'Does Covid-19 Hit Women and Men Differently? U.S. Isn’t Keeping Track' diff viewer (4/5)

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Does Covid-19 Hit Women and Men Differently? U.S. Isn’t Keeping Track	Does Covid-19 Hit Women and Men Differently? U.S. Isn’t Keeping Track
2020-06-06 01:12:43 UTC	2020-06-09 07:00:30 UTC (3 days later)
— Caroline Criado Perez, author of “Invisible Women”	— Caroline Criado Perez, author of “Invisible Women”
[In Her Words is available as a newsletter. Sign up here to get it delivered to your inbox.]	[In Her Words is available as a newsletter. Sign up here to get it delivered to your inbox.]
As the novel coronavirus sweeps the world, sickening hundreds of thousands of people and killing at least 50,000 individuals to date, scientists have learned more and more about it. We know that older adults — aged 60 and above — are at greater risk of dying from it. And, based on data from China, Italy and South Korea, we also know that men seem to have higher fatality rates.	As the novel coronavirus sweeps the world, sickening hundreds of thousands of people and killing at least 50,000 individuals to date, scientists have learned more and more about it. We know that older adults — aged 60 and above — are at greater risk of dying from it. And, based on data from China, Italy and South Korea, we also know that men seem to have higher fatality rates.
But in the U.S., where ramped-up testing is churning out reams of data by the minute, there’s one thing we’re not monitoring: the sex breakdown. How many women are infected versus men? Are men and women equally likely to get infected? What is the fatality rate for each sex? Are symptoms exactly alike for men and women?	But in the U.S., where ramped-up testing is churning out reams of data by the minute, there’s one thing we’re not monitoring: the sex breakdown. How many women are infected versus men? Are men and women equally likely to get infected? What is the fatality rate for each sex? Are symptoms exactly alike for men and women?
The latest update on cases and deaths in the U.S. from the Centers for Disease Control and Prevention contained no mention of male and female patients. When asked why, a spokesperson for the C.D.C. said the agency simply does “not have that information to share at this time” and “additional investigation is needed.” Even The Times’s case tracker, which was made public last week and provides county-level data, has no sex breakdown because that information isn’t consistently available across states and counties.	The latest update on cases and deaths in the U.S. from the Centers for Disease Control and Prevention contained no mention of male and female patients. When asked why, a spokesperson for the C.D.C. said the agency simply does “not have that information to share at this time” and “additional investigation is needed.” Even The Times’s case tracker, which was made public last week and provides county-level data, has no sex breakdown because that information isn’t consistently available across states and counties.
“We can confidently say from the data from many countries that being male is a risk factor,” said Sabra Klein, a scientist at Johns Hopkins Bloomberg School of Public Health who studies sex difference in viral infections. “That, in and of itself should be evidence for why every country should be disaggregating their data. But the United States isn’t doing it.”	“We can confidently say from the data from many countries that being male is a risk factor,” said Sabra Klein, a scientist at Johns Hopkins Bloomberg School of Public Health who studies sex difference in viral infections. “That, in and of itself should be evidence for why every country should be disaggregating their data. But the United States isn’t doing it.”
This kind of information — or lack thereof — matters because men and women are likely to have fundamentally different reactions to the virus, vaccines and treatment, health experts say. Indeed, research has shown that the SARS, influenza, Ebola and HIV viruses all affect men and women differently.	This kind of information — or lack thereof — matters because men and women are likely to have fundamentally different reactions to the virus, vaccines and treatment, health experts say. Indeed, research has shown that the SARS, influenza, Ebola and HIV viruses all affect men and women differently.
“Researchers have found sex differences in every tissue and organ system in the human body,” including the immune system, writes Caroline Criado Perez in her award-winning book “Invisible Women.”	“Researchers have found sex differences in every tissue and organ system in the human body,” including the immune system, writes Caroline Criado Perez in her award-winning book “Invisible Women.”
