Individuals with Developmental Disabilities May Suffer More Severe COVID Outcomes

Risk Dependent on Residency, Age, and Comorbid Conditions

As the global pandemic continues to grow, concerning news originating from SUNY Upstate Medical University shows that COVID-19 appears to pose a greater threat to people with intellectual and developmental disabilities (IDD). The report published in Disability and Health Journal set out to compare COVID-19 outcomes among people with and without IDD through three different age spans.

The research team gathered data using TriNetX, a global federated network of electronic medical records from 42 healthcare organizations representing hospitals, primary care and specialty treatment providers. The team collected data and examined trends in comorbidities, numbers of cases, numbers of deaths, and case fatality rates for individuals in both study cohorts who had a positive diagnosis for COVID-19 from April 14 through May 14, 2020.

Overall, the researchers found the death rate from COVID-19 between individuals with (5.1%) and without (5.4%) IDD was similar, however, there was a marked difference in two age cohorts. People with IDD had an almost twice higher case-fatality rate within the 18-74 age range (4.5%) compared to individuals without IDD (2.7%). Higher case fatality-rates were exhibited in the 0-17 age range with IDD (1.6%) compared to those without IDD (.1%). The death rate was nearly identical for both groups in the 75 years and older age range.

Although the authors were uncertain about the reasons for this trend, they ended their brief report by speculating that the higher fatality rate amongst individuals with IDD in the 0-17 and 18-74 age ranges could be due to co-morbid conditions. People with IDD have a higher prevalence of conditions such as hypertension, heart disease, respiratory disease, and diabetes. These conditions are often associated with poorer COVID-19 outcomes.

A recent National Public Radio (NPR) report investigated this phenomenon even further. NPR conducted their own investigation which focused on individuals with IDD in Pennsylvania. Similar to the SUNY report, their analysis showed that people who contracted COVID-19 and had IDD died at a rate nearly twice as high as other Pennsylvania residents.

While NPR recognized comorbid conditions in people with IDD as a factor for higher death rates, their report offered an additional potential reason for this trend in this vulnerable population, group homes. NPR discussed this issue with Scott Landes, one of the SUNY report authors.

Landes explained to NPR, “People with developmental disabilities are far more likely to have preexisting health condition, such as respiratory disease that adds to their risk. They’re much more likely, than even elderly people, to live in a setting with roommates and staff like group homes where two or four or 10 or more people live together, About 13% to 20% of people with developmental disabilities live in such settings, compared with only about 6% of people over age 65.”

Another expert included in their report, Nicole Jorwic, senior director for public policy at advocacy group, the Arc, explained that individuals with IDD who live in care home settings are often overlooked, as opposed to the focus given to the elderly living at nursing homes. This disregard can lead to heavy consequences. She also shed more light on the challenges for group home staffers, who typically have low salaries, have encountered since the pandemic hit.

Jorwic stated, “…it has been harder for the groups that serve people with disabilities to get personal protective equipment or extra pay for staff workers. In most states, these workers don’t get the bonus pay that is sometimes offered to other front-line health care workers and, in some states, the staff who serve people in group homes or their own homes aren’t considered essential workers.”

The NPR report ended with a conversation with a Washington state resident, Shane Cody Fairweather, who lives in a group home and receives supports from group home service providers. He worries that people like him are not receiving the consideration they should, even though they have a higher risk of poor outcomes from contracting COVID-19.

“We’re part of society. We’re more vulnerable,” says Fairweather. “It should be on equal footing. They should be paying attention to the elderly and the disabled as well.”

References

Margaret A. Turk, Scott D. Landes, Margaret K. Formica, Katherine D. Goss. Intellectual and Developmental Disability and COVID-19 Case-Fatality Trends: TriNetX Analysis. Disability and Health Journal. May 24, 2020.

Joseph Shapiro. COVID-19 Infections and Deaths Are Higher Among Those With Intellectual Disabilities. National Public Radio. June 9, 2020.

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