COVID-19 & Disability Inclusion

There are over 1 billion people with disabilities globally and 80% of them live in low and middle income countries. Globally, people with disabilities are at increased risk of contracting COVID-19 and more likely to be disproportionately affected by the health, economic and social impact of the global health pandemic.

If not designed properly, COVID-19 responses can have unintended consequences for people with disabilities. People with disabilities report experiencing additional barriers which that make it difficult to keep themselves safe from contracting COVID-19. This is concerning, as many people with disabilities have an elevated risk of serious illness and death if infected with COVID-19, due to pre-existing health conditions and other risk factors. People with disability may also be disproportionately impacted during this global health pandemic because of disruptions to the services they rely on. People with psychosocial disabilities, deaf people, people who are blind, those living in remote and border communities, and children and older people with disabilities are particularly vulnerable. Factors placing people with disabilities at increased risk include:

  • People with disabilities experience significant barriers in accessing information in an accessible way from government and other sources such as health or community-based organisations regarding the spread and prevention of infection; how to obtain testing or treatment; or about disruptions to their daily lives (such as the shut-down of services, public restriction plans or closing of borders).
  • Physical distancing, a key strategy for reducing the spread of infection in communities, is difficult for those who need support for everyday activities, such as self-care or sign language interpretation, and may be impossible for those involuntarily confined in institutions. For some people, there is also a reliance on physical contact with the environment for information or for mobility which can increase risk.
  • People with disabilities are more likely to be living in poverty and crowded living arrangements where self-isolation or quarantining of individuals is difficult.
  • Poverty and higher household costs can make it difficult for people with disabilities to access medication and hygiene products, including menstrual products, especially as demand and prices rise.
  • Water and hygiene, essential for frequent handwashing to prevent the spread of infection, is lacking in many communities and is often not accessible to people with disabilities.
  • People with disabilities are likely to face additional barriers when getting to and accessing health care services. This includes an increased likelihood of experiencing discrimination and negligence by health care workers.

Alongside recognising the increased risks they face, it is important to recognise that people with disabilities and their representative organisations also have significant untapped capacity and should be consulted and meaningfully involved in ensuring COVID-19 preparedness, response and recovery activities are inclusive and accessible.

Social Protection Approaches to COVID-19 (SPACE) (2021) Inclusive Information Systems for Social Protection: Intentionally Integrating Gender and Disability

This resource considers disability as one of many additional identities women may hold, including older women, youth, refugee, migrant, Indigenous, LGBTI and other minority groups. This resource refers to the need for disaggregated data by sex, age and disability. It also refers to the need for gender and disability-sensitive and transformative social protection involving gender, disability and protection specialists throughout the programme cycle. It suggests project staff could develop a network and learning platform between actors working on gender, disability, social protection, humanitarian response and protection issues.

CBM IAG & Nossal (2021) A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection

Researchers reviewed the available results from rapid assessments of impacts of COVID-19 on people with disabilities in low- and middle-income countries in Asia and the Pacific, finding that people with disabilities were disproportionally impacted by the COVID-19 pandemic.

CBM IAG & Nossal (2021) A Synthesis of Findings from ‘Rapid Assessments’ of Disability and the COVID-19 Pandemic: Implications for Response and Disability-Inclusive Data Collection

Researchers reviewed the available results from rapid assessments of impacts of COVID-19 on people with disabilities in low- and middle-income countries in Asia and the Pacific, finding that people with disabilities were disproportionally impacted by the COVID-19 pandemic.

CBM Australia and the Nossal Institute of Health, 2021 Policy Brief Inclusive Vaccinations

The COVID-19 Inclusive Vaccinations Policy Brief document has been developed to assist OPDs in their advocacy work around inclusive COVID-19 vaccinations.

CBM Australia and the Nossal Institute of Health, 2021 COVID-19 Vaccination Fact Sheet

The COVID-19 Vaccination Fact Sheet has been developed to support DPOs communicate information about COVID-19 vaccination with members.

CBM Australia and Nossal Institute for Global Health (2021) Evidence summary: Experiences of people with disabilities during COVID-19 in Asia and the Pacific: Updated March 2021

This review (completed in January 2021) presents a synthesis of the evidence of the health, economic and social impact of COVID-19 on people with disabilities in low and middle-income countries, with a focus on Asia and the Pacific. It provides an update to the evidence summary published July 2020.

