COVID-19 and the spinal cord injury community: Concerns about medical rationing and social isolation.

PURPOSE/OBJECTIVE: To provide a descriptive account of the impact of the COVID-19 pandemic on the spinal cord injury (SCI) community focused on participants' concerns about medical discrimination and medical rationing, the impact of the pandemic on access to personal care attendants and medical supplies, and the impact of the pandemic on overall and mental health. Research Method/Design: Cross sectional, observational study among community-dwelling adults with SCI. Data were collected online between May 1, 2020 and August 31, 2020 (n = 187). The online questionnaire included questions regarding medical discrimination and rationing, the impact of the pandemic on access to care and medical supplies, and the impact of the pandemic on overall and mental health. RESULTS: Individuals with SCI have experienced difficulty accessing medical supplies due to the pandemic, and approximately half of our participants (52%) perceived that discrimination through medical rationing was occurring. Furthermore, compared to the general U.S. population, our sample reported that the pandemic had a greater negative impact on their mental health and access to medical supplies. CONCLUSION/IMPLICATIONS: Our findings suggest that the COVID-19 pandemic has negatively impacted mental health and increased concerns of social isolation as well as access to medical supplies among those with SCI. Rehabilitation psychologists must advocate alongside the disability community to limit health disparities and to conduct outreach, specifically with regard to mental health issues. Future research should focus on the effects of pandemic-related fears and social isolation, as well as resilience in the context of public health care threats. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Resilience and mental health in individuals with spinal cord injury during the COVID-19 pandemic.

STUDY DESIGN: Cross-sectional, observational study. OBJECTIVES: To understand how resilience, access to personal care attendants (PCAs) and medical supplies, and concerns about medical rationing, finances, and social isolation are related to overall and mental health in individuals with spinal cord injury (SCI) in the context of the COVID-19 pandemic. SETTING: Community dwelling adults (N = 187) with SCI. METHODS: Data were collected online between May 1, 2020 and August 31, 2020. Outcomes were overall and mental health, depression and anxiety symptoms, and quality of life (QoL). Predictors were resilience, access to PCAs and medical supplies, and concerns about medical rationing, finances, and social isolation. RESULTS: Incomplete injury, concern about medical rationing, medical supply disruption, and social isolation predicted a greater perceived impact of the pandemic on overall heath. Younger age, decreased resilience, and concern about medical rationing and social isolation predicted greater perceived impact of the pandemic on mental health. Decreased resilience and concern about medical rationing and finances predicted increased anxiety symptoms. Incomplete injury, believing that medical rationing was occurring, decreased resilience, and concern about finances and social isolation predicted increased depressive symptoms. Decreased resilience and concern about finances, medical rationing, and social isolation predicted lower QoL. CONCLUSIONS: The negative effects of the pandemic on the overall and mental health of individuals with SCI may be ameliorated by resilience. In future crises, it may be beneficial to screen individuals for resilience so that those with decreased resilience are offered the appropriate resources to enhance resilience and improve overall wellbeing.

No body is expendable: Medical rationing and disability justice during the COVID-19 pandemic.

The health threat posed by the novel coronavirus that caused the COVID-19 pandemic has particular implications for people with disabilities, including vulnerability to exposure and complications, and concerns about the role of ableism in access to treatment and medical rationing decisions. Shortages of necessary medical equipment to treat COVID-19 have prompted triage guidelines outlining the ways in which lifesaving equipment, such as mechanical ventilators and intensive care unit beds, may need to be rationed among affected individuals. In this article, we explore the realities of medical rationing, and various approaches to triage and prioritization. We discuss the psychology of ableism, perceptions about quality of life, social determinants of health, and how attitudes toward disability can affect rationing decisions and access to care. In addition to the grassroots advocacy and activism undertaken by the disability community, psychology is rich in its contributions to the role of attitudes, prejudice, and discriminatory behavior on the social fabric of society. We call on psychologists to advocate for social justice in pandemic preparedness, promote disability justice in health care settings, call for transparency and accountability in rationing approaches, and support policy changes for macro- and microallocation strategies to proactively reduce the need for rationing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).