THINGS TO KNOW AND DO WHEN DEALING WITH A PERSON WITH DISABILITY WHO HAS CONTRACTED THE CORONAVIRUS

Persons with
disabilities are regarded as one of the most vulnerable groups in any society.
Their vulnerability is due to stigma and discrimination and ensuing social
barriers which have restricted their inclusion and participation in governance,
cultural and social issues and denied or limit access to services and programmes
on an equal basis with other members of society in which they live. This
vulnerability makes them susceptible to varied challenges of life. One such
challenge that impacts them is that of the disease COVID-19.

COVID-19 has
been declared as a global pandemic by the World Health Organization (WHO).
Since its first manifestation in December 2019, it has affected over 1 million
individuals in over 200 countries across the world and has killed over 70,000
people. The WHO has cited persons with disabilities among the vulnerable groups
as being particularly susceptible to the disease as most of them have
underlying conditions that can be exacerbated by the coronavirus.

Furthermore,
the pandemic has increased the burden on health care systems in countries to
the extent that persons with disabilities who normally experience significant
challenges in accessing health services are less likely to receive attention
during the pandemic. The consequence of such disregard is death.

One
must recognize that persons with disabilities are human beings and as such,
have the right to quality health care as anyone else. Article 25 of the United
Nations Convention on the Rights of Persons with Disabilities (CRPD) reaffirms
this right to health care for persons with disabilities. There are different
types of disabilities and one must seek to understand how to treat and relate
with them.

This document
categorizes and highlights the major types of disabilities and provides key
considerations for addressing each. It also provides some things for health professionals
to comprehend about persons with disabilities and what to do if they should contract
coronavirus. The list is not exhaustive but should be construed as a guide to dealing
with these vulnerable citizens in a time of preeminent health crisis. The
things to know are:

