Men, Covid-19, the pandemic, and stressful life events – not a good mix.

 Men, Covid-19, the pandemic, and stressful life events – not a good mix.

So much has happened since I last updated my blog. It has been an intense and difficult time for so many of us for so many different reasons, both related to COVID-19, other work commitments and life events that none can predict, but can hit hard. This blog tries to give an update on what’s been happening in my life since the start of 2020.

COVID-19 and pandemic

What became clear early on in the pandemic was the higher rates of severe disease and death in men. Working with the Men’s Health Forum [www.menshealthforum.org.uk] there was a need to understand what was going on. A key factor appeared to be a very complex biological sex differences in the immune system, which we tried to explain in one of papers we managed to get published over the year(1). We also held a number of webinars (with the Men’s Health Forum [GB], Men’s Health Forum [Ireland], Global Action on Men’s Health [GAMH] and for the journal Trends in Urology and Men’s Health] to help share our growing understanding and to learn from colleagues’ experiences. 

Early on in the pandemic I was fortunate to join an important international collaboration - the Gender and Covid-19 Working group [https://www.genderandcovid-19.org/gender-working-group-page/]. This has been a most active group, helping to pool information on the differential impact of the disease on men and women and further supporting the need for gender to be taken as a serious consideration in planning and service delivery. This lead to a call to action in the International Journal of Environmental Research and Public Health (2).

Another early important output from this collaboration was our Lancet Commentary – “Men’s health: COVID-19 pandemic highlights need for overdue policy action” (3). Where we reflected on the dearth of policy focusing onto the health of men and how this was now limiting the effectiveness of work reaching out to men across the globe. This issue was also focused on by James Smith and colleagues as we rightly recognised the important policy implications of the pandemic on men, which led to a paper in the International Journal of Men’s Social and Community Care (4).  

There were also longer term impacts becoming apparent, which was the impetus to me pulling together the paper on ‘Men and Covid-19: the aftermath’ (5). In this paper I explored both the possible direct consequences on men, both short and long term, of being infected by the virus and the wider health and social care implications of living through the pandemic. 

Throughout the pandemic our work on men’s health in Leeds has been continuing, albeit with major challenges in trying to reach out to vulnerable men without the opportunity of holding the groups and one-to-one work. We had a paper almost written exploring the impact of social isolation and loneliness with Tim Taylor, Head of Adult Health Services at Leeds City Council and Rachel Cooper the CEO of Forum Central in Leeds prior to the pandemic so that it’s publication in July had particular resonance (6). It is great to know that the collaboration of key third sector organisations in Leeds lead to a successful bid to the Coronavirus Community Support Fund distributed by the National Lottery Community Fund for ‘Men’s Health Unlocked’. This work is focused on connecting with men through the offer of internet enabled tablets with training and support to use them; group and 1:1 support work; along with an 'Unlocked' Magazine which will communicate important healthcare messages, social and support group information, fun activities and competitions. This project will also create and maintain a central platform for men's voices in Leeds at a strategic level during a time when Covid-19 has highlighted health inequalities and the need for a gendered approach to services, support and information.

Non-Covid-19 related work

From March through to August I was also working with the West Yorkshire Health & Care Partnership on a perinatal mental health project to help in preparation for the new Maternal Mental Health Service. The study explored the mental health challenges faced by women and their partners when faced with child loss (miscarriage, stillbirth, termination of pregnancy, and child removal into care at birth), tokophobia (extreme fear of childbirth), birth trauma and those who have had fertility treatment. The first phase of this study was conducted during the lockdown and comprised a comprehensive scoping literature review of these issues followed by a more localised report for the Commissioners(7). The scoping review is available on my website. 

With Roger and Mike Kirby and Culley Carson I was also working on the 4th Edition of the Men’s Health medical text book (8), which is due out in the early spring. Two chapters to finish and another to write on Men and Suicide along with reviewing the chapters for my two sections of the book certainly added to the challenge of the lockdown. This is a great book, with excellent contributions from leaders in the field of men’s health.  

Taking time out

On a personal note my life was turned upside down in January by the decision by my wife of 35 years that she wanted a separation. This has led to a difficult time for me and I have to admit that coming to terms with a life without Liz, the solitude of the lockdown, along with the complexity of the work on the perinatal mental health study and the papers on COVID-19 etc. has been very hard and I have struggled to keep it all together. I have now moved from Yorkshire to Penrith in Cumbria to be nearer my family and I am now taking some time to get some sense of direction and back on my feet. 

6rd November 2020

1. White A, Kirby M. COVID-19 : biological factors in men’s vulnerability. Trends Urol. 2020;(August):1–5. 

2. Bischof E, Oertelt-Prigione S, Morgan R, Klein SL. Towards precision medicine: Inclusion of sex and gender aspects in COVID-19 clinical studies—acting now before it is too late—a joint call for action. Int J Environ Res Public Health. 2020;17(10). 

3. Baker P, White A, Morgan R. Men’s health: COVID-19 pandemic highlights need for overdue policy action. Lancet [Internet]. 2020;395(10241):1886–8. Available from: http://dx.doi.org/10.1016/S0140-6736(20)31303-9

4. Smith JA, Griffith DM, White A, Baker P, Watkins DC, Drummond M, et al. COVID-19, equity and men’s health: using evidence to inform future public health policy, practice and research responses to pandemics. Int J Men’s Soc Community Heal. 2020;3(1):e48–64. 

5. White A. Men and COVID-19: the aftermath. Postgrad Med [Internet]. 2020 Sep 14; Available from: https://doi.org/10.1080/00325481.2020.1823760

6. White A, Taylor T, Health P, Cooper R, Executive C. Social isolation and loneliness : a hidden killer. Trends Urol Men’s Heal. 2020;(August):31–5. 

7. White A. A Scoping study on Maternal Mental Health Services: Loss, Tokophobia, Birth trauma and Assisted Reproductive Technology. Wakefield: West Yorkshire & Harrogate Health & Care Partnership; 2020. 

8. Kirby R, Carson C, White A, Kirby M. Men’s Health. 4th ed. Abingdon, Oxon: CRC Press, Taylor & Francis;  (due to be published 2021)