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Considerations for people with disability during COVID-19 in WHO's Eastern Mediterranean Region

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Considerations for people with disability during COVID-19 in WHO's Eastern Mediterranean Region

Over 100 million people (15%) in the WHO Eastern Mediterranean Region are living with some form of disability. Data from the “World report on disability” show that 50% of people with disability cannot afford health care and face challenges that impede their access to those services.

With the spread of COVID-19, it is vital that everyone, including people with disability follow basic measures to protect themselves and others from becoming ill with the virus. Equally as important is social distancing and self-isolation that can be difficult for some people with disability.

All service providers must ensure that people with disability are not left behind during the COVID-19 outbreak and that they are treated with respect, dignity and without discrimination.

Specific actions must be taken by various groups to ensure that people with disability have equal access to information, health care services and the support they need to stay healthy and safe.

Actions for people with disability

  • Avoid crowded spaces and transport as much as possible and reduce the frequency with which you need to access public places, as well as your physical contact with others.
  • Stock adequate food, medicines and essential health and hygiene products to cover your needs for at least 2 weeks.
  • Make purchases online or over the phone where possible and ask family, friends or caregivers for help.
  • Make sure you regularly clean and disinfect any assistive or other products you use inside or outside your home such as wheelchairs, white canes, orthoses and hearing aids, etc.
  • Put a plan in place to ensure continuity of care and support.
  • Identify relevant organizations in your community, hotlines or people from your family, friends, peers or caregivers that you can ask for assistance, if needed.

Actions for caregivers

  • If you have COVID-19 symptoms, inform the person you are taking care of or their family and seek medical help early.
  • If you suspect that the person you are taking care of has COVID-19 symptoms, wear a medical mask and wash your hands thoroughly before and after contact, and seek medical help immediately.
  • Make sure that any assistive or other products used by the person you are taking care of are regularly cleaned and disinfected.
  • Keep a list of public services and organizations in the community and what they offer for people with disability.
  • Plan ahead with the person you are taking care of to ensure continuity of care, including identifying medications or any needed supplies, additional medical care, psychosocial support and mental health services, and any other requirements, such as repairing or replacing assistive products.

Actions for governments

  • Ensure all health care facilities that provide testing and services for COVID-19, including quarantine and isolation services are accessible and inclusive.
  • Use all available channels to communicate with people with disability and make all public health information accessible to all forms of disabilities.
  • Engage people with disability and their representatives in planning for the COVID-19 response, to address the needs of all persons, including in peripheral and remote areas.
  • Ensure that financial compensation schemes are inclusive of people with disability and provide flexible work arrangements for them, their families and caregivers to cope with economic implications of the COVID-19 situation such as lockdown and physical isolation.  
  • Ensure continuity of services and support where the number of available caregivers may be reduced, including fast-track training opportunities for new workforce.
  • Provide a hotline in multiple formats (e.g. telephone, email, SMS, easy language apps, video calls or another accessible format) for people with disability to communicate with the government, ask questions, and raise concerns.
  • Ensure service providers and caregivers of people with disability have access to no-cost personal protective equipment, such as masks, gloves and hand sanitizers, and to COVID-19 testing alongside other identified priority groups. 

Actions for health care workers

  • Adapt alternative modalities for provision of healthcare for people with disability, such as home visitation programmes or telehealth (e.g. telephone consultation, text messaging and video conferencing) based on the local context to sustain their health care services and COVID-19-related needs.
  • Adopt understandable ways to deliver information and communicate with people with disability in diverse formats to suit the different needs. Do not rely solely on either verbal or written information.
  • Deliver sufficient support for people with disability with more complex needs.
  • Develop and disseminate information to other health workers to ensure they are aware of the potential health and social consequences of COVID-19 for people with disability.

Actions for disability service providers  

  • Develop and implement service continuity plans in case the workforce is reduced or new workers are recruited in consultation with people with disability, their families and other local disability and caregiver agencies. 
  • If resources for continuity plans are not available, consider engaging the community and asking for additional support, particularly from people in relevant disciplines (e.g. nursing, physical therapy, occupational therapy).
  • Communicate frequently with people with disability and their support networks to provide targeted information on COVID-19 using different communication modalities and ensure that they are accessible.
  • Reduce potential exposure to COVID-19 during provision of disability services and rapidly upskill the disability care workforce regarding infection control.
  • Continue to provide sufficient support for people with disability who have complex needs in consultation with families and community support agencies.

Actions for the community

  • Establish flexible work arrangements for people with disability and caregivers, including taking paid leave if they are at high risk of severe symptoms.
  • Increase access to stores and set up special hours for people with disability.
  • Schools and other educational facilities should take appropriate action to ensure continuity of education for people and children with disability.
  • Family, friends and neighbours should check in regularly on people with disability to provide emotional, practical and communication support.

Public advice campaigns and information

Public advice campaigns and information should be made available in sign language and accessible means, modes and formats, including accessible digital technology, captioning, relay services, text messages, easy-to-read and plain language.

Humanitarian and emergency settings

Most countries in the WHO Eastern Mediterranean Region are directly or indirectly affected by emergencies. Healthcare services and systems are disrupted, and people with disability are often neglected in emergency preparedness and response efforts. COVID-19 poses additional challenges to those already fragile situations. It is thus crucial to sensitize and build the capacities of health care and protection service providers in emergency settings for inclusion of people with disability in population-wide responses and sustaining rehabilitation services and assistive products provision during the pandemic.

Counselling and psychosocial support

People living with disability who have suspected or confirmed COVID-19 may need support with their mental health, similar to other population groups. Social distancing and self-isolation may make people feel vulnerable, stressed or worried. People with disability should seek the counselling and psychosocial support they may need from appropriately trained health care professionals and also community-based lay and peer counsellors, on their own or with the support of family, friends, neighbours or caregivers.

Basic protective measures against COVID-19

  • Wash your hands frequently with soap and water or use an alcohol-based hand rub to kill the virus that may be on your hands.
  • Avoid touching your eyes, nose and mouth because hands touch any surfaces and can pick up the virus.
  • Make sure you (and the people around you) practise good respiratory hygiene by covering your mouth and nose with your bent elbow or tissue when you cough or sneeze (then dispose of the tissue immediately).
  • Clean and disinfect surfaces frequently.
  • Maintain at least 1 metre distance between yourself and anyone who is coughing or sneezing to avoid getting sprayed with liquid droplets from their nose or mouth which may contain the virus
  • If you have fever, cough and difficulty breathing, seek medical help early.
  • Stay informed and follow advice given by your health care provider to protect yourself and others from COVID-19.