By Ezekiel J. Emanuel

Dr. Emanuel is the vice provost for global initiatives and a professor of medical ethics and health policy at the University of Pennsylvania.

Azita Ghahramani worried she wouldn’t survive Covid-19 because of her health conditions, including high blood pressure. So she and her husband, Scott Downing, and their son became hypervigilant. They moved to a remote part of Maine and avoided most social interactions. Even so, all three got Covid-19 in March 2021, possibly from exposure during a family funeral. But it wasn’t Ms. Ghahramani who nearly died of the disease; it was her husband.

Despite being in his 50s and an avid tennis player, eating healthfully and having no medical conditions, Mr. Downing ended up in the intensive care unit. Nearly eight months later, he remains out of work on sick leave and only recently started weaning off supplemental oxygen at night.

Ms. Ghahramani is an acquaintance of my family, and her husband’s case is a good example of a persistent pandemic issue. Men are much more likely than women to die of Covid-19 and are more likely to be intubated and have long hospitalizations. This disparity in Covid-related deaths has existed since early in the pandemic, before there were any vaccines. Men are also more likely to develop certain rare complications from some Covid-19 vaccines and to experience a faster decline in measures of immunity once vaccinated. The reasons remain unclear.

Historically, women have been largely excluded from medical studies, and health issues that predominantly affect women have been underresearched. This is both morally wrong and medically foolish because it limits physicians’ ability to deliver optimal care. Rather than ignore sex differences in Covid-19 outcomes, scientists should pay attention to them to better understand the disease and how to treat it.

Data from the Centers for Disease Control and Prevention shows that in the United States, women account for 45.6 percent of Covid-19 deaths so far and men account for 54.4 percent. (Men make up slightly less than half the U.S. population.) Among Americans ages 65 to 84 — the group at highest risk for severe Covid-19 — the gap is even larger: 57.9 percent of deaths have occurred among men and 42.1 percent among women. According to the Brookings Institution, at least 65,000 more men than women have died of Covid-19 in the United States. Globally, the death rate has been about 50 percent higher for men.

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