Charting the Unprecedented Impact of COVID-19 on Individuals Living with Disabilities
On 19 June 2020, the Office for National Statistics (ONS) finally published a granular analysis of coronavirus-related deaths recorded in England and Wales between 2 March and 15 May 2020.[1] The publication of this data was particularly significant as it had been preceded by several months of sustained campaigning by prominent disability rights groups and charities.
The data encompasses the latter half of April 2020, which the government’s chief medical officer, Professor Christopher Whitty, identified as the “peak”[2] of the COVID-19 pandemic in the United Kingdom. The ONS’ data shines a disturbing light on the disproportionate impact that COVID-19 has had on certain sections of the population and once more brings into focus the significant inequalities in healthcare outcomes that exist in the England and Wales.
A statistical overview
During the early stages of the COVID-19 pandemic, a number of charities conducted independent analysis of the data available to them and suggested that individuals living with disabilities were at a greater risk of death from COVID-19 than non-disabled individuals. For example, as early as May 2020, the charity Mencap highlighted the disproportionate mortality rate due to COVID-19 of individuals living with learning disabilities.[3] However, it was not until the ONS’ statistics were published that a fuller picture of the disproportionate impact of COVID-19 on individuals living with disabilities became apparent.
For the purposes of the ONS’ data analysis, all individuals were sorted into one of three categories according to the extent to which their daily activities are impaired by a ‘health problem or disability which has lasted, or is expected to last, at least 12 months.’[4] Those whose daily lives were ‘limited a lot’ or ‘limited a little’ were classified as disabled.
Of particular significance is that 30.3%[5] of COVID-19 deaths were among people who described their daily activities as ‘limited a lot.’ In total, according to the ONS data, almost 60%[6] of all individuals who died from COVID-19 during the period covered by the statistics were disabled. In practical terms, this translates to approximately 22,400 deaths among people with a disability, compared to around 15,500 deaths among non-disabled individuals.
By way of comparison, according to the 2011 Census figures published by the ONS, individuals whose daily activities were ‘limited a lot’ and those whose activities were ‘limited a little,’ when combined, accounted for under a fifth of the population (17.9%)[7] in England and Wales. In other words, though accounting for less than a fifth of the general population, disabled individuals accounted for roughly three fifths of all coronavirus-related deaths during the peak of the pandemic.
The causes of this disparity are undoubtedly nuanced and inextricably linked to the individuated circumstances of each person. Nonetheless, it is the author’s opinion that the ONS’ figures, at a minimum, further evidence the now well-documented inequality, in terms of both access to healthcare and healthcare outcomes, that disabled individuals face in England and Wales when compared to their non-disabled counterparts.
Healthcare inequalities
Numerous studies have shown that individuals living with disabilities face a variety of obstacles when accessing healthcare. The author acknowledges that, since the passage of the Equality Act 2010 which enshrines the duty to make reasonable adjustments,[8] the NHS has made a number of improvements in the provision of its services, such as the introduction of more accessible buildings. However, research published in The BMJ has found that disabled people continue to experience unequal healthcare outcomes caused by a variety of additional factors, including a lack of accessible transport, the cost of prescribed medication, and long waiting lists.[9] Among disabled individuals, it has been found that women living with disabilities are the most affected by these inequalities (being up to seven times[10] more likely to have an unmet healthcare need than non-disabled individuals). Moreover, individuals living with sensory, learning, and/or physical disabilities continue to grapple with external misconceptions about their lives that further impede the provision of healthcare.
Beyond the devastating and disproportionate death toll caused by COVID-19 on individuals living with disabilities in England and Wales, the pandemic has further compounded the obstacles that many individuals living with disabilities face when trying to access healthcare. For instance, in May 2020, reports emerged documenting the widespread redeployment of specialist nurses—trained to provide support to patients with learning difficulties during the height of the COVID-19 pandemic[11]—away from their specialist roles. These reports led Edel Harris, the chief executive of Mencap, to warn that individuals with learning disabilities were being ‘largely forgotten or ignored’[12] during the height of the COVID-19 pandemic. It is the author’s view that, while the redeployment of nurses is understandable, such measures should not result in a disproportionate diminution in the provision of vital healthcare and support services to individuals living with disabilities who, as noted in the preceding paragraphs, already receive poorer access to healthcare.