Washington Group (2020) Using the Washington Group Tools to Assess the Impact of COVID-19 on Persons with Disability

This document has been developed provide guidance on using the Washington Group tools to assess the impact of COVID-19 on persons with disability. The resource also provides information on using the questions in online or phone-base surveys, which will be useful for other population surveys, not only COVID-19 research activities.

United Nations (May 2020) Policy Brief: A Disability-Inclusive Response to COVID-19

This Policy Brief highlights that people with disabilities are among the hardest hit by COVID-19, with the share of C19 related deaths in care homes (where older people with disabilities are overrepresented) ranges from 19 per cent to 72 per cent. The brief outlines key actions and recommendations to make the response and recovery inclusive of persons with disabilities. While the brief contains specific recommendations focusing on key sectors, it identifies four overarching areas of action that are applicable for all: (1) Ensure mainstreaming of disability in all COVID-19 response and recovery, together with targeted actions; (2) Ensure accessibility of information, facilities, services and programs in the COVID-19 response and recovery; (3) Ensure meaningful consultation with and active participation of persons with disabilities and their representative organisations in all stages of the COVID-19 response and recovery; and (4) Establish accountability mechanisms.

Jessie Meaney-Davis, Harri Lee and Nick Corby (April, 2020) The impacts of COVID-19 on people with disabilities: a rapid review

A rapid review of how COVID-19 might impact on people with disabilities and pre-existing health conditions. This document draws on emerging global evidence from the current outbreak and on other similar epidemics and covers both primary and secondary impacts. Recommendations for a disability-inclusive COVID-19 response is included.

UNPRPD (2020) Disability Inclusive Social Protection Response to COVID-19 Crisis

Social protection at any point in time is critical for persons with disabilities. The COVID-19 crisis demonstrates the importance for comprehensive and inclusive social-protection systems. This brief presents guidance on how to ensure social protection systems response to COVID-19 support and are inclusive persons with disabilities.

CBM (April 2020) Disability inclusion in COVID-19 preparedness and response

This guidance note provides advice for organisations planning and undertaking preparedness and response for COVID-19, to ensure that people with disabilities are considered in all aspects of outbreak mitigation and response. Key recommendations include: involve people with disabilities and their representative organisations in the planning and implementation of COVID-19 responses; provide rapid training for health workers on disability inclusion; specify that people with disabilities in need of health services cannot be deprioritized on the ground of their disability or discriminated against even though medical resources are scarce during the COVID-19 outbreak; work with the disability movement, including DPOs and disability service providers, to provide communication to people with disabilities and their families; ensure people with disabilities must have access to interpretation and support services even while they are in isolation or quarantine.

Pacific Disability Forum, 2020 Human rights based approach guideline on disability inclusion in COVID-19 response

To guarantee that no one is left behind, discriminated against or excluded from the COVID-19 response, a human rights based approach must be adopted. Using the General Principles (Article 3) of the UN Convention on the Rights of Persons with Disabilities, PDF outline measures that key stakeholders can take to uphold human rights in COVID-19 response efforts.

World Health Organisation (2020) Disability considerations during the COVID-19 outbreak

WHO and public health authorities around the world are taking action to contain the COVID-19 outbreak. Certain populations, such as those with disability, may be impacted more significantly by COVID-19. This impact can be mitigated when key stakeholders take actions and protective measures. This publication from WHO highlights the actions that stakeholders can take to reduce the barriers experienced by people with disability during the COVID-19 outbreak.

Joint Statement (April 2020) COVID-19 and persons with psychosocial disabilities

This Joint Statement, from persons with psychosocial disabilities from regional and international organisations across the world, raises concerns about the vulnerability of persons with psychosocial disabilities to COVID-19 infection and deaths. Key issues include barriers in accessing health information, including lack of information in plain language, and reluctance to access the health system due to experiences of discrimination, dismissiveness and traumatisation in that system. The statement calls on national and local governments to implement measures including reducing the number of people in psychiatric units and institutions, providing sanitary measures to avoid infections in institutional settings, ensuring non-discrimination and equal access to testing, healthcare and information, supporting vulnerable groups including homeless people and people at risk of abuse and violence, and consulting with people with psychosocial disabilities and their representative organisations.

UNICEF (2020) COVID-19 response: Considerations for Children and Adults with Disabilities

This UNICEF guidance document highlights that in the context of the COVID-19 pandemic, people with disabilities may have increased risk for exposure to the virus, and they may have underlying health conditions that increase their risk of serious complications from COVID-19. UNICEF provides suggestions of what to do to make the response inclusive, including reaching out to local organisations of people with disabilities and engaging with them at every stage of the response. When disseminating messaging on prevention of COVID-19 remember that many children with disabilities are out of school, and that people with disabilities may have lower levels of access to social media. UNICEF also calls for disaggregation of monitoring data by disability, using the Washington Group Short Set of Disability Questions and the Washington Group-UNICEF Children Functioning Module.

