When in doubt, look to social factors first, not biology.
More men than women are dying of Covid-19. The numbers are striking. In Italy, men in their 50s died at four times the rate of women in their 50s. Globally, twice as many men than women may be dying of Covid-19.
When a sex difference is observed with some magnitude in deaths across diverse populations, it is commonly assumed that factors in women’s and men’s bodies drive the difference. This assumption has even led some clinicians to experiment with injecting estrogeninto men suffering from Covid-19. However, early indicators and past experience with similar diseases suggest that social and other demographic factors, including age, race or ethnicity and class, and comorbidities, not sex, most likely explain a far greater portion of variation in Covid-19 outcomes between women and men. Appreciating the role of these factors is important, because understanding what’s really driving these outcomes helps better target both the research and the public health efforts that can save lives.
As we report this week, emerging Covid-19 data already shows an important role for social context in generating sex disparities. In Connecticut and Massachusetts there is no sex difference in confirmed Covid-19 fatalities, while in New York and Florida, men account for about 60 percent of Covid-19 deaths. Globally, the male-to-female death ratio varies from a staggering 2:1 in the Netherlands to 1:1 in Iran and Canada. It’s too early to say what accounts for these levels of variation; what they do seem to indicate is that sex difference alone isn’t meaningful without incorporating other factors. Continue reading.