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      COVID-19 and the gendered markets of people and products: explaining inequalities in infections and deaths

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          Abstract

          COVID-19 has exposed and exploited existing inequalities in gender to drive inequities in health outcomes. Evidence illustrates the relationship between occupation, ethnicity and gender to increase risk of infection in some places. Higher death rates are seen among people also suffering from non-communicable diseases – e.g. heart disease and lung disease driven by exposure to harmful patterns of exposure to corporate products (tobacco, alcohol, ultra-processed foods), corporate by-products (e.g. outdoor air pollution) or gendered corporate processes (e.g. gendered occupational risk). The paper argues that institutional gender blindness in the health system means that underlying gender inequalities have not been taken into consideration in policies and programmatic responses to COVID-19.

          Résumé

          La pandémie de COVID-19 a à la fois révélé et renforcé des inégalités de genre déjà existantes, provoquant une augmentation des inégalités dans les statistiques de santé. Les données recueillies révèlent que la combinaison de facteurs tels que l’occupation, l’ethnicité et le genre contribuent à une augmentation du risque d’infection dans certains lieux. Des taux de mortalité plus élevés ont ainsi été constatés dans des populations souffrant également de maladies non transmissibles, telles que les maladies cardiaques et pulmonaires causées par l’exposition aux effets nocifs de produits industriels (tabac, alcool, produits alimentaires ultra-transformés), de leur productions dérivées (pollution atmosphérique extérieure), ou de processus industriels genrés (risques professionnels liés au genre). Cet article démontre que le déni institutionnel des différences de genre dans le système médical a pour conséquence la non-prise en compte des inégalités de genre sous-jacentes dans la mise en place de réglementations et de programmes de réponses au COVID-19.

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          Most cited references84

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          Clinical Characteristics of Coronavirus Disease 2019 in China

          Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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            Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

            Summary Background In December, 2019, a pneumonia associated with the 2019 novel coronavirus (2019-nCoV) emerged in Wuhan, China. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia. Methods In this retrospective, single-centre study, we included all confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. Cases were confirmed by real-time RT-PCR and were analysed for epidemiological, demographic, clinical, and radiological features and laboratory data. Outcomes were followed up until Jan 25, 2020. Findings Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the Huanan seafood market. The average age of the patients was 55·5 years (SD 13·1), including 67 men and 32 women. 2019-nCoV was detected in all patients by real-time RT-PCR. 50 (51%) patients had chronic diseases. Patients had clinical manifestations of fever (82 [83%] patients), cough (81 [82%] patients), shortness of breath (31 [31%] patients), muscle ache (11 [11%] patients), confusion (nine [9%] patients), headache (eight [8%] patients), sore throat (five [5%] patients), rhinorrhoea (four [4%] patients), chest pain (two [2%] patients), diarrhoea (two [2%] patients), and nausea and vomiting (one [1%] patient). According to imaging examination, 74 (75%) patients showed bilateral pneumonia, 14 (14%) patients showed multiple mottling and ground-glass opacity, and one (1%) patient had pneumothorax. 17 (17%) patients developed acute respiratory distress syndrome and, among them, 11 (11%) patients worsened in a short period of time and died of multiple organ failure. Interpretation The 2019-nCoV infection was of clustering onset, is more likely to affect older males with comorbidities, and can result in severe and even fatal respiratory diseases such as acute respiratory distress syndrome. In general, characteristics of patients who died were in line with the MuLBSTA score, an early warning model for predicting mortality in viral pneumonia. Further investigation is needed to explore the applicability of the MuLBSTA score in predicting the risk of mortality in 2019-nCoV infection. Funding National Key R&D Program of China.
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              Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation

              Structure of the nCoV trimeric spike The World Health Organization has declared the outbreak of a novel coronavirus (2019-nCoV) to be a public health emergency of international concern. The virus binds to host cells through its trimeric spike glycoprotein, making this protein a key target for potential therapies and diagnostics. Wrapp et al. determined a 3.5-angstrom-resolution structure of the 2019-nCoV trimeric spike protein by cryo–electron microscopy. Using biophysical assays, the authors show that this protein binds at least 10 times more tightly than the corresponding spike protein of severe acute respiratory syndrome (SARS)–CoV to their common host cell receptor. They also tested three antibodies known to bind to the SARS-CoV spike protein but did not detect binding to the 2019-nCoV spike protein. These studies provide valuable information to guide the development of medical counter-measures for 2019-nCoV. Science, this issue p. 1260
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                Author and article information

                Journal
                101085680
                Rev Can Etudes Dev
                Rev Can Etudes Dev
                Revue canadienne d'etudes du developpement = Canadian journal of development studies
                0225-5189
                31 March 2022
                2021
                23 October 2020
                25 April 2022
                : 42
                : 37-54
                Affiliations
                [a ]Institute for Global Health, University College London, London, UK
                [b ]The George Institute for Global Health, University of New South Wales, Sydney, Australia
                Author notes
                CONTACT Sarah Hawkes s.hawkes@ 123456ucl.ac.uk
                Author information
                https://orcid.org/0000-0003-1062-3538
                https://orcid.org/0000-0002-5485-0110
                Article
                EMS144066
                10.1080/02255189.2020.1824894
                7612661
                5eb7aaef-d340-4349-831a-736deb7d2fad

                This work is licensed under a CC BY 4.0 International license.

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                health policy,gender,covid-19,inequality,intersectionality
                health policy, gender, covid-19, inequality, intersectionality

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