People with disabilities, older adults and older adults with disabilities may be more likely to become infected with COVID-19, and if infected, they may be more likely to experience severe illness, which can lead to hospitalization, intensive care, ventilation, or death. The risk of severe illnesses increases with age and is also increased if there are any underlying medical conditions. In addition to these direct effects of COVID-19, these populations may also be more likely to experience more severe secondary impacts.

We describe the reasons for this in more detail below.

Direct consequences of COVID-19 on people with disabilities, older adults and older adults with disabilities

Source: Chinese Centre for Disease Control and Prevention on the BBC

  • Increased exposure due to a reduced ability to practice physical distancing: People with disabilities and older individuals may be reliant on caregivers to aid with common daily tasks, so physical distancing and isolation measures may be particularly challenging or impossible to practice. Caregivers going in and out of households may also put people with disabilities, older people and their families at higher risk of exposure to the virus. However, caregivers play a vital role in allowing people with disabilities and older people to manage daily lives. In addition, data from Iraq, India, Ethiopia and Tanzania show that up to 95% of older adults live alone during COVID-19. Older adults are told to self-isolate for extended periods of time to protect over-stretched healthcare systems, but social isolation can put older adults at a greater risk of mental health problems, such anxiety and depression.
  • Increased exposure due to inaccessibility of built infrastructure: People with disabilities, older adults and older adults with disabilities may be unable to avoid coming into contact with surfaces that others have touched, putting them at increased risk of being exposed to the virus. For example, people with disabilities, older adults and older adults with disabilities are more likely to have limited access to safe water, sanitation and hygiene (WASH) services and facilities. Even in households that have WASH facilities available, household members with disabilities may not be able to use them in an acceptable or hygienic manner.
  • Fear, confusion and anxiety: People on the autism spectrum, or who have dementia or Alzheimer’s Disease may experience greater levels of confusion, anxiety and fear if their routines are disrupted. People with existing mental health conditions who have developed ways to live with distress or other symptoms of mental health conditions may experience additional ‘triggers’ during the crisis. For instance, people who have a history of excessive handwashing and cleaning to avoid contamination, but have successfully managed this compulsion, may experience heightened anxiety and renewed symptoms during COVID-19. In Iraq, findings from a rapid needs assessment on the impacts of COVID-19 on older adults show that 74% of older adults felt worried either ‘all the time’ or ‘most of the time’, and 22% reported being unable to cope.
  • Accessing services remotely: In many settings physical distancing restrictions have resulted in an increase in digital or remote healthcare approaches instead of face-to-face consultations. These present additional barriers to accessing healthcare for people with disabilities, older populations and older adults with disabilities as new technologies are not always accessible or inclusive. This may be because services are not in accessible formats. People with disabilities and older adults may also have reduced access to technologies such as mobile phones.

Secondary impacts of COVID-19: People with disabilities and older adults face inequalities that may be exacerbated during COVID-19 pandemic. These include:

Want to know more about disability and ageing in COVID-19 hygiene promotion programmes?

Editor's notes:

Written by: Jane Wilbur

Initially Reviewed by: Hannah Kuper, Islay Mactaggart, Sian White, Chelsea Huggett

Secondary review by: Bethany Caruso, Diana Hiscock, Islay Mactaggart

Last updated: 08.09.2020

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