Nokuthaba Dlamini

The Covid-19 pandemic is affecting more men than women in Zimbabwe with people aged between 20 and 40 more vulnerable to the respiratory disease, data has shown.

An analysis of Covid-19 statistics tracked by The Standard working in partnership with Information for Development Trust—a non-profit organisation supporting local investigative journalism – reveals a consistent trend in the sex and ages of Zimbabweans contracting the virus since the outbreak began in March.

At the peak of the first wave of the outbreak in August, Bulawayo—considered to be the epicentre of the Covid-19 outbreak at one time—buried an equal number of men and women, but national figures show that it is males that are more likely to fall sick or die after contracting the virus.

Twenty adults distributed among both sexes equally and a three-month-old baby were buried in Bulawayo’s cemeteries during the month after succumbing to Covid-19.

Men’s burden

The pattern, however, is clearer at the national level. Men constituted 55.15% percent of the 10 243 people that contracted Covid-19 between the end of March, when the first case was first detected in Zimbabwe, and December 2, Health and Child Care ministry data shows.

The majority of the cases, at 57%, are of men aged between 20 and 40 years, an analysis of the data revealed.

Portia Manangazira, the Health and Child Care ministry’s director of epidemiology and disease control, said although they had not paid attention to the statistical significance of the data, the pattern could be due to differences in behaviour between men and women.

Women seemed more risk averse and readier to comply with anti-Covid regulations.

“It could just be an incidental finding, but we have not checked statistical significance,” Manangazira said.

“Perhaps women keep within the home more than men, wash their hands more than men (proven during our cholera outbreak studies), while men indulge in more risky behaviours, visiting the legal and unregistered drinking places and sharing cigarettes and beer mugs.”

For Itai Rusike, the Community Working Group on Health executive, behaviour influences the coronavirus infections pattern.

Rusike said men tended to be inclined to take risks and were more likely to break the tough regulations to slow down the spread of the coronavirus that were first imposed by President Emmerson Mnangagwa in March.

Some of the measures that were imposed included the closure of bars and nightspots.

There are, however, reports of shebeens mushrooming across the country, together with the hosting of “wild parties” in contravention of the lockdown regulations.

“Generally men do not live healthier life styles compared to women,” Rusike said.

Smoking, drinking and diabetes

“It is most men who smoke and it is also the majority of them who also drink, so with Covid-19, it seems if you are a smoker you become more vulnerable  because people who smoke, their lungs are not in good shape and their immune system is also generally weak.

“Research has proved that. Also, more men suffer from diabetes compared to women and that puts them at risk,” he added.

Last month, the World Health Organisation said 18.3% – or nearly one in every five— Covid 19 deaths in Africa were of people with diabetes as an underlying condition.

The findings were drawn from an analysis of 14 African countries.  

Solwayo Ngwenya, the Mpilo Hospital acting chief executive officer, said behaviour played a significant role in the spread of the coronavirus that was first detected in China late last year and subsequently spread fast throughout the world, affecting millions.

“That (men are more affected than women) is purely due to behavioural issues where men engage in smoking and drinking alcohol while partying a lot,” Ngwenya said.

“The trends show that people that seem to be dying are men in the ages of 40 to 80 years, and also people with comorbidities such as hypertension, HIV and cancer. “

Andrew Chimatira, a Harare-based public health expert, said risky behaviour could be one of the reasons more men were falling sick due to Covid-19 compared to women.

“Experts say part of the reason is women tend to have stronger immune systems than men.

“They add that men also tend to engage in more risky behaviour such as ignoring physical distancing, and they don’t take symptoms as seriously (as women),” Chimatira said.

But the fact that men and women are affected differently could be because of factors outside behaviour.

Who was tested?

Rashida Ferrand, the director of the Zim-SHTM Research Partnership, a partnership between the London School of Hygiene and Tropical Medicine and the Biomedical Research and Training Institute in Harare, believes the statistics are not conclusive enough.

“The differences are very marginal, so it could mean that more men have tested than women,” Ferrand said.

“I don’t think that it is conclusive enough that more men are at risk than women, but men are, generally, risk takers and they go out more.

“But there is no evidence to suggest that women have stronger immune systems,“ he said.

On the 20-40 years age group being the hardest hit by the pandemic, the experts were unanimous that behaviour was a huge factor.

 “This is the (most) active age group moving about and travelling a lot, as you know. Covid-19 risk is greatest when one travels hence the shutdowns and lockdowns and border closures,” Manangazira said.

“But youthful ones may also have lower risk perception than the older age groups. The younger ones have been spared during the six months of schools closure, otherwise the picture would have been different. Our country has a young population, with a life expectancy 62 in last census in 2012, so we don’t see the picture of Europe of severe disease in those above 70,” she added.

Rusike said the 20 to 40 age group was more active than the others and would naturally be more prone to contracting diseases such as Covid-19.

“If you look at HIV, it is also that age group that is more vulnerable and these are people, who are more active in terms of unhealthy lifestyles,” he said.

“They are now into heavy drinking, smoking, eating unhealthy foods and they start having diseases such as diabetes. 

“They have to go out there and put food on the table. As a result, they have got more exposure to diseases like Covid-19 and with the collapsing economy, the majority of them are in informal employment where Covid-19 restrictions are not being properly followed,” added Rusike.

Chimatira, the health expert, concurred, saying the economically active age group was more susceptible given Zimbabwe’s largely informal economy set up.

Bulawayo with a population of slightly over 650 000 according to the last census in 2012, also appears to be disproportionately affected by the pandemic.

As of December 2, the city had 2 434 cumulative Covid-19 cases and 80 deaths compared to Harare’s 3 398 cases and 121 deaths.

In its latest report, Bulawayo City Council’s department of health also blamed risk-taking behaviour for the trend.

“The main drivers of transmission that were still at play included low risk perception, breach of quarantine and isolation protocols,” reads the report.

Chitima says there is need to explore possible links with other disease burdens such as HIV and tuberculosis to explain the high number of deaths in Bulawayo.