Impact of the COVID-19 pandemic on people with disabilities

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People with disabilities are at greater risk of contracting COVID-19 and have higher rates of mortality than non-disabled populations. This is especially true for people with intellectual and developmental disabilities, individuals who reside in care facilities, and women with disabilities. People with disabilities are at greater risk of experiencing mental health issues related to the pandemic, such as feelings of loneliness and isolation. They may be at greater risk of domestic violence and abuse during the pandemic. People with disabilities are more likely to experience unemployment as a result of the pandemic and may require changes to the types of accommodations they require for work. Children with disabilities are experiencing disruptions to their educational programming. Remote learning poses a host of challenges for children with disabilities, including disruptions to physical and occupational therapies and access to assistive technologies.

Contents

Risk of disease

According to the World Health Organization (WHO), individuals with disabilities may be at higher risk for contraction of COVID-19. They may not be able to follow preventative measures, such as social distancing, as a result of support needs. Additionally, individuals may face barriers to accessing information about the pandemic, may be at higher risk due to preexisting conditions related to their disability, and may face disruptions to critical support services due to the pandemic. Persons with disabilities are over-represented in institutions such as nursing homes or other care facilities where COVID is more likely to spread. Persons with intellectual and developmental disabilities are also over-represented in correction and other types of detention facilities where COVID is known to spread more easily. [1]

Globally, it is estimated that between 19% and 72% of COVID-related deaths have taken place in care facilities where persons with disabilities are over-represented. According to United Nations (UN) estimates, roughly 46% of individuals aged 60 or older have a disability worldwide, and about 80% of the world's disabled population lives in developing countries where access to health care is more limited. [2]

In the face of resource shortages and overwhelmed health systems, several entities, such as the World Health Organization (WHO), the UN, and UNICEF, have expressed concern over the access of disabled persons to medical treatment for COVID-related disease and illness. [3] Several disability rights entities have expressed concern over medical rationing during the pandemic and have argued that such measures are ableist and discriminatory toward individuals with disabilities. [4] The vast majority of health care providers in the United States cannot use disability as grounds to ration care as outlined both in the ADA and Affordable Care Act (ACA). [5] In response to these concerns, the Office for Civil Rights in the United States issued a bulletin at the end of March asserting that medical rationing measures cannot discriminate against people with disabilities and other protected groups. [6]

Based on figures issued by the Office for National Statistics, from March through May 2020, disabled persons made up roughly 2/3 of all of the UK's COVID-related deaths. The report also concluded that disabled women were eleven times more likely than their non-disabled counterparts to die of complications from COVID. Disabled men were 6.5 times more likely to die of COVID-related illness than their nondisabled counterparts. [7] People with intellectual and developmental disabilities are at particularly high risk for contracting and dying from COVID. According to initial data from the United States, people with intellectual disabilities are four times more likely to contract COVID and twice as likely to die from the disease. [8]

Impact

Social

Previous research on pandemics has indicated that people with disabilities are more vulnerable to a host of social and psychological issues. [9] They are more likely to experience loneliness and isolation which may lead to other poor health outcomes. [10] Women with disabilities and women who care for individuals with disabilities are at greater risk for domestic abuse and sexual violence during pandemics. They may also be unable to access reproductive care and may be more likely to experience socioeconomic disadvantages associated with the pandemic. [11]

Children with disabilities are also at higher risk for mental distress as a result of the pandemic and may also be at greater risk of experiencing domestic violence during the COVID crisis. [12] As of 2016, there were roughly 52 million children, age 5 and younger, with some form of developmental disability, and about 1 in 6 children in the United States, between ages 3–12, has a developmental disability. [13] Children with intellectual and developmental disabilities, especially those with Autism Spectrum Disorder may be more likely to experience anxiety, stress, and other ill effects resulting from the pandemic. They may be particularly sensitive to changes in their daily routines, such as school closures. [14] Children with disabilities are at higher risk of contracting COVID-19 and developing serious complications from the disease. They may not be able to adequately socially distance while interacting with others or may not be able to wear masks due to sensory issues. This may lead to further isolation both for disabled children and their families. [15]

