These people are at a higher risk for contracting COVID -19 with reduced access to health care services, personal protective equipment such as masks, basic hygiene facilities and sanitation .Many of these people with physical and mental disabilities may not be able to wash their hands not only because of a lack of running water and soap , inaccessibility to clean water but because they are not able to turn on a faucet and wash their hands due to their physical deformities. This is more so when people are wheelchair bound and are victims of Polio and Hansen’s disease which may leave them crippled and unable to perform simple tasks without assistance. In addition, people with special needs may not be able to social distance as they are unable to go about their daily activities without support from their attendants and care givers. This may heighten their risk of contracting COVID especially if their caregivers may be asymptomatic carriers.
In response to this heightened risk faced by this sect of the global community , the World Health Organization (WHO) issued guidelines to continue integrating people with disabilities into the mainstream of society while minimize their risk to contracting COVID-19. These included ensuring that caregivers use the necessary personal protective equipment (PPE) when attending to their needs, disinfecting any aids used and ensuring access to essential items including cleaning supplies.
In a recent survey conducted in the United States by the National Disability Institute in 2020 indicated that that 60% of the disabled adult population surveyed , report being concerned that they may face medical discrimination due to their special needs and being labelled high risk and resulting lack of access to services during the current COVID crisis.
According to a report released by the United Nations in May 2020, at present globally there are one billion people living with disabilities and 80% live in developing countries. As the released UN report ‘Shared Responsibility, Global Solidarity’ on the socio-economic impact of the pandemic showcases, COVID-19 is not simply a health crisis but is shaking the core of the foundation of global societies. Unfortunately, the response often linked to and is influenced by the preexisting -social determinants and prevailing inequalities associated with disability and threatens to place an additional burden on people with special needs.
In some countries, health care rationing decisions, including triage protocols and being bypassed from receiving the necessary medical interventions such as ventilators, medication and the reasons for this discrimination can be attributed to their being considered high risk and assumptions being made about the quality of life post COVID for these people and a contributing factor to this may be the overburdening of the health care systems during the crisis.
Globally the current economic crisis resulting from COVID has exacerbated the
unemployment rates for the people with disability and may face challenges finding employment post COVID. In most countries disabled people and their families are vulnerable as they do not have support from the social protection systems prevalent in their countries. According to a report released by the International Labor Organization only 28%of the global population with special needs have access to disability benefits and even more alarming that only 1% of the above mentioned in low income countries have any kind of social support .
Unfortunately, women and girls with disabilities face increased risk of gender-based violence and especially those affected by Hansen’s disease as they do not have access to social protective mechanisms and are often destitute and need to resort to begging for survival. These women seldom have access to feminine hygiene products, contraceptive services and are at an increased risk for sexual harassment.
It is of paramount importance that special attention is given to those living in humanitarian settings, including those living in situations of forced displacement as a result of armed conflict in refugee or migrant camps, informal settlements, urban slums, mental health facilities, old age homes and prisons is of paramount importance to contain outbreaks which have the tendency to become wide spread.
In addition, forging partnerships between stakeholders including advocacy bodies, foundations NGOs, government agencies, law and order and public health agencies is crucial to work together to provide the necessary support needed. It is vital that the needs of people with various types of disability , including the victims of Hansen’s disease are included in response operations for the COVID-19 outbreak and are rehabilitation so that they can be integrated into main steam of the societies they live in .
Padmini Murthy, MD, MPH, MS, MPhil, CHES, FRSPH, is a professor and director of the Global Health Department of Public Health at New York Medical College. Murthy is the NGO representative of MWIA to the United Nations and the chair of the Advisory Committee of The Nation’s Health, the newspaper of the American Public Health Association