How many UK deaths could have been prevented? We all now know that while the UK wasted precious weeks at the beginning of the Covid-19 epidemic, other nations – Germany, Denmark, Norway, Finland, New Zealand, to name but a few – acted much faster and are now successfully easing their lockdown restrictions. New Zealand just declared itself virus-free. What is becoming apparent is that many countries that failed to act decisively are led by men whose strong-man approach to health and wellbeing has turned out to inform disastrous policy. Meanwhile, few countries with female leaders have done badly in managing the crisis. Don’t believe that masculinities – how we socialise and teach men to be men – has anything to do with it? Read on.
I have been speaking to men and boys about their health for almost 20 years, in the UK, South Africa, Malawi and the United States. Across all these countries, rich and poor, young and old, married or unmarried, a common assertion among men has been that paying attention to your physical health is not being a real man. Countless men have expressed concern about what their family, friends or communities will think of them if they are seen to be going to a clinic or hospital. Many men have told me their sense of being a man is to be invincible, and that ill-health is emasculating and represents weakness. A common riposte by health experts is to ask why there are similar rates of men and women in hospital critical care in developed countries. It is precisely because men often only seek care when we absolutely have to, when we are already sick. But we don’t do health for health’s sake, as reflected by our under-representation in primary care and preventative services. Enter, stage left: a global, invisible killer.
In the context of Covid-19, the desire to be a ‘real man’ doesn’t just affect men. It affects us all. The impact of this macho approach to health has played out at a global leadership level over recent months, with a devastating impact on everyone. In the UK, Boris Johnson said he would vanquish a disease which later almost killed him; the man who skipped five Cobra meetings and did not heed the early warnings of his scientists. Rather than taking the challenge seriously in March – while we watched what was happening in Italy and Spain – and take action to stop large gatherings and encourage people to work from home, Johnson’s advice then was for us all to stop going on cruises or school trips. We’re now told by Johnson we should be proud of the UK’s record: a report card of over 40,000 deaths, more than any other European country. He said his senior advisor, Dominic Cummings, was acting admirably while clearly breaking the lockdown rules, treating so many who have made heart-breaking sacrifices during this period with contempt.
Beyond Boris himself, the impact of this masculine approach to health has also played out across our society and the UK government. When Boris was in intensive care, the media told us that he would be ok as he’s a fighter, as if personal strength has any impact on one’s ability to survive against this dreadful virus. Senior UK Government figures – mostly men, that have dominated out screens and the radio waves – continue to pretend that no mistakes were made and treat the British people with contempt. On the Andrew Marr Show this past weekend, when a member of the government’s SAGE advisory committee acknowledged he wished we had locked down earlier, the Secretary of State for Health and Social Care, Matt Hancock, swiftly disagreed. We’ve had bluster about a world beating test and trace system from the beginning of June, when the reality is it’s unlikely to be fully up and running until September. As a parent, I hear government Ministers telling me it’s safe to reopen schools and that “we’re following the science”, while my son’s school and teachers tell me it is not completely safe. Friends tell me of the challenges of returning to their workplace, without much clear plan or warning. This is a macho approach of ‘it will all be alright on the night’, rather than being honest about the predicament in which we find ourselves, and the need to correct mistakes quickly, particularly if we are to prevent a second wave.
And this is far from a British phenomenon, as we know. In America, Trump, a known germophobe, began by claiming the virus was under control in the US, then blamed China, while Covid-19 has continued to take a devastating toll on its people. The US now has more than 100,000 deaths. Friends living there fear a dreadful second wave. Trump’s macho politicising of Covid-19, such as cutting funding to the World Health Organisation, is playing even more with people’s lives. In Brazil, Bolsonaro used a nation-wide TV address in March to say he wouldn’t feel anything if infected with Covid-19. Now Brazil, with the second highest rates of infection globally, yesterday stopped sharing its data on Covid-cases. There has been some discussion about how men are more likely to die from Covid-19, but little talk about how these macho responses may be causing many thousand more unnecessary deaths and grieving families.
Compare such ‘leadership’ to my own home nation, Scotland. The First Minister of Scotland, Nicola Sturgeon, has been completely honest and open with the public about the challenges that she and other leaders face. Her government has published a clear lock-down exit strategy, with specific phases and milestones. She took quick action when a senior public servant broke the lockdown rules. I am no fan of Scottish Independence, but Nicola Sturgeon has shown brave and decisive leadership, while male UK politicians in our government have dithered. Similar plaudits could be made of the female leaders of Germany and New Zealand, among many others, where a more pragmatic leadership approach to illness has meant that these countries have acted quickly to confront the reality of the epidemic, have seen much lower rates of infection, and as a result can more safely reopen parts of their economies.
What do we do about this? We must begin by changing how we define leadership. For too long, machoism has been associated with decisiveness, whereas what we’ve seen with Covid-19 is a lack of leadership in the UK and US on how to interpret the science. As many scientific advisers have repeatedly said, we don’t make the decisions, we simply provide guidance. Alternatively, feminist leadership has weighed the facts, added their own judgement, and acted decisively. In a war against a virus, not each other, hard power is truly ill-suited for the task. Looking at the longer-term challenges before us, not least on climate change, soft power will become increasingly important.
We must call out the harm masculinities do to men, and the harm it causes to others. Men must learn that it is ok to be vulnerable and to express honesty – being able to change tack as new evidence comes to light, to admit fallability rather than bluster that we know best – and that strength, not weakness, comes from this. We must learn to be much more humble about our place on the planet. As Sir David Attenborough recently said, the question is not whether the planet survives climate change, but whether the human race survives.
Finally, we must have a conversation about masculinities and Covid-19, both now (including further analysis on why more men are dying than women), and also in the post Covid-19 environment. My research has shown that gendered masculine norms are a key contributor to men’s global burden of morbidity and mortality. This will require better collection of sex-disaggregated data by governments, and also policy acknowledgement on how masculinities and health affects women, children and society as much as they affect men themselves.
When history recounts this epidemic, I hope the question will increasingly be how a tough-man form of leadership was implicit in allowing the virus to get out of control, at a time when the world so desperately needed less testosterone and more grown up responses.
Tim Shand has published and spoken widely on masculinities, including a TEDx talk. His PhD at the UCL Institute for Global Health focuses on masculinities and health. He is an Associate of the Men’s Health Forum UK and fellow of the Royal Society of Arts. He is co-founder and Director of ShandClarke Consulting Ltd. Views his own. @timjcshand