COVID-19 has changed the way everyone lives their lives, and even though the virus itself does not discriminate, some groups are undeniably disproportionately affected, including those in insecure employment and public-facing essential jobs such as retail, aged care and health care. However, despite significant transmission in disability support service settings, a sophisticated and coordinated response has been slow to support the one in five Australians who live with disability, or the unpaid carers and disability support workers being impacted by the disease itself, but also by how certain infection control measures have been put in place without sufficient regard to access, equity and inclusion.
How COVID-19 is affecting People with Disability
Even without a global crisis like COVID-19, people with disability experience higher morbidity and mortality rates for preventable conditions than the general population, and on average have a life expectancy up to 36 years lower than people without disability. Comorbidity of other psychological, cognitive, sensory or physical conditions are often compounded by barriers such as inaccessible healthcare, negative attitudes of others, and inadequate support funding. During the pandemic, people with disability have expressed high levels of anxiety and concern that Australia’s emergency responses have not considered their needs. One example is the lack of clear and accessible messaging on mandatory mask-wearing and exemptions for people with health conditions or disability who cannot wear a mask, creating fear of public shaming for people already facing barriers to being included in their community. Social distancing is also having significant impacts on people who require assistance with personal care activities such as eating, bathing and dressing, who may experience additional delays or challenges in accessing these support services with changes to service provision, having serious consequences for their safety, dignity and independence.
It is expected that we will encounter learning curves whilst responding to the pandemic, however it is unacceptable that we are likely to see far higher rates of COVID-19 among people with disability, particularly First Nations People with disability, due to access barriers to health care, including screening and testing, posing a risk to the effective infection control of this virus for all Australians.
How COVID-19 is affecting the Disability Workforce
A report written by the Disability Advocacy Resource Unit (DARU) indicates that the disability workforce has been dangerously underprepared and unsupported throughout Australia’s response to the crisis, citing issues such as poor access to hygiene supplies, slow responses to outbreak risks in day program and other disability support settings, and uncertainty for the future of workers in the sector who are unable to self-isolate or face significant financial consequences for doing so.
With restrictions to address community transmission of COVID, face coverings or masks are now mandatory across most of Victoria. Whilst in support of this important Personal Protective Equipment (PPE) requirement to help stop the spread of the virus, critics have pointed to a lack of consideration about equity and ease of access to such PPE for disadvantaged members of the community.
The rhetoric of purchasing PPE being a ‘personal choice’, despite disability support workers having a strong need to purchase this equipment when supporting clients in a close proximity poses equity and ethical concerns. Furthermore, confusion is rife regarding funding options for purchasing masks, as people with disability and the sector navigate whether they can be bought as part of the National Disability Insurance Scheme (NDIS) consumables budget, or if this expense must be worn by individual clients who are often on limited incomes. Concerns have also been raised with regard to how people with disability can retain access to advocacy and safety measures such as the Community Visitors Scheme and other safeguarding protocols that arose from the staggering findings of the Disability Royal Commission regarding neglect and abuse occurring in disability service settings.
Unpaid carers, often family members or friends of a person with disability, are also feeling the additional pressures of the pandemic. Around 12% of Australians have caring responsibilities, providing over $70 billion of unpaid care each year. Unpaid carers are generally more vulnerable to ill health, and face challenges such as poverty, social isolation and unstable employment at rates far higher than people without unpaid caring roles. This disadvantage is being compounded by COVID-19, however increases to a range of government social security payments has not been extended to the carer payment, despite advocacy and feedback from peak carer support bodies.
How the sector is responding
The Australian Government has released a Management and Operational Plan for People with Disability, with the aim of ensuring the pandemic response considers the needs, rights, barriers and dignity of people with disability. Crucially, this living document provides guidance and recommendations for the sector to
- Minimise COVID-19-related transmission, morbidity and mortality among people with disability
- Inform, engage and empower all people with disability, their families, carers and support workers in relation to COVID-19
- Identify and characterise the nature of the virus, and the clinical severity of the disease as it relates to people with disability
- Support effective care, including rehabilitation, for people with disability who contract COVID-19, and reduce additional burden from COVID-19 for healthcare and disability support workers
- Support people with disability continuing to have access to essential health care for non-COVID conditions, including mental health conditions, through the pandemic period.
The disability sector is doing a great job in an already high demand and low resource environment, adapting to quickly-evolving information and advice about this health crisis, and is working swiftly to protect people with disability, their friends, family and support workers. However, as people with disability access a range of services and aspects of community life outside the disability sector, this advice and responsibility should be shared among all private and nonprofit organisations. Strategies to improve the accessibility and safety of services should include:
- Creating accessible information about the virus and relevant prevention measures. Formats should include Easy English, audio, Auslan, community languages and closed captions and audio description for any video content. · Providing training for staff around infection control, such as the online version the Australian Government has provided.
- Encouraging all staff, clients and close contacts to download the COVID Safe app.
- Educating staff and the public on how to navigate telehealth appointments and utilise technology to access other essential services.
- Provide access to PPE such as masks and/or face shields for people with disability and those who they come into close contact with in personal or professional settings
- Provide information, guidance and support on issues specific to people’s individual circumstances, such as this tip sheet for infection control measures for people who use a wheelchair.
Disability support organisation Scope Australia is one of many disability support organisations changing the way they run programs, support clients and encourage social connections and personal development by providing online activities and developing resources to help people with disability navigate this strange new world. They have also established a COVID-19 hotline for their clients or people wishing to clarify the impact of the pandemic on their services. Petitions and advocacy work is being done to protect the continuation of disability service delivery, in a sector rife with insecure employment contracts and a casualised workforce which is more vulnerable to disruptions such as COVID-19. Peak bodies such as People with Disability Australia (PWDA) are trying to bridge the gaps by creating online resource hubs for the sector, however more formal support is required to ensure the safety of our essential disability workers now and into the future.
People with disability and those who support them are an integral part of our community, and to truly address this crisis in a way that is equitable, fair and just, they need to be included in the conversation about how we move forward to protect the safety and human rights of all Australians, regardless of ability.