COVID-19 disproportionately impacts access to basic needs among households with disabled members

Observed Mask Wearing and Presence of SARS-CoV-2 in School Wastewater, San Diego County, CA, 2022

Objectives. To test the association between directly observed school masking behaviors and the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in school wastewater. Methods. We randomly sampled a subset of schools participating in a translational study on the effectiveness of passive wastewater surveillance in nonresidential K‒12 settings in San Diego County. Trained observers conducted biweekly systematic observations of masking behaviors between March 2 and May 27, 2022. Results. The proportion of individuals observed masking was a significant predictor of detecting SARS-CoV-2 in school wastewater (adjusted odds ratio = 0.91; 95% confidence interval = 0.85, 0.99; P = .034). For every 10% increase in the percentage of observed individuals who were fully masked, the odds of detecting SARS-CoV-2 in school wastewater decreased by nearly 10%. Conclusions. Masking does not need to be perfect to be effective. Mask mandates are unlikely to be reimplemented in US schools, but interventions that encourage moderate increases in masking may have an important role to play in improving children's health and decreasing the spread of COVID-19 and other respiratory diseases. (Am J Public Health. 2025;115(4):519-527. https://doi.org/10.2105/AJPH.2024.307925).

COVID-19 vaccine uptake in individuals with functional difficulty, disability, and comorbid conditions: insights from a national survey in Bangladesh

BACKGROUND

COVID-19 vaccine uptake among individuals with disabilities is crucial for safeguarding their health and well-being. However, the extent of vaccine uptake among this group remains largely unknown in low- and middle-income countries. This study aims to assess the COVID-19 vaccine uptake among persons with functional difficulty, disability and/or comorbidity in Bangladesh and their associated factors.

METHODS

Data from 9,370 respondents extracted from the 2021 National Household Survey on Persons with Disability were analysed. The outcome variable was the uptake of at least one dose of the COVID-19 vaccine (yes, no). Key explanatory variables included the presence of disability (yes, no), comorbidity (yes, no), and both comorbidity and disability (yes, no) among persons with functional difficulty. The relationship between the outcome and explanatory variables was determined using mixed-effects multilevel logistic regressions adjusted for covariates.

RESULTS

The overall uptake of at least one dose of the COVID-19 vaccine among persons with functional difficulty was 57.37%, among persons with functional difficulty and disability was 48.63% and among persons with functional difficulty and single (57.85%) or multi-comorbidity (60.37%). Compared to the respondents with functional difficulty only, the adjusted odds ratio (aOR) of not receiving any dose of the COVID-19 vaccine for individuals with both functional difficulty and disability was 1.37 (95% CI, 1.22-1.53), and for individuals with functional difficulty, disability and one or more comorbid conditions was 1.30 (95% CI, 1.15-1.47). The aOR of receiving at least one dose of the COVID-19 vaccine among individuals with functional difficulty and one or more comorbid conditions was significantly higher than among those with functional difficulty only.

CONCLUSION

In Bangladesh, COVID-19 vaccine uptake was relatively low among individuals with disabilities. The existing COVID-19 vaccine rollout programs and similar future programs should prioritise individuals with disabilities and include targeted strategies to reach them.

Navigating new normals: the influence of COVID-19 policies on community access and well-being of people with mobility disabilities in everyday life

Context

This study explores the influence of COVID-19 public health mandates on people with mobility disabilities in the United States in their everyday lives. It highlights the intersection of disability with social determinants of health, emphasizing the need for a comprehensive policy response.

Methods

Qualitative data were collected through 76 semi-structured interviews with people with mobility disabilities. Interviews focused on experiences with COVID-19 mandates and community access, analyzed using thematic analysis and coded for emergent subthemes.

Results

The relationship between community participation and COVID-19 compliance was complex for people with disabilities. Inaccessible environments and inflexible policies made it difficult for people with disabilities to practice good safety measures, while widespread noncompliance by community members limited their community participation. The findings revealed additional mixed lived experiences of COVID-19 policies on community participation, accessibility, and access to resources and support. While technology facilitated some aspects of community participation, issues with accessibility, public transportation, and personal assistance services were exacerbated.

Conclusion

COVID-19 policies have complex implications for people with mobility disabilities. Findings suggest a need for inclusive policymaking, improved disability awareness, and continued support for accessible technology and services. Future research should further explore these dynamics to inform policy and practice.

Disproportionately High Rates of Burnout Among Disabled Caregivers During the COVID-19 Pandemic

Background

Burnout is exhaustion caused by exposure to chronic stress. Prior to the COVID-19 pandemic, people with disabilities experienced high levels of burnout due to discrimination, barriers to accessing resources, and lack of accommodations. Caregivers have also experienced high levels of burnout during the COVID-19 pandemic.

