Gender and the virus

Covid-19 has become the most serious health crisis ever faced by the modern world. It has laid bare the inability of under-resourced health sectors and colossal failure of market forces to meet this challenge globally.

In view of past experiences of natural disasters and conflicts, it can be safely assumed that this pandemic will also have a differential impact on people based on their class, gender, age, religion and ethnicity. Women and girls will bear the disproportionate burden of this situation now and in the post-coronavirus economic crisis. This needs to be recognized in the Covid-19 response.

What prompted me to write this article is some comments on social media in response to my tweet in which I requested the Command and Control Center to provide me gender and age disaggregated data of coronavirus infection and mortality. I was reprimanded that the coronavirus did not discriminate against any gender. Men and women are equally affected, so why bother?

What alarmed me was that similar thinking prevails amongst our policymakers, as well as those who are currently managing the health emergency. Gender is not featured in the national response except in the Ehsaas program where women are the direct beneficiaries of the cash support program. However, the process of disbursement of Rs12000 per family is such that it is exposing women to a higher risk of virus contraction, as they have to gather in crowded long queues all day long to fill forms and receive money. We need the data to be broken down by sex and age not only to help health ministry/departments to plan and monitor critical care capacity in hospitals but also for public health messaging and in the post-corona phase to support people in rebuilding their lives.

Evidence from around the world shows that, while there is no gender differential in contracting coronavirus, there is a gender gap in fatalities. More men are losing their lives to Coronavirus as compared to women. According to the Global Health 50/50 Initiative, 64 percent of men died in China due to coronavirus as compared to 36 percent of women. Similarly 71 percent of the deaths in Italy were male, while in Spain almost twice as many men as women have died.

Several biological and social explanations explain why men – particularly middle aged, older men – are hit hard by the coronavirus. The virus is found to have an association with pre-medical conditions or underlying health conditions that compromise the immune system. Men carry the burden of these diseases more than women sometimes because of their lifestyle choices. Smoking and drinking is more common amongst men than women worldwide, and smokers made up about 26 percent of those that ended up in intensive care or died of the disease.

Biology appears to play a role in the spread and impact of the virus too. There is a growing body of evidence that shows women have stronger immune systems than men due to genetic structure. Estrogen is found to boost the antiviral qualities of immune cells. Experts found that the genes that control the immune system are encoded in the X Chromosome. While men have XY sex chromosomes, women have two Xs. Biological differences in the immune systems between men and women impact their ability to fight an infection.

While men are more vulnerable to the virus itself, women will be affected much more from the indirect impact of the Pandemic due to their social positioning in society.

Gender norms associate women with the care economy within the family and in the health sector. Women make up 70 percent of the workforce in the health sector in Pakistan. Nurses are at the frontline to provide essential healthcare to Corona patients. Nurses and paramedics have more direct physical contact with corona patients in quarantine and isolation wards. But, despite their integral role in patient care, nurses and paramedics are given less preference in providing personal protective gear that makes them more vulnerable and exposed to virus contraction.

Furthermore, women are responsible for taking care of families, children and sick relatives in their homes. Due to lockdown measures, closure of workplaces and schools, family members are confined to their homes, which has increased domestic workload on women and girls. This situation has also given rise to domestic violence. The global spike in domestic violence had led UN Secretary-General Antonio Guterres to make an appeal for peace in homes around the world and urged all governments to put “women’s safety first as they respond to the pandemic”.

Women also suffer adversely due to reduced access to sexual and reproductive healthcare, as all services are being directed to essential medical needs. Lack of pre- and postnatal healthcare may give rise to maternal mortality rate as was witnessed during the Ebola pandemic. In 2015, the UNFPA projected the outbreak of Ebola would cause 120,000 preventable maternal deaths – more than 10 times the number killed by the disease itself. Lack of access to contraceptives may result in unwanted pregnancies and unsafe abortions that will put women’s physical safety at risk.

It also goes without saying that women will be hit harder by the economic crisis. The majority of our female workforce is concentrated in the informal sector of the economy in Pakistan. In the formal sector they are crowded in the service sector that is affected the most by the lockdown. Women will bear the brunt of job losses. They are excluded from salary compensation packages introduced by the government and employers to the labour working in the formal sector of the economy. The financial bail-out that is provided to the construction industry will not benefit women, as they are not employed by large infrastructure projects.

Therefore, it is important for policymakers to understand and recognize that the impact of Covid-19 is not gender neutral. Women are at the center of care and response. The integration of a gender perspective is imperative for a holistic, inclusive and non-discriminatory effective response to Covid-19.

The writer is ex-director of Gender Studies at the Quaid-e-Azam University. Email: drfarzanabari@gmail.com