Conclusion
Beyond the immediate calls for an inquiry that have accompanied the publication of the ONS’ statistics, it is the author’s view that the COVID-19 pandemic has uncovered a significant disparity between disabled and non-disabled individuals as regards both access to healthcare and individual healthcare outcomes in England and Wales. Therefore, while we are currently experiencing unprecedented global challenges as regards the provision of healthcare, these pervasive inequalities should not be ignored.
It is the author’s view that the COVID-19 pandemic has uncovered a significant disparity between disabled and non-disabled individuals as regards both access to healthcare and individual healthcare outcomes in England and Wales. Image source: The World
Though accounting for less than a fifth of the general population, disabled individuals accounted for roughly three fifths of all coronavirus-related deaths during the peak of the pandemic in England and Wales. Image source: nurses.co.uk
In May 2020, reports emerged documenting the widespread redeployment of specialist nurses—trained to provide support to patients with learning difficulties during the height of the COVID-19 pandemic—away from their specialist roles. Image source: CC0 Public Domain
The ONS’ data shines a disturbing light on the disproportionate impact that COVID-19 has had on certain sections of the population and once more brings into focus the significant inequalities in healthcare outcomes that exist in the England and Wales. Image source: The Power to Persuade
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Sources Cited
[1] ‘Coronavirus (COVID-19) related deaths by disability status, England and Wales: 2 March to 15 May 2020’ (Office for National Statistics, 19 June 2020) <https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/coronaviruscovid19relateddeathsbydisabilitystatusenglandandwales/2marchto15may2020> accessed 5 July 2020.
[2] Andrew Woodcock, ‘UK reaching coronavirus peak with signs nation is flattening the curve, experts say’ (Independent, 15 April 2020) <https://www.independent.co.uk/news/uk/politics/coronavirus-uk-peak-new-cases-lockdown-chris-whitty-latest-a9467356.html> accessed 4 July 2020.
[3] ‘Mencap sounds the alarm as higher proportion of people with a learning disability dying with Covid-19 than people in care homes’ (mencap, 19 May 2020) <https://www.mencap.org.uk/press-release/mencap-sounds-alarm-higher-proportion-people-learning-disability-dying-covid-19> accessed 5 July 2020.
[4] Office for National Statistics (n 1).
[5] ibid.
[6] ibid.
[7] ‘Disability in England and Wales: 2011 and comparison with 2001’ (Office for National Statistics, 30 January 2013)<https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/disability/articles/disabilityinenglandandwales/2013-01-30> accessed 4 July 2020.
[8] Equality Act 2010, s 20.
[9] Dikaios Sakellariou and Elena S Rotarou, ‘Access to healthcare for men and women with disabilities in the UK: secondary analysis of cross-sectional data’ (2017) 7(8) BMJ Open <https://bmjopen.bmj.com/content/7/8/e016614> accessed 4 July 2020.
[10] ibid.
[11] Leanne Patrick, ‘What does Covid-19 mean for mental health and learning disability patients?’ (NursingTimes, 30 March 2020) <https://www.nursingtimes.net/opinion/what-does-it-mean-for-mental-health-and-learning-disability-patients-30-03-2020/> accessed 6 July 2020.
[12] Gemma Mitchell and Megan Ford, ‘Covid-19 crisis has exposed inequalities for mental health and learning disabilities’ (NursingTimes, 3 July 2020) <https://www.nursingtimes.net/news/coronavirus/covid-19-crisis-has-exposed-inequalities-for-mental-health-and-learning-disabilities-03-07-2020/> accessed 6 July 2020.