On Saturday — the same day the first U.S. coronavirus death was reported in Washington state — Vice President Pence, who has been tasked with overseeing the country’s response to the outbreak, sent a tweet. “Today we had a very productive meeting of the White House Coronavirus Taskforce in the Situation Room,” it read.
Along with the tweet, a photograph showed members of the task force sitting around a large rectangular table. About 20 people were pictured. Not a single woman was included in the shot — a detail that didn’t go unnoticed on Twitter.
In late January, the Trump administration announced the formation of the President’s Coronavirus Task Force. Led by Secretary of Health and Human Services Alex Azar, it included 11 additional members — all of whom were men.
Last week, after officials from the Centers for Disease Control and Prevention warned that U.S. citizens should begin making preparations for the spread of the infectious disease, more members were added to the task force. That included one woman: Deborah Birx, the State Department’s global AIDS director, who was named the “coronavirus response coordinator.” (Officials from the White House and the CDC have not responded to requests for comment.)
The task force’s apparent lack of gender diversity isn’t just about optics, according to public health experts: It’s likely to carry real consequences for women.
“We can’t ignore 50 percent of the population when it comes to effective health policy,” says Imogen Coe, a professor of chemistry and biology at Canada’s Ryerson University who has written about gender equality in medicine. “The consequences of doing so could range from inconvenience to very severe.”
The coronavirus death toll has now passed 3,000 globally, and the U.S. government has confirmed 87 coronavirus cases in total as of Monday afternoon, including the first in New York. On Monday, the Washington State Department of Health announced four more deaths, bringing the U.S. total to six. An analysis has suggested the virus has probably been spreading in the state, undetected, for weeks.
Experts say they can’t understate the importance of having a diversity of perspectives when it comes to addressing as serious an outbreak as this. Many cite the 2014 Ebola outbreak in West Africa as an example. Sarah Hawkes, a professor of global public health and co-director of the gender equality initiative Global Health 50/50, points to research that showed women were absent in leadership decisions related to the outbreak. They were disproportionately affected by the epidemic: Health teams reported that 75 percent of those who were infected with or died from Ebola were women.
“You can design all sorts of systems and responses, but the one thing we should’ve learned from the Ebola crisis is that if we don’t engage good representation from the communities you’re trying to reach, you’re not likely to be a very effective program,” she says.
Although men are likelier to die from the coronavirus, women contract it in similar numbers, based on data from the Chinese Center for Disease Control and Prevention.
Among the biggest risks for women is that they vastly outnumber men when it comes to both paid and unpaid care work. In other words, they will be largely responsible for caring for the sick, recognizing when to keep their children home from school and dealing with other day-to-day realities of such an outbreak, according to experts.
When you lack those perspectives “at the table,” it’s easy to create policy removed from the needs of the health-care workers on the ground, says Coe, the Ryerson professor. “You need to be asking specific questions for the women who are taking care of families and ill people and who are often on the front lines,” she says.
A recent New York Times article found that the situation for female health workers in China has been especially harrowing: One nurse’s superiors “told her and her female colleagues that they ‘lacked the spirit of devotion’ and discipline after they sought help getting pads and tampons.”
Women make up 70 percent to 80 percent of the U.S. health-care workforce, but they’re underrepresented in leadership, according to the National Institutes of Health (NIH). Public health is somewhat of an anomaly, with many women leading the field, according to Susan Wood, director of the Jacobs Institute of Women’s Health at George Washington University. In other words, the lack of women in Pence’s photo “is not for there being a lack of qualified women in public health,” she says.
Wood has seen emergency response flounder when it comes to addressing women’s specific health needs, she says. In the cases of emergency evacuations or quarantines specifically, supplies such as diapers and baby formula are often included — but menstrual supplies aren’t necessarily a given.
Coe agrees: Considerations around women’s reproductive health is crucial in addressing the coronavirus outbreak. “If you are a young woman who’s pregnant and you have a family member who just came back from one of the hot spots — Italy, Iran — what is the advice you should be getting?” she asks. “What are the recommendations going to be for women who are breast-feeding?”
Experts worry that if these perspectives aren’t represented in initial conversations, those needs won’t be adequately addressed in policies. Regardless of the qualifications of some on the task force — Hawkes points to Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases — there are likely to be blind spots. What the photo communicates, says Hawkes, “is that there’s either a systematic bias or a systematic blindness to the importance of diversity.”
But there is a potential bright spot, according to Kelly Thompson, co-author of a World Health Organization report on gender disparities in the global health workforce: There’s opportunity for increasing perspectives going forward. The NIH, for example, has a mandate that its research needs to include women and minority groups. As Thompson puts it, “Looking toward any research that’s going to be done on the coronavirus, or future vaccine work, we definitely need to make sure that mandate is given priority.”