Are more women dying of Covid-19 in India?

Soutik Biswas

India correspondent

BBC

22 June 2020

More men are dying from Covid-19 than women around the world, data shows.

In Italy, China and US, for example, more men have been infected, and a higher proportion of men have died.

a higher proportion of : proportion有占比，面积的含义，该短语：更高比例

Sabra Klein, a scientist who studies sex differences in viral infections at Johns Hopkins Bloomberg School of Public Health, says "being male is as much a risk factor for the coronavirus as being old".

But something puzzling is happening in India.

New research by a group of scientists in India and US shows that although men make up the majority of infections, women face a higher risk of dying from the coronavirus than men.

The study, based on Covid-19 deaths in India until 20 May, shows early estimates that 3.3% of all women contracting the infection in India were dying compared to 2.9% of all men. (India had a caseload of more than 110,000 with 3,433 deaths and a fatality rate of 3.1% when the study was conducted.)

Contract：我们常见的是名词含义，合同，契约的意思；作动词的含义在文中是医学上的感染疾病，如•to contract AIDS/a virus/a disease 感染艾滋病╱病毒╱疾病；此外它作动词还可以表示缩小，收缩；如Glass contracts as it cools. 玻璃遇冷收缩。 •a contracting market 萎缩的市场；还有与···签订合同/契约等意思。

caseload：以前的文章提到过，待处理案件的数量

In the 40-49 age group, 3.2% of the infected women have died, compared to 2.1% of men. Only females have died in the 5-19 age group.

I asked SV Subramanian, a professor of population health at Harvard University and one of the leader authors of the study, what this implied.

 Implied hinted at or suggested; not directly expressed 暗指的; 暗示的; 不直接表达的•  an implied criticism

He told me that the narrative of calculating the Covid-19 fatality rate by groups has conflated two key metrics - mortality risk and mortality burden.

narrative/ˈnærətɪv/ 叙述；故事；讲述   fatality rate：死亡率

fatality /fəˈtæləti/ a death that is caused in an accident or a war, or by violence or disease （事故、战争、疾病等中的）死亡； the fact that a particular disease will result in death （疾病的）致命性；the belief or feeling that we have no control over what happens to us 宿命；听天由命；天数

conflate /kənˈfleɪt/  [ VN ] ( formal ) to put two or more things together to make one new thing 合并；合成；混合

metric adj. /ˈmetrɪk/  1.based on the metric system 米制的；公制的

•metric units/measurements/sizes 公制单位╱尺寸╱大小；2.made or measured using the metric system 按公制制作的；用公制测量的

mortality n. /mɔːˈtæləti/  1.[ U ] the state of being human and not living for ever 生命的有限；2.[ U ] the number of deaths in a particular situation or period of time 死亡数量；死亡率•the infant mortality rate  婴儿死亡率；3.[ C ] ( technical 术语 ) a death 死亡

mortality risk：死亡风险   mortality burden：这个是学术术语，没查到对应准确翻译，意思是特定人群的死亡百分比

Mortality risk measures the probability of death in a specific group- in this case, total number of deaths of women divided by confirmed infections among women.

the probability of：···可能性/概率  divided by：除以

文中COVID-19死亡风险Mortality risk=女性死亡总数/确诊女性人数

On the other hand, mortality burden gives you the number of deaths among women as a percentage share of the total deaths, both men and women.

文中指COVID-19的mortality burden=女性感染死亡人数/总死亡人数*100%

Prof Subramanian says for the large part, the statistics have looked at the latter - men having a greater share of total deaths (63% in India, hewing to international data) - but "inferred the former risk".

hew v. /hjuː/  ( hewed or hewed hewn /hjuːn/  )1.( old-fashioned ) to cut sth large with a tool 砍，劈（大的物体）•to hew wood 劈木头2.( formal ) to make or shape sth large by cutting 砍成，劈出（某种形状、某物）

Infer vt. 推断；推论vi. 推断；作出推论

"Our overall conclusion is that, when infected, women do not seem to have any specific survival advantage [in India]," says Prof Subramanian.

"How much of this can be attributable to biological factors and how much of this is associated with social factors is unclear. Gender can be a critical factor in Indian settings," he says.

critical factor：关键因素；临界因素   be attributable to：··归因于··；可归咎于

Be associated with：···与···相关

But the findings are certainly striking because they run counter to what has been observed elsewhere in the world.

