Disability

considerations
during
the COVID-19
outbreak
In March 2020 the World Health Organization
(WHO) declared the outbreak of a novel
coronavirus disease, COVID-19, to be a pandemic,
due to the speed and scale of transmission.
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 if simple
actions and protective measures are taken by key
stakeholders.
COVID-19

Why are additional considerations needed

for people with disability during the
COVID-19 outbreak?
Actions need to be taken to ensure that people with disability
can always access the health-care services and public health
information they require, including during the COVID-19
outbreak.
People with disability may be at greater risk of contracting
COVID-19 because of:

− Barriers
 to implementing basic hygiene measures, such as
hand-washing (e.g. handbasins or sinks may be physically
inaccessible, or a person may have physical difficulty rubbing
their hands together thoroughly);

− D
 ifficulty in enacting social distancing because of additional
support needs or because they are institutionalized;

− T
 he need to touch things to obtain information from the
environment or for physical support;

− Barriers to accessing public health information.

Depending on underlying health conditions, people with
disability may be at greater risk of developing more severe
cases of COVID-19 if they become infected. This may be
because of:

− C
 OVID-19 exacerbating existing health conditions, particularly
those related to respiratory function, immune system function,
heart disease or diabetes;

− Barriers to accessing health care.

People with disability may also be disproportionately impacted
by the outbreak because of serious disruptions to the services
they rely on.
The barriers experienced by people with disability can be
reduced if key stakeholders take appropriate action.
COVID-19

Considerations for actors

Actions for people with disability and

their household

Reduce your potential exposure to COVID-19

Everyone with disability and their household should follow the
WHO guidance on basic protection measures during the
COVID-19 outbreak.1 If you have any difficulty following these
basic protection measures (for example, you are not able to
access a handbasin or sink to wash your hands regularly), work
with your family, friends and caregivers to identify adaptations.
In addition:

− A
 void crowded environments to the maximum extent possible
and minimize physical contact with other people. Consider
making necessary visits outside of peak time periods. Take
advantage of special opening hours for people with disability
where these are offered.

− M
 ake purchases online or request assistance from family,
friends, or caregivers to avoid needing to access crowded
environments.

− C
 onsider gathering urgent items you need such as food,
cleaning supplies, medication or medical supplies to reduce the
frequency with which you need to access public places.

− W
 ork from home if possible, especially if you typically work in a
busy or crowded environment.

− E
 nsure that assistive products, if used, are disinfected
frequently; these include wheelchairs, walking canes, walkers,
transfer boards, white canes, or any other product that is
frequently handled and used in public spaces.

Put a plan in place to ensure continuation of the care

and support you need

− I f you rely on caregivers, consider increasing the pool of those

you can call upon, in preparation of one or more becoming
unwell or needing to self-isolate.

1 h
 ttps://[Link]/emergencies/diseases/novel-coronavirus-2019/
advice-for-public
COVID-19

− I f you organize caregivers through an agency, find out what

contingency measures they have in place to compensate for a
potential workforce shortage. You may want to talk to family and
friends about what additional support they can provide, and the
scenarios in which you may need to call upon them.

− I dentify relevant organizations in your community that you can

access if you need help.

Prepare your household for the instance you should

contract COVID-19

− M
 ake sure those in your household, including the friends and
family you trust, know of any important information they would
need should you become unwell. This may include information
about your health insurance, your medication, and the care
needs of any of your dependants (children, elderly parents or
pets).

− M
 ake sure everybody in your household knows what they
should do should you contract COVID-19 or require assistance.

− I f they are not already connected, introduce people in your

support network so that they can communicate effectively
should you become unwell.

− K
 now the telephone number of relevant telehealth2 services and
hotlines, should you have questions or require non-urgent
medical assistance.

The mental and physical health of household members

and caregivers
Follow the WHO guidance on mental health considerations and
guidance on managing existing noncommunicable diseases
(forthcoming) during the COVID-19 outbreak..3
If anyone in the household is symptomatic of the virus, the
person needs to be isolated and instructed to wear a mask, and
to access testing as soon as possible. All surfaces need to be
disinfected, and everyone in the household needs to be
monitored for symptoms. If possible, anyone with an underlying
health condition or reduced immunity needs to be moved to a
separate location until the completion of isolation periods.