A recent research paper from Huazhong University of Science and Technology in Wuhan, China, backs that up: Scientists studied the plasma of 331 confirmed coronavirus patients and found that in the most severe cases, women had a higher level of antibodies than men. Though the paper hasn’t been peer-reviewed, it provides yet another reason to capture sex data.	A recent research paper from Huazhong University of Science and Technology in Wuhan, China, backs that up: Scientists studied the plasma of 331 confirmed coronavirus patients and found that in the most severe cases, women had a higher level of antibodies than men. Though the paper hasn’t been peer-reviewed, it provides yet another reason to capture sex data.
Despite this, the coronavirus vaccine trials underway in the U.S. aren’t really considering sex yet, said Dr. Klein.	Despite this, the coronavirus vaccine trials underway in the U.S. aren’t really considering sex yet, said Dr. Klein.
The National Institute of Allergy and Infectious Disease — a part of the National Institutes of Health — is already running phase one trials of a potential vaccine on 45 healthy adults. The purpose of phase one trials is to “learn about safety and identify side effects,” according to the agency’s website. It is also at this stage that researchers determine the correct dosage for a vaccine.	The National Institute of Allergy and Infectious Disease — a part of the National Institutes of Health — is already running phase one trials of a potential vaccine on 45 healthy adults. The purpose of phase one trials is to “learn about safety and identify side effects,” according to the agency’s website. It is also at this stage that researchers determine the correct dosage for a vaccine.
But the trials of this vaccine will only explore age and sex “as part of subgroup analysis” because “a larger number of participants would be needed to conduct a meaningful analysis of sex and age differences,” the agency said in a statement.	But the trials of this vaccine will only explore age and sex “as part of subgroup analysis” because “a larger number of participants would be needed to conduct a meaningful analysis of sex and age differences,” the agency said in a statement.
“N.I.A.I.D. is developing plans for potential larger-scale clinical trials,” the statement continued.	“N.I.A.I.D. is developing plans for potential larger-scale clinical trials,” the statement continued.
This approach can be dangerous. Between 1998 and 2000, women represented just 22 percent of initial small-scale safety trials for new drug applications submitted to the F.D.A., according to the U.S. Government Accountability Office. The same agency also found that 8 of the 10 F.D.A.-approved drugs that were withdrawn from the market between 1997 and 2001 “posed greater health risks for women than men,” including causing valvular heart disease and liver failure.	This approach can be dangerous. Between 1998 and 2000, women represented just 22 percent of initial small-scale safety trials for new drug applications submitted to the F.D.A., according to the U.S. Government Accountability Office. The same agency also found that 8 of the 10 F.D.A.-approved drugs that were withdrawn from the market between 1997 and 2001 “posed greater health risks for women than men,” including causing valvular heart disease and liver failure.
On the other hand, Johnson & Johnson, which is pushing to get clinical trials of a vaccine started by September, said it would analyze data by sex and age from phase one onward.	On the other hand, Johnson & Johnson, which is pushing to get clinical trials of a vaccine started by September, said it would analyze data by sex and age from phase one onward.
Sex data blind spots can be traced back to the fact that, historically, science didn’t study the female body.	Sex data blind spots can be traced back to the fact that, historically, science didn’t study the female body.
“It’s been assumed that there wasn’t anything fundamentally different between male and female bodies other than size and reproductive function,” writes Perez, so anything that deviates from the “default’ — a white, male archetype — is considered an anomaly. Moreover, researchers often argue that the female body is “too complex” to be studied, with its “fluctuating, ‘atypical’ hormones.”	“It’s been assumed that there wasn’t anything fundamentally different between male and female bodies other than size and reproductive function,” writes Perez, so anything that deviates from the “default’ — a white, male archetype — is considered an anomaly. Moreover, researchers often argue that the female body is “too complex” to be studied, with its “fluctuating, ‘atypical’ hormones.”
