Sex and Gender and Pandemics

by Lynn Posluns:A crisis has a way of highlighting problems that garner too little attention in more normal times. The pandemic has laid bare a vast array of social challenges, everything from the state of long-term care to the plight of precarious workers to the effectiveness of public health policy.In the Covid-19 saga, sex and gender issues have arisen in ways both sadly familiar and troublingly surprising. Researchers are scrambling to adapt, learn and look for the answers that we all need.At the centre of the public health crisis, there is a puzzling gender divide, with Canada diverging from international trends.In most of the world, early research is finding that while the coronavirus appears to be hitting the sexes at about the same rate, it has been far more lethal for men. In China, 64 per cent of the fatalities were male. In Italy, men represented 71 per cent of the deaths; in Germany, 66 per cent.  Scientists can only speculate as to the causes, but they suspect that higher rates of smoking among men may play a role. Lungs already weakened by tobacco might be more vulnerable to the ravages of a virus that attacks the respiratory system.For reasons that are not entirely clear, Canada is seeing the reverse. As of May 15, statistics from the Public Health Agency of Canada showed 55 per cent of Covid-19 cases were women and 53 per cent of the fatalities were female. Colin Furness, an epidemiologist at the University of Toronto, suggested to Global News that it could be a byproduct of the heavy toll being felt at long term care homes, which have suffered the majority of pandemic deaths. Most residents are women, as are most care workers.We need to find out the truth. Discovering the reasons behind the disparity between the sexes will help us understand the virus better and can assist in the fight against Covid-19. This is a familiar theme for Women's Brain Health Initiative (WBHI), the charity I lead. Since our founding we have been arguing the same point for dementia, given that Alzheimer’s and other disorders hit women far more frequently than men, but research traditionally focused on men. We could say the same thing about heart disease and many other disorders. Women and men are different, and those differences must be explored. Otherwise, the picture is incomplete and the search for treatments and cures can be flawed.It is encouraging to see that decision makers agree with our point.  In issuing guidelines for funding Covid-19 research projects, the Canadian Institutes of Health Research (CIHR) are requiring scientists to consider sex and gender issues in their work. But our scientists may be hampered by insufficient access to data. As reported by the Globe and Mail and others, Canada has lagged the world in collecting essential basic information about the progress of the disease, including mortality rates and detailed information about the people getting the virus.The respected organization Global Action on Men’s Health (GAMH) has issued a call to the world to do better with data collection, to give us a fuller picture about how the pandemic’s impact differs between men and women, and to cross reference with race and economic status. The world should listen.It matters, because if you look at the broader carnage being wrought by the pandemic, women are suffering disproportionately in many ways—both economic and personal.As many experts in the field warned, the lockdown has produced an increase in intimate partner violence (IPV). An article in the Canadian Medical Association Journal cited shocking rises across Canada and internationally. Reliable statistics are hard to find at the best of times, given that IPV is known to be under-reported, with many women reluctant to go to police. The evidence comes indirectly, via reported increases in calls to shelters and support services.When you mix the stresses of the pandemic with a requirement to stay home it produces a toxic brew of danger for women at risk. Sudden unemployment adds immeasurably to existing stresses and the lockdown makes it harder to get away from an abuser. Support services were already overburdened and underfunded before the pandemic.“We don’t have enough services for women experiencing violence,” says Pat O’Campo, Executive Director of the Li Ka Shing Knowledge Institute at Toronto’s St. Michael’s Hospital.She cites a telling statistic: 19,000 women are turned away from Canadian shelters every month.  And that was before the pandemic.Dr. O’Campo has launched an urgent research project to help women at risk, proposing to update a web-based app with specialized information for women and service providers on how to cope with the threat of IPV during a lockdown. Given public health measures that require physical distancing, it may not be practical to meet a counsellor face to face; and if your abuser is sitting in the next room, a phone call for help could be dangerous.“We need a whole different strategy to deal with home confinement,” she says.She is seeking funding for her project, which she hopes would deliver the modified app within three months, lightning fast in the world of research. In the meantime, service providers are improvising the best they can to help women in danger.The unprecedented economic catastrophe has also delivered a different, female-led kind of slowdown. In most traditional recessions, well-paid manufacturing jobs are often the first to disappear, jobs where men tend to dominate. But in the mandated shutdowns of the pandemic, service industries were the initial casualties. They are lower paid, more precarious and overwhelmingly held by women. That is why the slowdown has been dubbed a "she-cession". The victims are people who are less able to cope with a sudden loss of income. Savings are meagre and options limited. They are people who may feel pressured to return to work, even if they are at risk of exposure to the coronavirus. Given that women dominate in the caring professions, they may face the greatest dangers. We need them now more than ever and I hope the pandemic gives us a greater appreciation of their contribution. Although we are all affected in this public health crisis, clearly, we are not all suffering equally.Someone once said never let a crisis go to waste. It may have been meant cynically, but it can also be a call to action. Profound challenges can inspire profound change for the better. I hope when we emerge from the pandemic, it will be with greater insights, deeper knowledge and tangible improvements in social justice.