The rise of virtual gatherings has allowed some people with disabilities to participate in activities that were previously difficult to attend. For example, individuals with certain physical disabilities do not need to worry about whether a location is wheelchair-accessible when the event is conducted fully online. [16]

Employment

In the United States, According to the Equal Employment Opportunity Commission, employers must follow guidelines set out by the Americans with Disabilities Act (ADA) with consideration to COVID-19. This means that employers must keep all medical information they gather from employees related to COVID prevention confidential. They must continue to offer individuals with disabilities reasonable accommodations as well as take into consideration the accommodation requests made by individuals at higher risk for contracting more serious cases of COVID-19, such as individuals who are 65 years or older and those with preexisting conditions. Employers may have to renegotiate reasonable accommodations for individuals with disabilities based on the changes to work environments brought about by the pandemic, such as the prevalence of telecommuting. [17] In some respects the expansion of "work from home" arrangements in many businesses has actually improved employment opportunities for disabled people. [18] [19]

According to the UN, individuals with disabilities are more likely to lose their jobs as a result of the pandemic and face more difficulty in returning to work during the recovery period. [2] Individuals with longterm effects of COVID, such as chronic fatigue, may also face employment challenges. [20]

Visually challenged youth shared his trauma about loosing his job due to COVID-19 pandemic because of outstation issue-interviewed at Kolkata-West Bengal-India-September 2021

Education

As of April, 2020, schools had ceased in-person operation in 189 countries, affecting roughly 1.5 billion children worldwide. [12] [21] Children with disabilities have faced a host of challenges related to remote learning. They have faced disruptions to the services they require as laid out in their Individualized Education Programs (IEP) and have struggled with many of the technologies used to carry out remote learning. Many types of assistive technologies, such as Screen readers for the blind, are not compatible with the software platforms being used for remote learning. [22] Children with disabilities often require in-person assistance, such as various physical and occupational therapies, and most teachers are not trained in how to conduct education remotely for children with disabilities. [12] [21] Parents of disabled children are also struggling as they are being asked to provide many of the services their children receive in schools without the training or expertise to do so. [22] Parents of children with disabilities are also concerned about the risks involved in their children returning to school. Children with disabilities are more likely to have other health conditions that increase their risk of COVID-related complications. [23]

See also

Related Research Articles

Disability Impairments, activity limitations, and participation restrictions

A disability is any condition that makes it more difficult for a person to do certain activities or effectively interact with the world around them. These conditions, or impairments, may be cognitive, developmental, intellectual, mental, physical, sensory, or a combination of multiple factors. Disability can be acquired at birth or during a person's lifetime. The United Nations Convention on the Rights of Persons with Disabilities defines disability as:

long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder [a person's] full and effective participation in society on an equal basis with others.

Americans with disabilities are a significant minority group in the United States, making up a fifth of the overall population and over half of Americans older than eighty. There is a complex history underlying the United States and its relationship with its disabled population, with great progress being made in the last century to improve the livelihood of disabled citizens through legislation providing protections and benefits. Most notably, the Americans with Disabilities Act is a comprehensive anti-discrimination policy that works to protect Americans with disabilities in public settings and the workplace.

Developmental disability is a diverse group of chronic conditions that are due to mental or physical impairments that arise before adulthood. Developmental disabilities cause individuals living with them many difficulties in certain areas of life, especially in "language, mobility, learning, self-help, and independent living". Developmental disabilities can be detected early on and persist throughout an individual's lifespan. Developmental disability that affects all areas of a child's development is sometimes referred to as global developmental delay.

