- The Washington Times - Thursday, April 23, 2020

The coronavirus outbreak in the U.S. is taking the lives of more men than women, even in some states where women account for more of the confirmed cases of COVID-19.

The higher rate of deaths among men is one of the idiosyncrasies of COVID-19, the respiratory disease caused by the coronavirus, which in some states also proves disproportionately deadly for blacks but takes a smaller toll on Hispanics.

The seemingly random impact of the virus has become one of its defining characteristics. Some people catch it and quickly enter a downward spiral of sickness, hospitalization, intubation and death. Others have coldlike symptoms or no symptoms at all.

A constant in the epidemiological data has been the high mortality rate for older Americans. People older than 70 represent roughly half the deaths in most states.

Several other trends, however, have emerged from a Washington Times analysis of data collected by state health departments across the country. In most cases, men fare worse than women among people who test positive for the virus.

In Washington state, the first hot spot for the disease in the U.S., men accounted for 46% of the COVID-19 cases but 55% of the deaths, according to state data reported this week.

Similar disparities in outcomes for men and women were found in other states, including Maryland, Michigan, New York, New Jersey, Illinois and Virginia.

Yotam Ophir, a health and science communication scholar at the University at Buffalo, said sex and race influence susceptibility to COVID-19 but news media haven’t sufficiently delivered the message.

“This is not surprising me, though,” he said. “The more developed the epidemic is and the more time has passed, the media’s short attention span pushes it to stop talking about the science and to focus almost exclusively about the political, economic and cultural aspects.”

In Michigan, where more than 33,900 people in a population of 10 million have tested positive and more than 2,800 have died from COVID-19, a stark 10 percentage point swing separates case fatality ratios for the sexes.

Women had roughly 54% of the cases but represented 45% of the deaths. Men had the reverse tally of 45% of the cases and 54% of the deaths.

The gender was unknown for 1% of the cases and 1% of the fatalities, according to Michigan’s statistics.

Men might become sicker and die from COVID-19 as a result of genetic and social factors, said Dr. Robert Quigley, senior vice president and regional medical director of International SOS, a medical and travel securities firm.

The answer, he said, likely rests with women having two “X” chromosomes, which could help their immune systems respond more rapidly to infection than men, who have one “X” and one “Y” chromosome.

“The female’s immune and the immune response to an invasion by this very aggressive virus is more robust and complete on the front end,” Dr. Quigley told The Times.

Another factor to consider in the gender breakdown could be social differences.

“Men are much more likely to take risks than women are,” he said, noting that more men engage in hazardous habits such as smoking that can contribute to fatalities from the virus.

Amira A. Roess, a professor in epidemiology at George Mason University, said women’s immune systems respond differently to pathogens and vaccines than do men’s.

Behavior also plays a role.

“Women and men have different health care seeking behaviors, which might partially explain the difference,” she said, noting that men often wait longer to go to a doctor.

“Men have higher rates of some chronic conditions as well,” she said. “African American men have higher mortality rates from cardiovascular disease in general, and this could also explain their vulnerability to particularly poor outcomes from COVID-19.”

Black communities have been hit particularly hard by the coronavirus. The trend emerged early in places such as New York City and New Orleans. Although the high fatality rates for blacks receded in New York state and Louisiana as the disease spread outside urban areas, the rates remain higher than for whites or Hispanics.

The disparity in outcomes for blacks has been widely attributed to higher incidents of hypertension, diabetes, asthma and other underlying conditions that contribute to COVID-19 fatalities.

“It’s not that they’re getting infected more often. It’s that when they do get infected, their underlying medical conditions wind them up in the ICU and ultimately give them a higher death rate,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and a key member of the White House coronavirus task force.

Hispanics in many states appear to have dodged death from COVID-19 despite their high rates of obesity and diabetes.

In California, Hispanics make up about 40% of the population but account for 31% of the deaths, according to statistics from the state health department.

The 12% coronavirus death rate for black Californians is double their 6% share of the state population.

The 36% death rate from COVID-19 for white Californians tracks their 36% population figure.

In New Jersey, Hispanic residents account for 20% of the population but 16% of the COVID-19 deaths. The state’s black residents represent 15% of the population and 20% of the COVID-19 deaths, and white residents represent 55% of the population and 50% of the COVID-19 deaths.

Hispanic communities in New York City, however, bore the brunt of the fatalities. The city’s Hispanic residents make up 29% of the population and account for 34% of the COVID-19 deaths. Blacks account for 22% of the population but 28% of COVID-19 deaths, and white residents represent 32% of the population but account for 27% of COVID-19 deaths, according to state health department data.

As far as the data for Hispanics, Dr. Quigley said, the rate of deaths depends on myriad factors such as pre-existing conditions and access to health care.

“Whether or not that can be further subdivided on an ethnic basis remains to be seen. What we really need to look at is what are the characteristics of those people getting sicker,” he said.

• S.A. Miller can be reached at smiller@washingtontimes.com.

• Alex Swoyer can be reached at aswoyer@washingtontimes.com.

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