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，面積的含義，該短語：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：我們常見的是名詞含義，合同，契約的意思；作動詞的含義在文中是醫(yī)學(xué)上的感染疾病，如?to contract AIDS/a virus/a disease 感染艾滋病╱病毒╱疾??；此外它作動詞還可以表示縮小，收縮；如Glass contracts as it cools. 玻璃遇冷收縮。 ?a contracting market 萎縮的市場；還有與···簽訂合同/契約等意思。

caseload：以前的文章提到過，待處理案件的數(shù)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; 不直接表達(dá)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/?n?r?t?v/?敘述；故事；講述? ?fatality rate：死亡率

fatality?/f??t?l?ti/ a death that is caused in an accident or a war, or by violence or disease （事故、戰(zhàn)爭、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；聽天由命；天數(shù)

conflate?/k?n?fle?t/ ?[ VN ] ( formal ) to put two or more things together to make one new thing 合并；合成；混合

metric?adj. /?metr?k/ ?1.based on the metric system 米制的；公制的

?metric units/measurements/sizes 公制單位╱尺寸╱大??；2.made or measured using the metric system 按公制制作的；用公制測量的

mortality?n. /m???t?l?ti/ ?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 死亡數(shù)量；死亡率?the infant mortality rate ?嬰兒死亡率；3.[ C ] ( technical 術(shù)語 ) a death 死亡

mortality risk：死亡風(fēng)險(xiǎn)? ?mortality burden：這個是學(xué)術(shù)術(shù)語，沒查到對應(yīng)準(zhǔn)確翻譯，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死亡風(fēng)險(xiǎn)Mortality risk=女性死亡總數(shù)/確診女性人數(shù)

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=女性感染死亡人數(shù)/總死亡人數(shù)*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. /hju?/ ?( hewed or hewed hewn /hju?n/ ?)1.( old-fashioned ) to cut sth large with a tool 砍，劈（大的物體）?to hew wood 劈木頭2.( formal ) to make or shape sth large by cutting 砍成，劈出（某種形狀、某物）

Infer?vt. 推斷；推論vi. 推斷；作出推論

"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：關(guān)鍵因素；臨界因素? ?be attributable to：··歸因于··；可歸咎于

Be associated with：···與···相關(guān)

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

Striking?adj. 顯著的，突出的，驚人的；打擊的；罷工的v. 打（strike的ing形式）

run counter to：違反；與…背道而馳eg.This course is actually going to run counter to that historical tendency. 這門課實(shí)際上與歷史趨勢背道而馳。

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：副發(fā)病變，共病 morbidity /m???b?d?ti/ n. 發(fā)病率；病態(tài)；不健全

underlying health conditions：潛在健康狀況

cardio-vascular disease：心血管疾病??cardio-/?kɑ?di??/ 心，與心相關(guān)

vascular?/?v?skj?l?(r)/ adj 血管的? ?Hypertension?/?ha?p??ten?n/ 高血壓，過度緊張

epidemiology??/?ep??di?mi??l?d?i/ ?流行病學(xué)

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：參與，參加

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. ??/?st??di/ ?( stur·dier --- stur·di·est )

1.( of an object 物品 ) strong and not easily damaged 結(jié)實(shí)的；堅(jiān)固的??a sturdy pair of boots 一雙結(jié)實(shí)的靴子

2.( of people and animals, or their bodies 人、動物或身體 ) physically strong and healthy 強(qiáng)壯的；健壯的??sturdy legs 強(qiáng)壯有力的腿

3.not easily influenced or changed by other people 堅(jiān)決的；堅(jiān)定的；頑強(qiáng)的

immune defences：免疫防御?immune system:免疫系統(tǒng)

immune?/??mju?n/?~ (to sth) that cannot catch or be affected by a particular disease or illness 有免疫力；~ (to sth) not affected by sth 不受影響?You'll eventually become immune to criticism. 你終究會不用在乎批評了。 ~ (from sth) protected from sth and therefore able to avoid it 受保護(hù)；免除；豁免

hormones?/'h?:m?un/?荷爾蒙 ?oestrogen/?i?str?d??n/ 雌激素

upper and lower airways：文中理解為--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? /?skru?t?na?z/→scrutinizevi. 作仔細(xì)檢查；細(xì)致觀察?vt. 細(xì)看；仔細(xì)觀察或檢查；核對

in the context of ···范圍，情況，框架下?diagnose?/?da??ɡn??z; ?da??ɡ?n??z/?診斷

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. /?a?t?l?v/ ?1.to live longer than sb 比…活得長?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…結(jié)束或消失后）繼續(xù)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：自己治療

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 看護(hù)人，照顧著 be?more prone to?：更傾向于

undernourished?/??nd??n?r??t/ under-nourished營養(yǎng)不良的；缺乏營養(yǎng)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. 被禁錮的

unhygienic?adj. /??nha??d?i?n?k/ not clean and therefore likely to cause disease or infection 不清潔的；不衛(wèi)生的；易致?。ɑ蚋腥荆┑?/span>

ill-ventilated: 通風(fēng)條件差 ventilate?/?v?nt??le?t/ V-T If you ventilate a room or building, you allow fresh air to get into it. 使通風(fēng)

dwelling?/?dw?l??/ 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. /d??sekt/ ?/da??/ ?1.to cut up a dead person, animal or plant in order to study it 解剖（人或動植物）2.to study sth closely and/or discuss it in great detail 仔細(xì)研究；詳細(xì)評論；剖析?3.to divide sth into smaller pieces, areas, etc. 把…分成小塊

virology?n. /va??r?l?d?i/ ?[ U ] the scientific study of viruses and the diseases caused by them 病毒學(xué)

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