1. There are eight major categories of disabilities and
   these are: blindness/visual impairment, deafness/hard-of-hearing, speech
   disorders, physical disabilities, mental disabilities, intellectual
   disabilities, learning disabilities and neurological disorders.
2.  A blind person
   or an individual with a visual impairment is someone with major problems with
   his or her eyes and these problems can come about due to varied disease. One
   significant disease to contribute to blindness is that of diabetes that can
   lead to glaucoma, diabetic retinopathy or diabetic macular edema. The diabetic
   condition makes the blind person extremely vulnerable and these individuals
   must be very careful at this time since the diabetes has already compromised
   their immune system.
3. If the blind person contracts the COVID-19, then
   support mechanisms must be put in place for this individual. This individual
   will be isolated and will therefore be alone for most of the time. Arrangements
   must therefore be made to ensure that attention is given to this individual and
   that the necessities are available for him or her. Please take note that blind
   persons are auditory individuals and as such, they listen attentively and hear
   voices keenly and so they must be spoken with on a consistent basis and in a
   descriptive manner.
4.  Deaf or hard of
   hearing refers to the total or partial loss of hearing. A deaf person has no
   hearing and a hard-of-hearing person has some degree of hearing. These hearing
   loss can be caused by myriads of factors including accidents and excessive
   noise. Deaf or hard-of-hearing persons are visual beings, in that they depend on
   their sight for daily functioning. It is therefore imperative that when dealing
   with a person who is deaf or hard-of-hearing who has contracted the coronavirus,
   that Sign Language or some form of captioning is made available. This means
   that a Sign Language Interpreter or a caregiver will have to be involved with
   the medical team caring for the person who is deaf or hard-of-hearing.
5.  A person with a
   physical disability is one who has lost a limb or has a physical impairment
   which affects a particular body part. A physical disability can occur because
   of multiple factors. In the context of this paper, the most concerning are
   those individuals who have developed a physical disability through diabetes or
   hypertension. Diabetes can contribute to the loss of a limb and also a stroke
   that restricts physical movement. Similarly, an individual with uncontrolled
   hypertension can develop a stroke. With both diseases, persons with physical
   disabilities are extremely vulnerable to the coronavirus. If any individual with
   a physical disability should contract the COVID-19, then particular care will
   have to be given to them whilst they are in isolation. Someone has to be around
   to give support and in this context, special equipment and protective gear will
   have to be provided for these individuals. Special consideration must be given
   to the location where these individuals will be isolated as the issue of
   accessibility is paramount to their functioning.
6.  Persons with
   speech disorders are individuals who have problems in speaking and expressing
   themselves vocally. This occurs because of a range of factors. Whilst there are
   no recognized underlying conditions relating to speech disorders that can be
   exacerbated by the coronavirus, there can be problems communicating with these
   individuals if they should contract the COVID-19. In this context, special
   efforts should be made to communicate with these individuals by writing so that
   they can understand what is taking place and to provide a possible response.
7.  Learning
   disabilities constitute the inability of an individual to function effectively
   in a learning environment. This inability to function can manifest itself
   verbally, linguistically, mathematically, graphically and a number of other
   ways that will cause the person to underperform in a particular academic area.
   These disabilities are regarded as the “hidden” disabilities because they
   cannot be seen or observed by the naked eyes. In the context of COVID-19, one
   would have to identify the particular learning difficulty and formulate the
   strategy to relate to the individual. For example, if a person has a difficulty
   in reading and writing, it is obvious that the person has a learning
   disability. In this regard, oral communication is the means by which the medical
   professionals should relate with this person. There is no need for
   extra-special support for such an individual, unless he or she has another type
   of disability.
8.  Mental illness
   is one of the major categories of persons with disabilities. It ranges from
   mild depression among young people to the more complex dementia in older
   persons. Special attention has to be given to these cases because the person
   with the mental illness will require 24 hour assistance and a caregiver has to
   be available to give support. In this context, special supportive equipment and
   gears will have to be provided for the caregiver to attend to the person with
   mental illness who has contracted COVID-19. Simultaneously, efforts must be
   placed on treating the mental illness of the person with the disability in
   order to bring about a stable environment to treat COVID-19.
9.  Neurological
   disorders are critical forms of disabilities. A neurological disorder is a
   condition that affects the health, function and even structure of an individual’s
   nervous system. The nervous system is a collection of tissues and cells that
   serve to transmit electro-chemical signals about the body in order to stop or
   promote a voluntary and involuntary action. When there is an interruption in
   the electro-chemical signals, it contributes to a neurological disorder. These
   neurological disorders can contribute to disabling conditions such as cerebral
   palsy and epilepsy. In the case of the coronavirus, it can pose chronic problems
   for these individuals. For example, an individual who is epileptic can develop
   significant complications through a seizure and therefore will need specific
   attention if he or she should contract the coronavirus. Again, any individual
   with a neurological disorder that results in a disabling condition will need to
   have 24 hour attention and therefore a caregiver will have to be involved with
   the medical team administering to the individual.
10.  Intellectual disability is another preeminent
    category of disability. It is a disability that is characterized by
    considerable limitations both in intellectual functioning (reasoning, learning
    and problem solving) and in adaptive behavior, which covers a range of everyday
    social and practical skills. This disability generally occurs before the age of
    18. It ranges from mild intellectual functioning to profound. If an individual
    with intellectual disability should contract the coronavirus, one must
    determine where the individual falls on the spectrum. This is imperative to
    determine the extent of support that the person will need. It must be noted
    however that if the individual has severe or profound intellectual limitations,
    then there will be the need for a caregiver to be around to consistently give
    support. All the relevant equipment and gears will have to be provided for this
    caregiver as well.

The above cited scenarios are by no means exhaustive. However, they are developed to give an indication to health professionals as to how to treat and relate to persons with disabilities if they should contract the coronavirus. Having an understanding of the types of disabilities and how to relate to these individuals are quintessential in providing the best health care for these vulnerable citizens if they should develop COVID-19. Persons with disabilities are human beings and therefore one must always remember that they too have a right to quality health care, irrespective of the circumstances.

By Senator
Floyd Morris, PhD

CARICOM
Special Rapporteur on Disability