Triple jeopardy: disabled people and the COVID-19 pandemic.
Triple jeopardy: disabled people and the COVID-19 pandemic.
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DOI：
10.1016/s0140-6736(21)00625-5
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发表时间：
2021-04-10
期刊：
影响因子：
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通讯作者：
Seketi QE
中科院分区：
文献类型：
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作者：
Shakespeare T;Ndagire F;Seketi QE
残疾人受到COVID-19的不同影响，原因有三个：疾病本身导致不良后果的风险增加，获得常规医疗保健和康复的机会减少，以及缓解大流行病的努力造成的不利社会影响。10年前，世卫组织的《世界残疾报告》指出，残疾人更有可能是老年人、穷人、患有合并症和女性。1老年、贫困和合并症也与COVID-19严重后果的风险增加有关。2 2020年1月24日至11月30日期间，英格兰残疾男性和残疾女性死于COVID-19的风险分别是非残疾男性和女性的3.1倍和3.5倍。3生活在集中居住环境（主要与高收入环境相关）的智障人士死于COVID-19的风险高于非残疾人士。4，5但即使在家庭环境中，6智力残疾的人患COVID-19死亡的风险也会增加。7在世界范围内，灾害和紧急情况往往对残疾人群体造成不成比例的影响，这一流行病也不例外。8-10残疾人在纳入COVID-19应对措施方面面临许多障碍（小组）。社会在COVID-19大流行期间采取的封锁措施意味着残疾人的处境更糟，更加被排除在外。11如果安全部队采取激进行动实施封锁和宵禁，如在南部非洲的一些国家，那么可能需要获得医疗保健或药房的残疾人将受到惩罚。取消或推迟定期保健或康复将对那些有额外保健需求的人产生不同的影响。10，12当辅助技术没有规定，维护或维修时，残疾人会变得依赖。当社会照顾被搁置、取消或减少时，残疾人就得重新依靠家庭的支持，如果他们有的话。如果残疾人无法参加日托中心或志愿项目，他们可能就没有人可以见面。13当人们被要求使用口罩和身体距离时，不能读唇的听力损失者或使用导盲犬的视力障碍者可能会发现很难遵守这些规则，因此他们可能会被污名化。此外，被关在家中增加了身体或性暴力和虐待的风险，残疾儿童和成年人更容易受到伤害。十四，十五
People with disabilities have been differentially affected by COVID-19 because of three factors: the increased risk of poor outcomes from the disease itself, reduced access to routine health care and rehabilitation, and the adverse social impacts of efforts to mitigate the pandemic. 10 years ago, WHO's World Report on Disability noted that people with disabilities were more likely to be older, poorer, experience comorbidities, and be female. 1 Older age, deprivation, and comorbidities are also associated with increased risk of severe outcomes from COVID-19. 2 Risk of death from COVID-19 between Jan 24 and Nov 30, 2020, in England was 3· 1 times greater for men with disabilities and 3· 5 times greater for women with disabilities than for men and women without disabilities. 3 People with intellectual disabilities living in congregate residential settings, relevant mainly to high-income settings, had a higher risk of death from COVID-19 than people without disabilities. 4, 5 But even in household settings, 6 people with intellectual disability have an increased risk of COVID-19 death. 7Worldwide, disasters and emergencies often disproportionately impact the disability community, and this pandemic is no exception. 8–10 People with disabilities have faced many barriers to inclusion in the COVID-19 response (panel). The lockdown measures societies have taken during the COVID-19 pandemic have meant people with disabilities are worse off and more excluded. 11 If lockdown and curfew are enforced through aggressive actions by security forces, as in some countries in southern Africa, then people with disabilities who may need to access health care or pharmacies are penalised. Cancellation or postponement of regular health care or rehabilitation will differentially impact those with additional health needs. 10, 12 When assistive technology is not prescribed, maintained, or repaired, people with disabilities are rendered dependent. When social care is put on hold, cancelled, or reduced, people with disabilities are thrown back on the support of families if they have them. When it is not possible to attend day centres or voluntary projects, people with disabilities may be left with no one to meet. 13 When individuals are expected to use face masks and physically distance, people with hearing loss who cannot lip read or people with visual impairment who use guide dogs can find it difficult to follow these rules and as a result they might be stigmatised. Additionally, confinement in homes increases the risk of physical or sexual violence and abuse, to which children and adults with disabilities are additionally vulnerable. 14, 15