ABSTRACT
Objective: To examine how the COVID-19 pandemic impacts the behavioral health of people with intellectual and/or developmental disabilities (IDD) in the US. Background: The general population has suffered increasing rates of mental health problems during the COVID-19 pandemic. Having an intellectual disability was the most significant independent risk factor for a diagnosis of COVID-19, and the second strongest independent risk factor to COVID-19 mortality. This study investigates how the pandemic uniquely impacted the behavioral health of people with IDD. Design/Methods: Data were collected using a modified version of the Coronavirus Health Impact Survey -Adapted for Autism and Related Neurodevelopmental conditions (CRISISAFAR). The survey was disseminated electronically to a non-probability (i.e., convenience) sample of community and advocacy groups through the authors' networks of IDD-affiliated organizations. Study data were collected and managed using REDCap electronic data capture tools from March to June 2021. Results: 437 individuals with IDD completed the survey. 52.2% listed having an intellectual disability and 48.7% listed autism spectrum disorder, among other diagnoses. 51.6% of the survey population reported that their mental health had worsened during the pandemic. 47.6% said that they were worrying more, 55.6% struggled with changes in routine, and 18.7% reported increased self-injurious behavior. Losing access to services and programs correlated with declining mental health. Loss of or decrease in community support also correlated with increased screen time, worse sleep, and needing more help with activities of daily living. Conclusions: The behavioral health of individuals with IDD was profoundly impacted by the changes caused by COVID-19. Despite pervasive needs for increased mental and physical health resources amongst individuals with IDD, the potential positive impact of physical activity and pandemic safe social supports and opportunities should be regarded as an important and accessible means to mitigate the overall gap in services.
ABSTRACT
Introduction: Hip fractures are the commonest serious injury in older people, the commonest reason for older people needing surgery and the commonest cause of death following an accident. The NHFD is a national database whereby markers of care are recorded prospectively for patients over 60 years sustaining a hip fracture and requiring inpatient care, with a Best Practice Tariff linked to key performance indicators. The aim of this study was to review how care varied for patients sustaining a hip fracture during the COVID-19 pandemic compared to the equivalent time last year. Methods: Using the NHFD we compared data from March-May 2019 to the same period in 2020 during the pandemic at St George's Hospital. The study provides a snapshot of care during the pandemic. Results: Therewere more admissions andmore discharges during the pandemic. There was an increase in time to theatre and subsequent reduction in BPT. There was also an increase in non-operative treatment for these patients. 6 patients were confirmed COVID-19 positive, one of whom died. Therewas a reduction in time to ortho-geriatrician review and also a reduction in deliriumreview post-operatively. Length of staywas also reduced. Conclusion: The COVID-19 pandemic had an effect on care provided to hip fracture patients. There was an increase in time and a deterioration in orthogeriatric review within 72 hours. The length of stay however improved due to improved focus on pathways and discharge processes. There was also a lower threshold to offer non-operative care wherever possible.