As a result, for years women have been underrepresented in medical research, clinical trials for drugs and vaccines, and biology textbooks. Even in 2015, in one of the tests of the so-called “female Viagra” — a product clearly designed for women — scientists tried out the drug on 23 men and two women, writes Perez.	As a result, for years women have been underrepresented in medical research, clinical trials for drugs and vaccines, and biology textbooks. Even in 2015, in one of the tests of the so-called “female Viagra” — a product clearly designed for women — scientists tried out the drug on 23 men and two women, writes Perez.
In 1990, the National Institutes of Health established the Office of Research on Women’s Health. And in 1993, U.S. lawmakers required the N.I.H. to include more women and minorities in clinical research and trials.	In 1990, the National Institutes of Health established the Office of Research on Women’s Health. And in 1993, U.S. lawmakers required the N.I.H. to include more women and minorities in clinical research and trials.
But the N.I.H. has been slow to enforce those rules. A 2015 report by the Government Accountability Office found that though more women than men were enrolled in trials overall from 2005 to 2014, it was unclear whether women were sufficiently represented in all research areas, leaving open the possibility that they may still have been underrepresented in some studies.	But the N.I.H. has been slow to enforce those rules. A 2015 report by the Government Accountability Office found that though more women than men were enrolled in trials overall from 2005 to 2014, it was unclear whether women were sufficiently represented in all research areas, leaving open the possibility that they may still have been underrepresented in some studies.
And in 2016, the O.R.W.H. noted that preclinical trials on animals still “rely heavily on male animals and/or omit reporting of the sex,” and added that all researchers applying for funding from 2017 onward must provide a “strong justification” for studying just one sex.	And in 2016, the O.R.W.H. noted that preclinical trials on animals still “rely heavily on male animals and/or omit reporting of the sex,” and added that all researchers applying for funding from 2017 onward must provide a “strong justification” for studying just one sex.
But these regulations only apply to federally funded research, which in 2015 accounted for 22 percent of total spending on medical and health research, according to a think tank that advocates increased funding for R&D.	But these regulations only apply to federally funded research, which in 2015 accounted for 22 percent of total spending on medical and health research, according to a think tank that advocates increased funding for R&D.
Updated June 5, 2020	Updated June 5, 2020
	A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.	The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.	Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.	Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.	States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.	Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.	Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)	If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.	Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.	The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.	If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.	If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
“These notions that ‘I’ve never done this for any other clinical trial. Why am I going to do this today?’ — these things get ingrained,” said Dr. Klein, and so any shift in procedure and culture “is perceived as an added complication.”	“These notions that ‘I’ve never done this for any other clinical trial. Why am I going to do this today?’ — these things get ingrained,” said Dr. Klein, and so any shift in procedure and culture “is perceived as an added complication.”
Obscuring any sex differences in studies and test results can have vast ramifications. “The moment we started to sex-disaggregate data during the 2009 H1N1 pandemic, we picked up pretty quickly that pregnant women were an at-risk population,” said Dr. Klein, and so “they were some of the first people to be offered the pandemic flu vaccine.” Today, we don’t know very much about the impact of Covid-19 on pregnant women.	Obscuring any sex differences in studies and test results can have vast ramifications. “The moment we started to sex-disaggregate data during the 2009 H1N1 pandemic, we picked up pretty quickly that pregnant women were an at-risk population,” said Dr. Klein, and so “they were some of the first people to be offered the pandemic flu vaccine.” Today, we don’t know very much about the impact of Covid-19 on pregnant women.
“It’s not a lot upfront to get that information, but the systems are often not set up to actually collect the information,” said Dyan Mazurana, a research professor who studies humanitarian crises at Tufts University and an author of a recent report about sex-disaggregated data. “And then what you need is people who can analyze and interpret that data.”	“It’s not a lot upfront to get that information, but the systems are often not set up to actually collect the information,” said Dyan Mazurana, a research professor who studies humanitarian crises at Tufts University and an author of a recent report about sex-disaggregated data. “And then what you need is people who can analyze and interpret that data.”