People with disabilities in COVID-19 responses

Hello everyone, I’m Manjula Marula from the Nossal Institute for Global Health at the University of Melbourne. I’m going to talk to you about the impact of COVID-19 response on people with disabilities. From the previous step, we learned that people with disabilities are more likely to be poorer, and that they usually experience limited opportunities to access health care, education, employment and to participate in their communities. These pre-existing inequities put people with disabilities at a greater risk of contracting COVID-19, and at higher risk of severe morbidity and mortality, if infected. And yet, they have been widely left out of official COVID-19 responses.

The United Nations Convention on the Rights of Persons with Disabilities have been signed and fully ratified by many countries. Under the article 11 of the Convention, state parties are obliged to ensure protection of people with disabilities in situations of risks, including situations of conflict, humanitarian emergencies and natural disasters. However, even in well-resourced countries like Australia, there was a delay in the provision of information on the pandemic response, in accessible format to people with disabilities and their caregiver.

The key response strategies to slow down the COVID-19 outbreak and relieve congestions in hospitals, have been physical distancing and confinement. These responses have been swiftly implemented by many governments under crisis situations. However, these measures have a significant impact on the continuity of health care needed for people with disabilities. and can exacerbate pre-exisiting inequities during, and the aftermath of the pandemic.

We learned in the previous step that, most people with disabilities rely on caregivers, and need additional support to maintain their physical functioning, and manage their underlying health conditions. Some of lockdown measures have also disrupted the continuity of health care, that people with disabilities rely on, which can worsen physical and psychological impairments and lead to adverse health outcomes.

Evidence suggest that people with disabilities have higher rates of psychological distress, compared to others. The pandemic may further impact the mental health of people with disabilities due to social isolation and other socioeconomic consequences.

People with disabilities can have different types of impairment such as physical, psychological, vision, hearing and speech impairment. They have diverse needs for accessing information on the virus and government measures, including details about accessing services for testing, treatment and other support through government and other sources.

People with disabilities are at risk of being left out if these information are not provided in accessible formats, such as large print, audio, videos with captioning, sign language and in simplified language. Consequently, they may not be able to make informed decisions and choices about physical distancing, and their need for support and accessing services.

In countries that were worse hit with the outbreak, stories have emerged where doctors had to make difficult decisions on prioritizations of care due to limited resources such as ventilators. People who are categorized as ‘frail’, were denied care. This included mostly older people and those with co-morbid conditions. People with disabilities are at increased risk of being denied care, particularly those with learning and developmental disabilities, who are considered to be frail in some countries, because of their need for assistance. These definitions are of a concern, as they are not based on treatment efficacy, but based on prejudices against people with disabilities.

People with disabilities are also at increased risk of experiencing violence and abuse. During this pandemic, it is critical to ensure they have accessible options for protections from violence and are in safe home environment.

Many people engaged in panic buying in response to the pandemic and lockdown measures, resulting in families of people with disabilities not having essential supplies, including groceries, medication and personal protective equipment. Any emergencies relief packages should consider the needs of people with disabilities, including their feeding support, medication and sanitation and hygiene. The pandemic is expected to result in longterm economic impacts. Any livelihood and social protection packages that governments plan should consider people with disabilities who are more likely to experience poverty.

One of the swift responses to the pandemic globally was school closure, and moving to remote learning, which has significantly affected students with disabilities and their families. Students with disabilities are provided with additional supports at schools, a crucial resource that has been discontinued during remote learning. Schools have largely failed to provide adequate resources for online learning that accommodate the individual needs of students with disabilities. This situation has caused both parents and students, a significant distress.

If we do not ensure people with disabilities are considered in the COVID-19 response, the pre-existing inequities are going to be widen further. In the next step, we will hear directly from a person with lived experience of disability about his views on disability-inclusive COVID-19 response. Thank you.