Genetic discrimination occurs when people treat others differently because they have or are perceived to have a gene mutation(s) that causes or increases the risk of an inherited disorder. It may also refer to any and all discrimination based on the genotype of a person rather than their individual merits, including that related to race. Some legal scholars have argued for a more precise and broader definition of genetic discrimination: "Genetic discrimination should be defined as when an individual is subjected to negative treatment, not as a result of the individual's physical manifestation of disease or disability, but solely because of the individual's genetic composition." Genetic Discrimination is considered to have its foundations in genetic determinism and genetic essentialism, and is based on the concept of genism, i.e. distinctive human characteristics and capacities are determined by genes.

Intellectual disability Generalized neurodevelopmental disorder

Intellectual disability (ID), also known as general learning disability and formerly mental retardation (MR), is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. It is defined by an IQ under 70, in addition to deficits in two or more adaptive behaviors that affect everyday, general living. Intellectual functions are defined under DSM-V as reasoning, problem‑solving, planning, abstract thinking, judgment, academic learning, and learning from instruction and experience, and practical understanding confirmed by both clinical assessment and standardized tests. Adaptive behavior is defined in terms of conceptual, social, and practical skills involving tasks performed by people in their everyday lives.

Sexuality and disability

Sexuality and disability is regarding the sexual behavior and practices of people with disabilities have a range of sexual desires and differ in the ways they choose to express their sexuality. Commonly, people with disabilities lack comprehensive sex education that would assist in their sexual lives. This roots from the idea that people with disabilities are asexual in nature and are not sexually active. Although some people with disabilities are asexual, it is a misconception to label all as such. Many people with disabilities lack rights and privileges that would enable them to have intimacy and relationships. When it comes to sexuality and disability there is a sexual discourse that surrounds it. The intersection of sexuality and disability is often associated with victimization, abuse, and purity.

Research published from 2000 to 2020 illustrates increased prevalence rates of sexual violence against people with intellectual disabilities compared to the general population.:61 The World Health Organization funded a study that found 15% of the adult population worldwide have a disability, putting them at increased risk of physical, sexual, and intimate partner violence. Of that 15%, 6.1% or an estimated 7,008,716,704 adults worldwide have intellectual disability with 5.5% experiencing sexual violence. In another report, the WHO found that worldwide, children with intellectual disabilities experience a 4.6 times greater risk of sexual violence than those without disability. In the United States, The Bureau of Justice Statistics reported in the National Crime Victimization Survey the rate of sexual violence for those with an intellectual disability is five times higher than for those without any disability. Both men and women with intellectual disabilities experience sexual violence that includes rape, sexual coercion without physical force, and sexual experiences without physical contact. Perpetrators of sexual violence are not only strangers but can be caregivers, acquaintances, and intimate partners. The perpetrator of the assault often determines if the crime will be reported.

Disability abuse is when a person with a disability is abused physically, financially, sexually and/or psychologically due to the person having a disability. Disability abuse has also been considered a hate crime. The abuse is not limited to those who are visibly disabled such as wheelchair-users or physically deformed such as those with a cleft lip but also those with learning disabilities or difficulties such as dyslexia and dysgraphia, major depressive disorder and other disabilities, including autism spectrum disorder, Down syndrome and developmental coordination disorder. Abuse of the disabled is not limited to schools. There are many known cases in which the disabled have been abused by staff of a care institution, such as the case revealed in a BBC Panorama programme on a Castlebeck care home near Bristol which led to its closure and the suspension or dismissal of some of the staff.

A disability hate crime is a form of hate crime involving the use of violence against people with disabilities. The reason for these hate crimes are often due to the prejudice an individual or individuals have against that disability. It is viewed politically as an extreme of ableism, or disablism, and this is carried through and projected into criminal acts against the person with a disability. This phenomenon can take many forms, from verbal abuse and intimidatory behaviour to vandalism, assault, or even murder. Of these forms, the most common hate experiences are viewed through verbal abuse and harassment. Disability hate crimes may take the form of one-off incidents, or may represent systematic abuse which continues over periods of weeks, months, or even years. Parking places, wheelchair spaces, and other distinguished areas for those with disabilities to utilize, have become a target for enforcers of disability hate crime. These accommodations are somehow seen as an exclusion to the rest of the population, giving them a negative connotation and a reason for these violent encounters. The reasoning for disability hate incidents has had a continuous pattern all too familiar. Many of those with disabilities fall victim to these violent situations because they are seen as "scroungers", people that are falsely portraying their disabilities as a way to receive benefits, physical barriers, or simply as "easy targets".

