Risks and vulnerability related to disability and COVID-19

Risks and vulnerabilities for people with disability in relation to COVID-19 are not uniformly distributed. They are shaped by context and individual factors such as age, gender and impairment.

In the first blog of a series that summarises our Twitter Chat on Disability and COVID-19 we discuss risk and vulnerability. There is a difference between vulnerability to infection, vulnerability to severe symptoms, vulnerability because of lack of access to services or de-prioritisation, and vulnerability to the social, political and economic effects of the pandemic. We discuss these multiple vulnerabilities in the following sub-sections.

Disability may intersect with other axes of oppression, for example women with disabilities may be at different kinds of risk to men. Younger people may experience different risks to older people. All layers of vulnerability and risk are important.

Vulnerability to infection and severe illness

People in refugee or internally displaced peoples’ camps, institutional care and other settings where people live closely together or where people have less agency are vulnerable to infection.

 

A number of people in a very crowded room where they live in Lagos, Nigeria

Some forms of disability increase vulnerability to infection, particularly those that affect the lungs or immune system. Some disabilities could exacerbate symptoms of COVID-19. Older people are more vulnerable to severe symptoms as are people with chronic illnesses such as heart disease or diabetes.

It is also true that our understanding of physical vulnerability is changing every day as we find out more about the virus.

Certain types of disability, for example intellectual disability, being deaf or blind may mean that you have less access to health promotion information and other forms or advice, increasing vulnerability to risk of infection when you are unsure or unaware of the need or ability to adapt behaviour. @IDA_CRPD_Forum pointed out that, “Blind persons need to sometimes touch surfaces to navigate…Deafblind persons rely on touch and hand language to communicate.”

Vulnerability to violence

We have seen rates of intimate partner violence increase in those countries most affected by the COVID-19 pandemic. Participants pointed out that people with disabilities might be vulnerable in this regard. For example, women with disabilities are often at greater risk of gender-based violence, which is exacerbated in times of crisis.

Impacts on education

The @iddcconsortium explained that disabled children are routinely deprioritised in terms of education and often drop out of school and there is a risk that the pandemic may exacerbate this situation.

Precarious livelihoods and risk to household income

Participants expressed fears that regularised relief that people with disabilities routinely received from their governments might be obstructed or hampered by the pandemic. They felt that in general people with disabilities are thought of last after others’ needs have been met and this makes them more vulnerable. Some disabled people will have to rely on charitable handouts for survival as a result, which was considered undignified and a denial of their rights.

In low- and middle-income settings disabled people may be employed in the informal sector (for example, deaf parking attendants in Uzbekistan) and thus find it more difficult to adhere to lockdown directives because they cannot work from home. This is particularly true in contexts where social protection is limited. In some settings disabled people may try to make up economic shortfalls through work within the sex industry, placing them at risk of violence and sexually transmitted infections. Children with disabilities may be at higher risk of family separation.

Mental ill-health

There are mental health considerations that relate to fear of the pandemic and also fear of the response to the pandemic which threaten the rights, health and lives of people with disabilities.

Those people who have been institutionalised because of mental ill-health are vulnerable in ways that all incarcerated people are; they have little opportunity to protect or isolate themselves and are subject to institutional rules that they have little power over.

There was also a concern that disabled people who contract COVID-19 may be subject to a double burden of stigma that would have psychosocial affects. Taking a holistic approach to health and wellbeing is critically important, particularly for those with multiple vulnerabilities. Ensuring all services are adapted for inclusion is essential.

<<Find out more about this series of blogs on disability and COVID-19