retrieved 7 April 2020.
  28. ^ "How Coronavirus Is Affecting Victims of Domestic Violence". Time. Retrieved 7 April 2020.
  29. ^ "Alcoholverbod Sint Maarten door stijging huiselijk geweld tijdens lockdown". Telegraaf (in Dutch). 13 April 2020. Retrieved 20 April 2020.