2 Telehealth involves the use of telecommunications and virtual technology to

deliver health care outside of traditional health-care facilities
3 h
 ttps://[Link]/docs/default-source/coronaviruse/mental-health-
[Link]?sfvrsn=6d3578af_2
COVID-19

Actions for governments

Ensure public health information and communication

is accessible

− I nclude captioning and, where possible, sign language for all

live and recorded events and communications. This includes
national addresses, press briefings, and live social media.

− C
 onvert public materials into “Easy Read” format so that they
are accessible for people with intellectual disability or cognitive
impairment.

− D
 evelop accessible written information products by using
appropriate document formats, (such as “Word”), with
structured headings, large print, braille versions and formats for
people who are deafblind.

− I nclude captions for images used within documents or on social

media. Use images that are inclusive and do not stigmatize
disability.

− W
 ork with disability organizations, including advocacy bodies
and disability service providers to disseminate public health
information.

Undertake targeted measures for people with disability

and their support networks
Work with people with disability and their representative
agencies to rapidly identify fiscal and administrative measures,
such as:

− F
 inancial compensation for families and caregivers who need to
take time off work to care for loved ones. This could include
paying, for a time-limited period, family members for support
provided during normal working hours.

− F
 inancial compensation for families and caregivers who are part
of the casual and self-employed disability workforce, who may
need to self-isolate, and where coming to work would place
people with disability at greater risk of infection.

− A
 doption of flexible, work-from-home policies, along with
financial compensation for the technology required to do so.
COVID-19

− F
 inancial measures (commonly within a broader-based
economic stimulus package) that include people with disability,
such as lump sum payments for qualifying individuals, tax relief,
subsidization of items and/or leniency and allowable deferral of
common expenses.

− A
 ppropriate action by schools and other educational facilities to
ensure continued education for students with disability who
may be required to study from home for longer periods.

− P
 rovision of a hotline in multiple formats (e.g. telephone and
email) for people with disability to communicate with the
government, ask questions, and raise concerns.

Undertake targeted measures for disability service

providers4
Work with the disability service providers to identify actions for
the continuation of services and priority access to protective
equipment:

− E
 nsure that agencies providing disability caregivers have
continuity plans for situations in which the number of available
caregivers may be reduced.

− W
 ork with disability service providers to reduce bureaucratic
recruitment barriers while still maintaining protection measures,
such as police checks for caregivers.

− C
 onsider short-term financial support for disability services to
ensure they remain financially sustainable if they experience a
downturn in their operations.

− P
 rovide a hotline for disability services to communicate with
government and raise concerns.

− P
 rioritize disability caregiver agencies for access to no-cost
personal protective equipment, including masks, aprons, gloves
and hand sanitizers.

− E
 nsure that caregivers of people with disability have access to
COVID-19 testing alongside other identified priority groups.

4 Disability service providers may include agencies that provide residential

accommodation, caregiver services, specialized employment opportunities, or
specialized therapies and consultation to people with disability.
COVID-19

Actions for health-care workers

Ensure COVID-19 health care is Accessible,

Affordable and Inclusive

− Follow the WHO guidance to health workers during the

5

COVID-19 outbreak.

− W
 ork to ensure all clinics providing testing and services related
to COVID-19 are completely accessible. Address physical
barriers (such as uneven pathways, stairs, hard-to-reach spaces
or hard-to-use equipment); attitudinal barriers (such as social
stigma against disability and the denial of essential services);
and financial barriers (such as high costs related to treatment or
accessing the facility). Ensure that information about the
accessibility of COVID-19 health services is disseminated to
people with disability and their caregivers.

− D
 eliver information in understandable and diverse formats to
suit different needs. Do not rely solely on either verbal or written
information, and adopt ways to communicate that are
understandable to people with intellectual, cognitive and
psychosocial impairments.

− D
 eliver home-based consultations for people with disability,
including for their general health needs and, where appropriate,
for COVID-19 related needs.

− D
 evelop and disseminate information to health workers so that
they are aware of the potential health and social consequences
of COVID-19 for people with disability.

− D
 eliver sufficient support for people with disability with more
complex needs, particularly if quarantined or isolated. When
needed, coordinate care between health and social services,
families, and caregivers.