The world's poor are significantly more likely to have or incur a disability within their lifetime compared to more financially privileged populations. The rate of disability within impoverished nations is notably higher than that found in more developed countries. Since the early 2010s there has been growing research in support of an association between disability and poverty and of a cycle by which poverty and disability are mutually reinforcing. Physical, cognitive, mental, emotional, sensory, or developmental impairments independently or in tandem with one another may increase one's likelihood of becoming impoverished, while living in poverty may increase one's potential of having or acquiring special needs in some capacity.

Disability in China is common, and according to the United Nations, approximately 83 million people in China are estimated to have a disability.

Disability is an issue that directly affects a significant proportion of the population of the United Kingdom. Section6(1) of the Equality Act 2010 defines disability as:

"A person has a disability for the purposes of the Act if he or she has a physical or mental impairment and the impairment has a substantial and long-term adverse effect on his or her ability to carry out normal day-to-day activities."

Women with disabilities have the same health issues as any other women, such as the need for routine breast and cervical cancer screening. Women with impaired mobility are often not given basic tests, such as weight monitoring, due to the lack of accessible equipment.

Social impact of the COVID-19 pandemic Indirect effects of the COVID-19 pandemic

The COVID-19 pandemic has had far-reaching consequences beyond the spread of the disease itself and efforts to quarantine it, including political, cultural, and social implications.

Mental health during the COVID-19 pandemic Psychological aspect of viral outbreak

The COVID-19 pandemic has impacted the mental health of people around the world. Similar to the past respiratory viral epidemics, such as the SARS-CoV, MERS-CoV, and the influenza epidemics, the COVID-19 pandemic has caused anxiety, depression, and post-traumatic stress disorder symptoms in different population groups, including the healthcare workers, general public, and the patients and quarantined individuals. The Guidelines on Mental Health and Psychosocial Support of the Inter-Agency Standing Committee of the United Nations recommends that the core principles of mental health support during an emergency are "do no harm, promote human rights and equality, use participatory approaches, build on existing resources and capacities, adopt multi-layered interventions and work with integrated support systems." COVID-19 is affecting people's social connectedness, their trust in people and institutions, their jobs and incomes, as well as imposing a huge toll in terms of anxiety and worry.

Gendered impact of the COVID-19 pandemic Aspect of viral outbreak

COVID-19 affects men and women differently both in terms of the outcome of infection and the effect of the disease upon society. The mortality due to COVID-19 is significantly higher in men. Slightly more men than women contract COVID with a ratio of 1:0.9.

Impact of the COVID-19 pandemic on children Overview of the impact of the COVID-19 pandemic on children

A systematic review notes that children with COVID-19 have milder effects and better prognoses than adults. However, children are susceptible to "multisystem inflammatory syndrome in children" (MIS-C), a rare but life-threatening systemic illness involving persistent fever and extreme inflammation following exposure to the SARS-CoV-2 virus.

Impact of the COVID-19 pandemic on African-American communities

The COVID-19 pandemic has revealed health care disparities with African-Americans experiencing the highest current COVID-19 mortality and morbidity rates in the US—more than twice as high as the rate for white people and Asians, who have the lowest current rates.

Impact of COVID-19 on education in the United States

In response to the COVID-19 pandemic, schools in the U.S. began closing down in March 2020. This was a historic and unprecedented upheaval of the U.S. schooling system, that forced schools to a near shut-down. At the very peak of school closures, they affected 55.1 million students in 124,000 public and private U.S. schools. The effects of widespread school shut-downs were felt nationwide-- and aggravated several social inequalities in gender, technology, educational achievement, and mental health.

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