Men, if you haven't heard yet - COVID-19 is hitting us harder than women. Globally, men who get sick with the novel coronavirus are more likely to be hospitalized than women, and they are almost two and a half times more likely to die from it. Men also tend to reduce the need for masks and other protective measures. Experts still have much to learn about men and COVID-19, but why and how its increased impact on men is coming under increasing scrutiny as they learn more about the disease.
- Eric Sioe-Peña, MD, MPH, director of global health at Northwell Health, New Hyde Park, New York, and an emergency medicine physician at Staten Island University Hospital, Staten Island, New York: "Men come to the emergency department when they are sicker, with more complications and with a greater need for ventilator support than women. And some men come to the ER later in their infection with the virus. This can lead to more serious respiratory problems and less time to use non-invasive breathing support. Men do need to wear a mask and should see a doctor when they get sick or if they are sick and start to feel worse. For example, if they are discharged from intensive care, they should return if their respiratory symptoms worsen. If this happens, it will usually happen on day 10-13 of their illness.
- Len Horowitz, MD, PhD , internist and pulmonologist, Lenox Hill Hospital, New York: "Since there is no natural immunity to COVID-19, all men are susceptible to infection unless they have been previously infected. Those who smoke, have diabetes, hypertension, coronary heart disease and related autoimmune problems are particularly susceptible to complications of COVID-19, such as needing oxygen or hospitalization. Obesity is also a risk factor. The obvious mitigation strategies of masks, social distancing and hand washing are fundamental.
- Travis D. Westbrook, Ph. Clinical Psychologist and Assistant Professor of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center: "When asked if they wear masks or keep social distance, more men than women answered no. Why, it's complicated. One factor may relate to masculinity and social influences on men's attitudes and behaviour. For example, men are socialized to suppress negative emotions and maintain a "strong" appearance. If a man strongly identifies with these definitions of "manliness" or masculinity, then wearing a mask or avoiding large gatherings may seem like a sign of fear and weakness.
- Matthew G. Heinz, M.D. M.D. , is an internist (physician) in Tucson, AZ: "How do you get the message to men about their increased risk? I hope that getting educated and learning about COVID-19, listening to the facts and science will help.We don't fully understand why, but a lot of it is probably due to differences in hormones and an enzyme called ACE2. The hormone estrogen may give women a protective advantage, but men have very small amounts of estrogen. Men may also have higher concentrations of ACE2. This enzyme binds to a so-called protein found in the virus that allows COVID-19 to enter the lungs more easily. And while we don't know the exact numbers, we do know that the more viral particles you are exposed to, the worse you will get sick.
- Matthew Rettig, MD Professor of Medicine and Urology at the David Geffen School of Medicine at UCLA and UCLA Jonsson Comprehensive Cancer Center: "We believe that male hormones such as testosterone make men more susceptible to COVID-19 and that these hormones also increase the chances that men who contract the virus will have a more severe illness. The question we want to answer with our study, known as the HITCH study, is whether suppressing male hormones will reduce men's time in hospital, reduce their need for intubation and prevent them from dying. All of our study participants are hospitalized male veterans.
So, what should men do to protect themselves? Wear a mask, wash your hands, keep social distance. But more than that, men should remember that they are modeling behavior for their family members. Remember that your children look to you for guidance. Follow public health recommendations and encourage others to follow your example. This protects everyone.