Deliver telehealth for people with disability

− P
 rovide telephone consultation, text messaging and video
conferencing for the delivery of health care for people with
disability. This may be for their general health, and include
rehabilitation needs and, where appropriate, COVID-19 related
needs.

5 h
 ttps://[Link]/docs/default-source/coronaviruse/who-rights-roles-respon-
[Link]?sfvrsn=bcabd401_0
COVID-19

Actions for disability service providers

Develop and implement service continuity plans

− P
 lan for a scenario in which the workforce is reduced, and
identify actions for scaling up administration and technical staff,
as well as caregivers, where appropriate.

− I dentify actions and work with government to reduce

bureaucratic recruitment barriers, while continuing to maintain
protection measures, such as police checks for caregivers.

− H
 old additional trainings and if possible, develop online
modules to prepare a new workforce and those who will take on
expanded roles.

− W
 ork with other local disability and caregiver agencies to
undertake the prioritization of the most critically needed
disability services and those that are essential to be kept open.
Identify the clients most vulnerable to a reduction in services.

Communicate frequently with people with disability and

their support networks

− P
 rovide additional targeted information on COVID-19,
highlighting information relevant to people with disability and
their support networks. This may include information on
continuity plans; telehealth and hotline phone numbers;
locations of accessible health services; and locations where
hand sanitizer or sterilizing equipment can be accessed when
their supplies are low, or in situations where they may be
required to self-isolate.

− U
 se a variety of communication platforms such phone calls, text
and social media to share information, and convert existing
information to accessible formats where necessary.

Reduce potential exposure to COVID-19 during provision

of disability services

− P
 rovide training, and rapidly upskill the disability care workforce
regarding infection control.

− E
 nsure the disability caregivers and service providers have
access to personal protective equipment including masks,
gloves and hand sanitizers; consider increasing orders of these
products.
COVID-19

− D
 eliver appropriate disability services through home-based
consultation or through similar platforms as used in telehealth.

− In residential settings, consider:

_ M
 odifying visitation hours to reduce infection risk, such as
staggering visiting times so that staff can monitor and clean
more effectively, while considering the potential impact on
the mental health of residents;
_ I mplementing additional isolation and infection control
measures for residents who are unwell and who are not
hospitalized, such as advising the resident wear to a mask
and remain in a restricted room, as well as limiting visitation.

Provide sufficient support for people with disability who

have complex needs

− I dentify people with disability with more complex needs, and

work with them, their families, and community support
agencies, to identify contingencies for when the number of
caregivers is limited or there are none available.

− I dentify the potential for increased violence, abuse and neglect

against people with disability because of social isolation and
disruption to daily routines; support mitigation of these risks, for
example providing an accessible hotline to report.
COVID-19

Actions for the community

Basic protection measures to be adopted by the

general public
− F
 ollow the guidance prepared by WHO on basic protection
measures against COVID-19. Take the risk of COVID-19
seriously; even if you, yourself, may not be at high risk of serious
symptoms, you may pass the virus on to someone that is.

Flexible work arrangements and infection control

measures to be supported by employers
− Follow WHO guidance on getting your workplace ready for the
COVID-19 outbreak.6
− W
 here possible, implement flexible working arrangements that
allow people with disability to telework. Ensure they have the
technology they need, including any assistive products typically
available in the workplace.
− I f teleworking is not possible, consider allowing people with
disability at high risk of severe symptoms to take leave
(including paid leave) until the risk of infection is reduced.
Explore government policy and support that may be available to
employers to enable the implementation of these measures.
− E
 nsure the accessibility of workplace infection control
measures, such as hand sanitization stations.

Increased access to stores to be provided by store

owners for vulnerable populations
− C
 onsider providing allocated hours for people with disability or
other potentially vulnerable people to access the store; or
consider alternative ways to allow people with disability to shop
(e.g. delivery, online).

Extra support to be provided by family, friends and

neighbours for a person with disability
− C
 heck in regularly with a person with disability to provide
emotional and practical support, respecting social isolation
restrictions that may be in place.
− B
 e cognisant of how you talk about COVID-19, and do not
exacerbate any existing stress

6 h
 ttps://[Link]/docs/default-source/coronaviruse/getting-workplace-ready-
[Link]?sfvrsn=359a81e7_6