Covid Kills More Men Than Women. Experts Still Can’t Explain Why

Harvard’s GenderSci Lab is unlike most university laboratories. The group’s mandate is to interrogate the scientific study of sex and gender; it brings together historians, anthropologists, social scientists, and philosophers. So when the coronavirus crisis reached the US in March, they didn’t have to halt half-completed experiments or scramble to make arrangements for lab animals. Nevertheless, the change wasn’t easy. “We were all struggling with the circumstances of living under Covid and wondering how we would continue to work together,” says Sarah Richardson, a professor of the history of science at Harvard University and the lab’s director. “We wondered, is all the work that we generally do even important in this moment?”
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Here's all the WIRED coverage in one place, from how to keep your children entertained to how this outbreak is affecting the economy. But sex and gender soon became major issues in the fight against Covid-19. In mid-February, the Chinese Center for Disease Control and Prevention analyzed data from 72,314 Covid-19 patients and reported that men in their sample were almost twice as likely to die as women. This initial result pointed researchers and commentators toward smoking as a reason for men’s relatively poor prognosis, since over half of Chinese men smoke while very few Chinese women do. But as the virus spread across the world and continued to kill men in greater numbers, alternative explanations proliferated, and references to intrinsic female biology—estrogen, the X chromosome—became more common. As of today, among the 53 countries that report their case and death data separated by sex, men account for approximately 51 percent of Covid-19 cases but 58 percent of deaths.
In these frequent appeals to biology, Richardson and her team saw a familiar pattern. They contend that physicians, researchers, and the media have a tendency to focus on biology while underemphasizing the social determinants of men’s and women’s health. While factors like chromosomes and hormones—often captured under the label “sex”—do indeed play a role in health, women and men also experience radically different social environments. Gender, a more amorphous concept that captures a person’s social roles and experiences, has profound implications for health: It helps determine how we are treated by our surroundings and how we treat them in return.
So Richardson and her team decided to investigate what was going on for themselves. “We were like, ‘OK, let’s start looking with a totally open mind,’” she says. But before they could begin, they had to get a better picture of who was contracting, and dying from, the disease. Yet data sets that track Covid-19 cases and deaths by sex, age, and other demographic factors are hard to come by. “We began by just simply trying to look for the data, and we couldn’t find it,” Richardson says. “So we realized that we would have to assemble it on our own.”
Combing the website of each US state’s public health department, the GenderSci Lab team created the largest centralized repository of sex-separated US Covid-19 data. Last month, they publicly released a data tracker that assimilates that information, in the hope that other scholars can unlock the mystery of why Covid-19 seems to kill more men. Richardson believes that a nuanced approach to this question could not only solve an academic problem but also assist in the fight against the disease. “If we really want tailored interventions that identify vulnerabilities and save lives, we have to be thinking about how these contextual factors are driving these patterns—not, necessarily, whether one is a man or a woman,” she says.But while researchers across disciplines broadly agree that both social and biological factors are likely to play a role in this disparity, they struggle to identify the most important causes for one critical reason: State data is often inadequate, incomplete, and unreliable. “It’s very hard to make accurate claims when you have terrible data,” says Emily Wentzell, an associate professor of anthropology at the University of Iowa who studies the relationship between gender and medicine. “And the data in the US on who actually has Covid is abysmal.”