How sex-disaggregated data can help understand Covid-19 better
Prof Dr Louann Brizendine, in her book The Female Brain, recollects an incident from the 1970s at Yale University. The professors discredited questions to study female bodies in behavioural and psychiatric studies, with the logic: "We never use females in these studies—their menstrual cycles would just mess up the data.”
A shift to socio-economic statistics and researches, it was only after the 1990s that any attention to female-centric data began surfacing. Nevertheless, at this moment, amidst the chaos of too many voices, the whispers of the most vulnerable are not felt in entirety. Health, home, economy — lack of women-centric data can manifest more than we think possible.
Health stats distinguish effects of Covid-19
Apparently, most of the diseases affect men and women differently. So does the SarsCoV-2 infection. The gender-based variance in the disease is multi-dimensional. The risk factors associated with Covid-19 — cancer, chronic kidney disease, COPD (chronic obstructive pulmonary disease), obesity, serious heart conditions like heart failure, coronary artery disease, or cardiomyopathies, sickle cell disease, diabetes mellitus — are more common with men putting them at a higher risk of getting infected. Additionally, men tend to have higher employment ratio which results in occupational exposure being certainly higher in them as compared to women. According to a study conducted by Dujrudee Chinwong from Chiang Mai University in Thailand, smoking affects the vulnerability of infectious respiratory diseases and commonly, men smoke more than women. A 2008 study in the American Journal of infection control clearly states that health-related hygiene practices are more strictly followed by females.
There is a common establishment in the medical community that biological and immunological factors have a great impact over the human behaviour in both genders, influencing the transmission of infection. Studies have shown that women mount a stronger innate and adaptive immune response than men as they have more number of immune-related genes in their genomic structure. Hormonal discrepancy which exists between men and women is hypothesised to play an important role in the progression of the disease. Oestrogen, progesterone and androgens play an important regulatory role in the progression of any disease. Oestrogen, the female sex hormone has an anti-inflammatory effect, hence protecting them from the severity of the disease. This effect of the hormone does not let the virus titre to increase in women.
ACE (Angiotensin Converting Enzyme) II receptors and enzyme signify a crucial role in the pathogenesis of the disease. SARS-CoV-2 and few other respiratory viruses utilise this receptor to enter into different cells of the human anatomical system like respiratory, excretory, cardiovascular as well as gastrointestinal. The number of these receptors are exceptionally high in the male reproductive organ as compared to female. The X chromosome and the hormones as well as protect females from the infection. Hence, the availability of sex-disaggregated data for epidemiological purposes can be of great help to understand Covid-19 at this perilous time.
Gendered home and economic space
Covid-19 has brought in a recognition that society, family and home are ‘gendered spaces’ that only transfer more burden to already actively caring members, which in the sociological context of our times are women. As children stay at home, much has already been quoted in researches and felt in practical scenarios about the sudden overburdening of the care workers in the family, the constant threat of domestic abuse — both physical and sexual, and pressure to manage household expenditure after a reduction in daily income, to name few amongst many. Not to forget how a small home size with more than possible members living inside is a very grave health risk for women as they cannot sideline serving even the quarantined family members who have migrated in the wake of the pandemic.
If being the victim of social, biological and economic wrath because of the novel coronavirus comes with any wakeup call, it should be the beginning of forming an epistemological foundation of data that specifically concerns itself with women. At present, in a list of sex-disaggregated data available on UN Women platform, India lies nowhere in sight. In the absence of individual country centric data, most studies are looking at the Asia-Pacific region as a whole entity. This creates, what we can call, filters to our understanding of the current status of women in our country further impairing any efforts for immediate relief.
The problem of data availability is an age-old Achilles’ heel for research in academics. Looking deeper, the problem is not as much as the lack of efforts to collect data than the slagging in collating the already available data. It comes as no surprise that the patients, dead or recovered, do have a mention of their gender on their medical examination report. The only task left then is to segregate it make it available for public use. While this may be of immense use to biological and medicinal research as mentioned above, more steps are needed to have a hold of socio-economic data targeted on women, if we plan to stop the intensified effect of the pandemic on them by redirecting wiser and more targeted policies for household level.
Zubaan — a publishing house under Kali — run by Padma Shri awardee Urvashi Butalia, launched a project Through her Lens that captures women in lockdown and narrates their stories. Initiations like these are qualitative in nature and are immensely representative of the intersectionality of feminist and artistic movements, but to form policies, there is an urgent need of more organised, medically backed and policy-oriented data that can bifurcate and individually streamline the process to form more medically informed, socially aware and economically uplifting changes in the way we see the population as a whole singular unit.
Also read: International Women’s Day: How India can unblock women’s access to economic opportunities