Background

While researchers have examined burnout among caregivers of disabled children, less research has focused on the experiences of disabled caregivers. We examined the association between caregiver disability and burnout during the pandemic.

Methods

We distributed an online survey to caregivers of children enrolled in socially vulnerable elementary and middle schools in San Diego County, California between September and December, 2022. Our survey included demographic questions, questions about pandemic experiences, and a continuous burnout measure. We analyzed survey data to test our hypothesis that caregivers with a disability experienced higher levels of burnout than their non-disabled counterparts during the height of the COVID-19 pandemic. We used multivariable linear regression analysis adjusting for household income and caregiver education level.

Results

Disabled caregivers self-reported higher levels of burnout than non-disabled caregivers (B = 0.72; p < 0.001) during the COVID-19 pandemic in bivariate and multivariable analyses. Caregivers with a higher household income (B = 0.04; p = 0.017) and more education (B = 0.13; p = 0.005) also reported higher levels of burnout.

Conclusion

The COVID-19 pandemic exacerbated existing difficulties faced by disabled caregivers who often struggle to balance the demands of caregiving with their available resources. Targeted programs and policies are needed to support disabled caregivers during health emergencies that exacerbate existing inequities in access to resources.

Disability and COVID-19: Challenges, testing, vaccination, and postponement and avoidance of medical care among minoritized communities

BACKGROUND

People with disabilities face heightened vulnerability to COVID-19.

OBJECTIVE

This study investigated (1) the relationships between disability and COVID-19-related challenges, testing, vaccination, and infection and (2) predictors of loss of healthcare coverage and postponement and avoidance of medical care during the pandemic.

METHODS

This cross-sectional study was conducted in Miami, Florida, between March 2021 and February 2022 as part of the NIH Rapid Acceleration of Diagnostics-Underserved Populations initiative. Disability was defined using a standard measure that assesses six universal functions. Participants reported sociodemographic data, COVID-19 testing, infection history, challenges, and healthcare history. Vaccinations were confirmed with medical records and COVID-19 positivity was assessed using real-time reverse transcription-polymerase chain reaction. Statistical analyses included multivariable logistic regression.

RESULTS

Among 1,689 participants with a median age of 57.0, 50.6% were male, and 48.9% were non-Hispanic Black. Disability was associated with greater odds of all assessed COVID-19 challenges: healthcare (aOR:1.60; 95% CI:1.23-2.07), housing (aOR:2.15; 95% CI:1.62-2.87), insufficient food (aOR:1.97; 95% CI:1.54-2.52), water scarcity (aOR:2.33; 95% CI:1.60-3.37), medications (aOR:2.04; 95% CI:1.51-2.77), and transportation (aOR:2.56; 95% CI:1.95-3.36). Those reporting employment disability were less likely to have received COVID-19 testing (81.1% vs. 85.3%, p = 0.026) or to have history of COVID-19 positivity (aOR:0.63; 95% CI:0.44-0.92). Disability predicted avoidance (aOR:2.76; 95% CI:1.95-3.91) and postponement (aOR: 2.24; 95% CI:1.72-2.91) of medical care.

CONCLUSIONS

Disability is associated with higher odds of COVID-19 challenges and postponement and avoidance of medical care. Those reporting employment disability had a lower likelihood of COVID-19 testing. Public health responses to healthcare crises should prioritize the special challenges of people living with disabilities.

Determinants of parent-reported child mental health status in San Diego public schools during the height of the COVID-19 omicron outbreak: A serial cross-sectional study

Despite extensive debate on the effects of COVID-19 mitigation measures in school settings, little evidence exists on trends in school children's mental health over the course of the COVID-19 pandemic. The objective of this paper was to identify factors affecting parent reports of school children's mental health during COVID-19 Omicron variant outbreak in a cohort of high-risk, socially vulnerable children attending public elementary schools. We analyzed four waves of cross-sectional, online-administered surveys completed by parents of children attending public elementary schools in San Diego between November 2021 and March of 2022. Children (n = 684) ranged in age from 2-17 years. We used multilevel linear mixed effects models to assess determinants of parent-reported child mental health status. The outcome was child mental health, as reported by the parent. Parents consistently rated their children's mental health as very good, though parents who experienced recent COVID-related challenges and who had older children reported lower levels of mental health in their children. Children's mental health was generally considered to be very good, as judged by their parents during a period of constant in-school masking and the Omicron variant outbreak. Structural support mechanisms aimed at mitigating COVID-related challenges for adults may offer benefit to children's mental health.