This article ‘Coronavirus reveals just how deep macho stereotypes run through society’ appeared in ‘The Conversation’ on April 9th 2020. The coronavirus pandemic was just getting going in the UK. A number of men who had volunteered to help in the NHS were barely cold in their graves when this poorly researched, poorly argued and insensitive article appeared. What it also revealed was a serious lapse of editorial judgement and perhaps departmental oversight of two junior researchers. The authors are both from the Department of Sociology at Durham University where Stephen Burrell was a Postdoctoral Fellow and Sandy Ruxton an Honorary Research Fellow.
The starting point of the article was the emerging finding that more men than women were dying of COVID-19. The authors who have no background in public health or epidemiology argued that ‘macho stereotypes’ running through society were likely to play an important role in the reported disparity in death rates. Broadly speaking it was the fault of men and they had nobody to blame but themselves.
The authors claimed that research indicates that men take personal hygiene less seriously than women. In fact, the evidence is mixed. High-quality data are hard to find and ethical committee approval for covert observation in toilets, for example, is unlikely to be granted. An important confounding factor in studies looking at soap disappearance in toilets is that women are more likely to take children to the toilet and wash their hands as well as their own. Perhaps the best test of personal hygiene compliance is bacterial cultures from the hands of men and women. The only study I am aware of compared faecal organisms on the hands of 409 people on public transport in a range of UK cities and that found no difference between men and women (Judah et al Dirty Hands: bacteria of faecal origin of commuters hands). Another study has shown that women’s hands tend to have a greater range of bacteria than men’s PNAS in 2008. The difference between men and women in terms of hand hygiene is likely to be small and the dominant message of most studies is that very few people of either sex wash their hands sufficiently often or thoroughly. Neither is it clear how important hand transmission rather than inhalation of aerosols is the transmission of the COVID-19. For a much better account than mine of this issue I recommend William Collin’s blogpost ‘filthy men deserve to die‘.
The authors suggested that men are more likely to indulge in risky behaviours such as smoking, drinking and drug-taking. Of these factors, there is only evidence that smoking increases the risk of COVID-19 mortality and the difference in smoking rates between men and women is small and not sufficient to account for the two-fold difference in mortality that has been observed. Obesity is also a risk factor for COVID-19 mortality and morbidity and that is more prevalent among women.
The authors went on to argue that there is a lack of research centred on female bodies. This questionable claim was only supported by reference to a polemical book rather than any scholarly reviews or primary sources. Because autoimmune disorders are more common among women the assertion is unlikely to be true in terms of understanding of the immune system at least. Furthermore, even if it is true, why research focusing on men rather than women should be a factor in the increased death rate of men was not made clear.
It was claimed that men are less likely to care for themselves. Evidence for this, however, is lacking. In aggregate men do make 32% fewer visits to the GP but this is accounted for a number of factors other than their own lack of self-care. Men live less long and spend a shorter period in chronic ill health at the end of life. Men, on average, work longer hours and at greater distances from home and that makes visits to the GP more difficult. However, if you look at the interval between symptom onset and presentation to primary care for ischaemic cardiac and cerebrovascular events there is no difference between men and women. The authors failed to present any evidence that men were being admitted at a later stage of the disease (evidenced by lower blood oxygen levels for example) and that this, in turn, was due to their lack of self-care rather than their symptoms being taken less seriously.
According to the article, men are less likely to be involved in caring for others. While this may be true of direct hands-on care, men were crucially involved in the maintenance of our critical infrastructure and in a way that was equally important, less valued and that put them at greater risk of contracting COVID-19. For example, bus drivers and delivery drivers were and are predominantly male and poorly paid. You should not assume that ‘hands on carers’ do more good in the world. For example, who saved the most lives in the Crimean hospitals – Florence Nightingale’s team of nurses or the men who dug out the excrement and dead animals obstructing the hospital sewers? It is a question worth asking. There are many ways of caring and contributing to society and if there is cultural neglect, it does not primarily affect hands-on carers.
The claim that men were less likely to take social distancing seriously was only supported by a ten-year-old reference looking at the use of public spaces but not actual evidence comparing male and female behaviour during the pandemic. I did speak to some agreeable and extremely funny Asian lads in my local park who informed me that they were there because they were not made welcome in the house by women, who viewed it as their domain during the day. I don’t know how prevalent these attitudes are but these issues are always more complex and nuanced than they appear at first sight.
The authors objected to the ‘patriarchal’ war analogy that was used to mobilise public support. But that war is not patriarchal. Boudica, Catherine the Great, Queen Elizabeth 1st, Margaret Thatcher, Golda Meir, Indira Gandhi, Benazir Bhutto and Aung San Su Kyi have all been very able but quite capable of adopting military solutions. The suffragettes, including the Pankhursts, viewed it as men’s duty to women to join up and fight during WW1, while they themselves stayed at home. Hetti Barkworth-Nanton has been appointed to the board of the domestic violence charity Refuge while she is chief executive of a Ministry-of-Defence spin-off company that manufactures ‘higher performance’ low noise captive ammunition. However distasteful it may be to some people, the war analogy as a means of mobilising the whole population, was actually an effective one during the pandemic. What metaphor would the authors have preferred? They don’t say.
You will be aware by now that I have a very low opinion of this article although I would defend the right of the authors to write and publish their views. In fact, there was only short window of opportinity to publish the article. It subsequently emerged that it was BAME men who were most at risk from COVID-19. The authors wouldn’t have dared extend their argument to suggest that macho stereotypes run even deeper in the BAME community. What was really indefensible, however, was that they engaged with comments that were favourable to their point of view even indulging in mutual congratulations whilst refusing to respond to carefully written counterarguments. That, more than their ill-informed, poorly researched and misandrist views is deserving of our contempt.
I note that Stephen Burrell is now an Assistant Professor in the Department of Sociology at Durham. This should confirm the suspicions of many about declining academic standards. It is well recognised that there has there been grade inflation but less well known is title inflation. There are now so many Professors and Assistant Professors but almost no Lecturers, Senior Lecturers or Readers. Mr Burrell’s research output looks to me to be rather too modest for his grand title.