COVID-19: the gendered impacts of the outbreak

846 www.thelancet.com Vol 395 March 14, 2020 Policies and public health efforts have not addressed the gendered impacts of disease outbreaks. The response to coronavirus disease 2019 (COVID-19) appears no different. We are not aware of any gender analysis of the outbreak by global health institutions or governments in affected countries or in preparedness phases. Recognising the extent to which disease outbreaks affect women and men differently is a fundamental step to understanding the primary and secondary effects of a health emergency on different individuals and communities, and for creating effective, equitable policies and interventions. Although sex-disaggregated data for COVID-19 show equal numbers of cases between men and women so far, there seem to be sex differences in mortality and vulnerability to the disease. Emerging evidence suggests that more men than women are dying, potentially due to sex-based immunological or gendered differences, such as patterns and prevalence of smoking. However, current sex-disaggregated data are incomplete, cautioning against early assumptions. Simultaneously, data from the State Council Information Office in China suggest that more than 90% of health-care workers in Hubei province are women, emphasising the gendered nature of the health workforce and the risk that predominantly female health workers incur. The closure of schools to control COVID-19 transmission in China, Hong Kong, Italy, South Korea, and beyond might have a differential effect on women, who provide most of the informal care within families, with the consequence of limiting their work and economic opportunities. Travel restrictions cause COVID-19: the gendered impacts of the outbreak the intervention, a careful interpretation of the negative findings is needed. Drug development and clinical evaluation of more potent and specific latency reversal agents alone and in combination in people living with HIV receiving ART and finding new approaches to put the kill into the kick and kill regimen are still warranted to determine if this strategy might allow people living with HIV to safely stop ART and achieve a cure.