The impact of coronavirus disease 2019 (COVID-19) on older adults with an intellectual disability during the first wave of the pandemic in Ireland

Mary Mccarron,Fidelma Flannery,Eimear Mcglinchy,Andrew Allen,Philip Mccallion,Fintan Sheerin,Eilish Burke,Retha Luus,Darren Mccausland

doi:10.12688/hrbopenres.13238.1

Abstract

Background: People with intellectual disability have increased risk of exposure to and adverse outcomes from coronavirus disease 2019 (COVID-19).They also face challenges to mental health and well-being from COVID-19-related social restrictions and service closures. Methods: Data from a supplemental COVID-19 survey from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA) (n=710) was used to assess outcomes from the first infection wave of COVID-19 among adults with intellectual disability aged 40+ years in Ireland. Data was gathered on testing, for symptoms and outcomes; procedures to manage COVID-19; and both stress/anxiety and positive experiences during the pandemic. Demographic and health-related data from the main IDS-TILDA dataset was included in analyses. Results: High rates were identified of health conditions associated with poorer COVID-19 outcomes, including overweight/obesity (66.6%, n=365), high cholesterol (38.6%, n=274) and cardiovascular disease (33.7%, n=239). Over half (53.5%, n=380) reported emotional, nervous or psychiatric disorders. Almost two-thirds (62.4%, n=443) were tested for COVID-19, with 10% (n=71) reporting symptoms and 2.5% (n=11) testing positive. There were no instances of COVID-19 related mortality. Common symptoms included fatigue, fever, and cough. Some participants (7.8%, n=55) moved from their usual home to isolate, most often (n=31) or relocate to a family home (n=11). Three-quarters (78.7%) of those who were symptomatic or who tested positive had plans to manage self-isolation and two-thirds were able to comply with guidelines. Over half (55%, n=383) reported some COVID-19 related stress/anxiety; and a similar proportion reported positive aspects during this period (58%, n=381). Conclusions: Our data suggests that people with intellectual disability avoided the worst impacts of COVID-19 during the first infection wave in Ireland. Nevertheless, participants' health profiles suggest that this population remains at high risk for adverse infection outcomes. Repeated measures are needed to track health and well-being outcomes across multiple infection waves.

Highlights

Since first being identified, our understanding of coronavirus disease 2019 (COVID-19) including its impact on people with intellectual disabilities (ID) has evolved rapidly following an unprecedented focus from the international scientific community.Risk factors of COVID-19 Research to date has identified that people whose living or working circumstances require them to be in proximity or contact with others such as healthcare workers have an increased exposure and increased risk of contracting the disease (Health Protection Surveillance Centre, 2020; Nguyen et al, 2020)
Our findings suggest that a concerted effort by people with intellectual disability, their families and service providers – including widespread testing, good planning and adherence to public health guidelines – may have helped to avert the worst impacts of COVID-19 during the first wave of infection in Ireland
1 https://www.tcd.ie/tcaid/about/webinars.php rates of COVID-19 mortality among people with intellectual disability, suggest that difficulties may arise in a prolonged fight through multiple waves of COVID-19

Summary

Introduction

Our understanding of coronavirus disease 2019 (COVID-19) including its impact on people with intellectual disabilities (ID) has evolved rapidly following an unprecedented focus from the international scientific community.Risk factors of COVID-19 Research to date has identified that people whose living or working circumstances require them to be in proximity or contact with others such as healthcare workers have an increased exposure and increased risk of contracting the disease (Health Protection Surveillance Centre, 2020; Nguyen et al, 2020). Risk and people with intellectual disability In Ireland, people with intellectual disability were included in the second tier of vulnerable, high-risk groups for severe outcomes of COVID-19, but not ‘extremely vulnerable’ or very high-risk (Health Service Executive, 2020). While not classifying people with intellectual disability as high-risk, the United States (US) identified intellectual disability as a factor which may require extra preventative precautions (Centers for Disease Control and Prevention, 2020). Australia issued additional advice for people with disabilities without including them among high-risk groups (Department of Health (Australia), 2020); and Canada identified people in group residences and people with reduced capacity as more exposed to COVID-19, without specifying people with intellectual disability as ‘vulnerable’ (Government of Canada, 2020). People with intellectual disability have increased risk of exposure to and adverse outcomes from coronavirus disease 2019 (COVID-19).They face challenges to mental health and well-being from COVID-19-related social restrictions and service closures. Threequarters (78.7%) of those who were symptomatic or who tested

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