Striking adj. 显著的，突出的，惊人的；打击的；罢工的v. 打（strike的ing形式）

run counter to：违反；与…背道而驰eg.This course is actually going to run counter to that historical tendency. 这门课实际上与历史趋势背道而驰。

For one, men are more likely to suffer from co-morbidities or underlying health conditions, like cardio-vascular disease and hypertension, says Kunihiro Matsushita, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health.

co-morbidity：副发病变，共病 morbidity /mɔːˈbɪdəti/ n. 发病率；病态；不健全

underlying health conditions：潜在健康状况

cardio-vascular disease：心血管疾病  cardio-/ˈkɑːdiəʊ/ 心，与心相关

vascular /ˈvæskjələ(r)/ adj 血管的   Hypertension /ˌhaɪpəˈtenʃn/ 高血压，过度紧张

epidemiology  /ˌepɪˌdiːmiˈɒlədʒi/  流行病学

Men also smoke more than women in many countries, and some studies have shown that men wash their hands less frequently than women.

Prof Matsushita says that studies he had participated in had shown that male patients have a higher risk of contracting severe Covid-19 infection.

have participated in：参与，参加

Scientists also believe that women have a lower mortality risk because of sturdier immune defences. And have hormones like oestrogen which has "beneficial effects on upper and lower airways and is associated with stimulation of the immune response to upper airway infections".

sturdy adj.   /ˈstɜːdi/  ( stur·dier --- stur·di·est )

1.( of an object 物品 ) strong and not easily damaged 结实的；坚固的 •a sturdy pair of boots 一双结实的靴子

2.( of people and animals, or their bodies 人、动物或身体 ) physically strong and healthy 强壮的；健壮的 •sturdy legs 强壮有力的腿

3.not easily influenced or changed by other people 坚决的；坚定的；顽强的

immune defences：免疫防御 immune system:免疫系统

immune /ɪˈmjuːn/ ~ (to sth) that cannot catch or be affected by a particular disease or illness 有免疫力；~ (to sth) not affected by sth 不受影响•You'll eventually become immune to criticism. 你终究会不用在乎批评了。 ~ (from sth) protected from sth and therefore able to avoid it 受保护；免除；豁免

hormones /'hɔ:məun/ 荷尔蒙  oestrogen/ˈiːstrədʒən/ 雌激素

upper and lower airways：文中理解为--上下呼吸道

"In that regard, a higher case fatality rate in women than men in this report is certainly unique," Prof Matsushita told me.

But he says the research data needs to be scrutinised in the context of how Covid-19 is diagnosed in India. "For example, is the opportunity to get a test same between men and women?" he wonders.

scrutinise  /ˈskruːtɪnaɪz/→scrutinizevi. 作仔细检查；细致观察 vt. 细看；仔细观察或检查；核对

in the context of ···范围，情况，框架下 diagnose /ˈdaɪəɡnəʊz; ˌdaɪəɡˈnəʊz/ 诊断

There could be more to this puzzle than what meets the eye.

Women outlive men in India and there are more older women than men. Is this leading to more deaths among women, as elderly people are vulnerable to the infection?

outlive v. /ˌaʊtˈlɪv/  1.to live longer than sb 比…活得长•He outlived his wife by three years. 他比妻子多活了三年。 2.to continue to exist after sth else has ended or disappeared （在…结束或消失后）继续存在

Also, women in India are more likely to delay going to doctors, and often self-medicate at home. And a woman's health is more likely to be ignored in a household. So are women arriving late for testing and treatment?

self-medicate：自己治疗

Homemaker caregivers are more prone to contracting the infection - during the 1918 Spanish flu more women in India - relatively undernourished, cooped up in unhygienic and ill-ventilated dwellings, and nursing the sick - died than men.

Caregivers：care-giver 看护人，照顾着 be more prone to ：更倾向于

undernourished /ˌʌndəˈnʌrɪʃt/ under-nourished营养不良的；缺乏营养的

cooped up ADJ If you say that someone is cooped up, you mean that they live or are kept in a place which is too small, or which does not allow them much freedom. 被禁锢的

unhygienic adj. /ˌʌnhaɪˈdʒiːnɪk/ not clean and therefore likely to cause disease or infection 不清洁的；不卫生的；易致病（或感染）的

ill-ventilated: 通风条件差 ventilate /ˈvɛntɪˌleɪt/ V-T If you ventilate a room or building, you allow fresh air to get into it. 使通风

dwelling /ˈdwɛlɪŋ/ N-COUNT A dwelling or a dwelling place is a place where someone lives. 住所; 居住地

"We need to dissect the gender data to find out more about what's going on," says T Jacob John, a retired professor of virology at Christian Medical College, Vellore.

dissect v. /dɪˈsekt/  /daɪ‑/  1.to cut up a dead person, animal or plant in order to study it 解剖（人或动植物）2.to study sth closely and/or discuss it in great detail 仔细研究；详细评论；剖析 3.to divide sth into smaller pieces, areas, etc. 把…分成小块

virology n. /vaɪˈrɒlədʒi/  [ U ] the scientific study of viruses and the diseases caused by them 病毒学

Researchers agree. "We will keep a close watch and keep updating the results," Prof Subramanian says.