The COVID-19 pandemic has brought to stark relief, and further exacerbated, social disparities, including those experienced by disabled people, a global population of over 1 billion people, according to 2010 global population estimates . Disabled people experience entrenched structural disadvantage, including barriers to accessing health care, increased poverty, lower employment, and lower education levels, in comparison to the general population .
It is important that the needs of disabled people are not ignored during the pandemic . The COVID-19 pandemic, and the government measures taken to address it, intersect with existing inequalities to create cascades of disadvantage across multiple domains, including health care, education, and employment. Government responses impact on disabled people’s ability to protect against the pandemic, to mitigate the effects of social distancing measures, to buffer against the ensuing financial downturn, and to navigate the disruption in the provision of general and specialist health services, including in their access to COVID-19-related health services [3,4].
‘Disablism’ are practices that exclude, discriminate against, and oppress disabled.
During the pandemic, ‘disablism’, defined as those discourses and practices that exclude, discriminate against, and oppress disabled people– has put disabled people at risk, pointing to a ‘disvaluing’ of their lives . This is exemplified through, for example, medical rationing and a lack of accessible information . Disabled people are asked to resort to self-protection, shielding from COVID-19 – often without access to resources to support this – a practice which individualises the responsibility for protection against COVID-19, shifting it away from the state to individual actors . Even when such shielding is possible, it has unintended consequences, ranging from the loss of informal-yet-necessary social support networks, to loneliness and food insecurity, exacerbating pre-existing inequities . This discourse of responsibilisation fails to recognise that social privileges – in the form of social capital, education, and income – are not equally distributed among the population, a fact which has become even more evident in the current context .
The failures of this discourse have now been well-documented.
The failures of this discourse have now been well-documented. In England and Wales, two-thirds of people who died from COVID-19 lived with disability, and it is estimated that disabled people had up to 11 times higher odds of dying from COVID-19 in the first two months of the pandemic compared to non-disabled people . Some of the first contagion clusters emerged in care homes, turning into sensationalist headlines. In New York State, a recent study showed how people with intellectual and developmental disability living in residential group homes were at a greater risk of poor COVID-19 outcomes . Lack of self-isolation and testing intersected with neglect and abandonment, leading to excess death rates in residential care homes. This is the result of government policies that failed to protect people, and are not a natural consequence of an inherent ‘vulnerability’. As documented in Australia, personal care workers may themselves work in precarious circumstances, placing them at higher risk of COVID-19 infection . Low pay, insecure and casualised employment, and a poorly regulated sector meant that care workers can neither afford to stay at home if infected nor work in only one workplace. This, combined with low use and insufficient training related to personal protective equipment, repeatedly exposes people with disabilities – recipients of intimate or close care – to the risk of infection.
The intersections of disability with poverty mean that disabled people often live in precarious situations, where it is difficult to maintain physical distancing and personal hygiene, often with poor access to clean water . This renders people with disability more likely to contract and become seriously ill due to COVID-19. Being less likely to find work in the formal sector means that disabled people have less access to employment-based social security and health insurance, and reduced economic resilience in the current context. A recent UK survey found that 60% of disabled people reported problems accessing food, medicine, and other necessities . This is unacceptable at the best of times, but can be lethal during a pandemic.
J Glob Health. 2021; 11: 03007. Published online 2021 Jan 16. doi: 10.7189/jogh.11.03007