World Federation of the Deaf and the World Association of Sign Language Interpreters (March 2020) WFD-WASLI Joint Statement on access to health services and interpreter occupational health during the Coronavirus (COVID-19) containment efforts

During the COVID-19 outbreak, the World Federation of the Deaf and the World Association of Sign Language Interpreters released this joint statement reminding governments of their commitments under the CRPD to ensure full access to information and accessibility of all services. The statement notes that it is imperative that all public health announcements made by government officials are also done in the national sign language(s) of that country. Televised (whether live or prerecorded) announcements related to the outbreak should be interpreted in real time into the national sign language(s) with sign language interpreters being on screen and clearly visible the entire time of the broadcast. The statement also notes that sign language interpreters who work in emergency and health settings should be given the same health and safety protections as other health care workers dealing with COVID-19.

International Disability Alliance (March 2020) Toward a Disability-Inclusive COVID19 Response: 10 recommendations from the International Disability Alliance

In the light of the COVID-19 pandemic and its disproportionate impact on persons with disabilities, the International Disability Alliance has compiled some practical solutions and recommendations, including: information must be provided in a diversity of accessible formats; additional protective measures must be taken for people with certain types of impairment; rapid awareness raising and training of personnel involved in the response is essential; no disability-based institutionalisation and abandonment is acceptable; during quarantine, support services, personal assistance, physical and communication accessibility must be ensured; and persons with disabilities in need of health services due to COVID19 cannot be de-prioritised on the ground of their disability.

Special Rapporteur on the Rights of Persons with Disabilities Ms Catalina Devandas Aguilar (2020) COVID-19: Who is protecting the people with disabilities?

This press release from the Special Rapporteur highlights that despite people with disabilities being a group that is at high-risk during the COVID-19 pandemic, little has been done to provide the guidance and support needed to protect them. To face the pandemic, the Special Rapporteur called on States to: consult with organizations of people with disabilities in all stages of the COVID-19 response, make public health information available in accessible formats, and establish clear protocols for public health emergencies to ensure that, when medical resources are scarce, access to healthcare does not discriminate against people with disabilities.

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WHO (2021) Disability considerations for COVID-19 vaccination (with international sign language and subtitles)

Persons with disabilities are disproportionately impacted by COVID-19, both directly because of infection, and indirectly because of restrictions to reduce the spread of the virus. This video, developed by WHO and UNICEF, provides a summary of the considerations for governments, health care providers and persons with disabilities when accessing COVID-19 vaccination.

Centre for Inclusive Policy (April 2020) Disability Inclusive Social Protection Response to COVID-19 Crisis

COVID-19 amplifies the economic risks and vulnerabilities faced by people with disabilities. Inclusive and well resourced social protection is needed now more than ever. This video provides insights into how people with disabilities are impacted by COVID-19 and what countries can do to ensure people with disabilities have access to the support they require.

International Labour Organization (24 March, 2020) Webinar: Disability inclusion in COVID-19 responses in the world of work

Facilitated by the ILO Global Business and Disability Network, this webinar was attended by approximately 330 participants on 24 March 2020. Presenters shared good practices on the inclusion of people with disabilities in the COVID-19 responses related to the World of Work. The key message from the discussion was that we cannot just sit back and expect that people with disabilities will not be excluded; instead we need to appeal for attention and action. We need to make sure that people with disabilities will not be over-represented among those who will lose their jobs during and after this pandemic.

World Health Organization (2020) AskWHO: Live Q&A on disability considerations during COVID-19

On 19/3/2020 the World Health Organisation hosted a live Q&A session on disability considerations during COVID-19, with the WHO Technical Officer Lindsay Lee responding to questions raised by viewers. During the session Lindsay pointed out that people with disabilities experience increased risk of contracting COVID-19, due to difficulties in implementing basic hygiene measures, barriers to WASH facilities, and being unable to practice social distancing because they require care or other support. Additionally, some persons with disabilities who contract the virus could develop a severe case of the disease as it can worsen existing health conditions, particularly related to immune response or respiratory function. The existing barriers to health care access were highlighted, including physical obstacles, discriminatory laws and existing stigma. “These things, if Governments and communities aren’t careful, can be exacerbated in crisis situations,” Lindsay stated. *Captions start at 3:52*