Supporting Students with Disabilities during the COVID-19 Pandemic: The Perspective of Disability Resource Professionals.

Utilizing national survey data, this paper details the academic and access challenges created by the pandemic for students with disabilities, as perceived by disability resource professionals. Data included in this paper capture disability support service challenges at two unique timepoints during the COVID-19 pandemic-May 2020 [n = 535] and January 2021 [n = 631]. Disability resource professionals reported there was difficulty in the initial months of the pandemic for students to provide documentation of a disability to receive accommodations, use assistive technology in the new remote academic setting, and receive testing accommodations within the remote environment. While access and resources improved for students with disabilities over time, a portion of the surveyed disability resource professionals noted no observed improvement in students' with disabilities communication with instructors as well as a worsening of conditions for students with disabilities throughout the pandemic related to access to counseling and mental health services. In addition to highlighting key obstacles faced by this student group during the pandemic, this paper provides recommendations and implications for institutions to better serve this student group, including how institutions of higher education can coordinate a holistic approach to support student mental health.

Telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic: A commentary.

BACKGROUND: Due to the coronavirus disease 2019 (COVID-19) pandemic, rehabilitation facilities have become less accessible for patients with a stroke. Lack of early, intensive rehabilitation misses the opportunity for recovery during the critical time window of endogenous plasticity and improvement post-stroke. OBJECTIVES: The purpose of this commentary was to highlighting the benefits of telework and telerehabilitation programs for workers with a stroke during the COVID-19 pandemic. METHODS: Relevant publications regarding the management of individuals with a stroke, telerehabilitation and teleworking in the setting of COVID-19 were reviewed. RESULTS: Previous studies showed that telerehabilitation can effectively provide an alternate method of promoting recovery for patients with a stroke. With the physical distancing precautions in place for mitigating viral spread, teleworking can also provide a method for long term recovery and improvements in quality of life after a stroke. CONCLUSIONS: Overall, this commentary addresses the benefits of physically distant, safe and effective alternatives to support individuals who live with a stroke during COVID-19 pandemic.

Evidence that dog ownership protects against the onset of disability in an older community-dwelling Japanese population.

OBJECTIVES: This study examined the association between dog and cat ownership, the onset of disability and all-cause mortality in an older population. Dog and cat owners take more regular exercise and have closer social relationships than non-owners. We further assess the beneficial effects of these moderating variables on the onset of disability and mortality. METHODS: Dog and cat ownership data were collected from 11233 community-dwelling adults age 65 years and older. These data were matched with data about the onset of disability held by the Japanese long-term care insurance system. Local registry data were used to ascertain all-cause mortality. RESULTS: During the approximately 3.5 year follow-up period, 17.1% of the sample suffered onset of disability, and 5.2% died. Logistic regression analysis indicated that, compared with a reference group of those who had never owned a dog (odds ratio fixed at 1.0), older adults who were currently dog owners had a significantly lower odds ratio of onset of disability (OR = 0.54 95% CI: 0.37-0.79). Our results further show that regular exercise interacts with dog ownership to reduce the risk of disability. The association of dog and/or cat ownership with all-cause mortality was not statistically significant. CONCLUSIONS: Dog ownership appears to protect against incident disability among older Japanese adults. Additional benefits are gained from ownership combined with regular exercise. Daily dog care may have an important role to play in health promotion and successful aging.

Outcomes in patients with and without disability admitted to hospital with COVID-19: a retrospective cohort study.

BACKGROUND: Disability-related considerations have largely been absent from the COVID-19 response, despite evidence that people with disabilities are at elevated risk for acquiring COVID-19. We evaluated clinical outcomes in patients who were admitted to hospital with COVID-19 with a disability compared with patients without a disability. METHODS: We conducted a retrospective cohort study that included adults with COVID-19 who were admitted to hospital and discharged between Jan. 1, 2020, and Nov. 30, 2020, at 7 hospitals in Ontario, Canada. We compared in-hospital death, admission to the intensive care unit (ICU), hospital length of stay and unplanned 30-day readmission among patients with and without a physical disability, hearing or vision impairment, traumatic brain injury, or intellectual or developmental disability, overall and stratified by age (≤ 64 and ≥ 65 yr) using multivariable regression, controlling for sex, residence in a long-term care facility and comorbidity. RESULTS: Among 1279 admissions to hospital for COVID-19, 22.3% had a disability. We found that patients with a disability were more likely to die than those without a disability (28.1% v. 17.6%), had longer hospital stays (median 13.9 v. 7.8 d) and more readmissions (17.6% v. 7.9%), but had lower ICU admission rates (22.5% v. 28.3%). After adjustment, there were no statistically significant differences between those with and without disabilities for in-hospital death or admission to ICU. After adjustment, patients with a disability had longer hospital stays (rate ratio 1.36, 95% confidence interval [CI] 1.19-1.56) and greater risk of readmission (relative risk 1.77, 95% CI 1.14-2.75). In age-stratified analyses, we observed longer hospital stays among patients with a disability than in those without, in both younger and older subgroups; readmission risk was driven by younger patients with a disability. INTERPRETATION: Patients with a disability who were admitted to hospital with COVID-19 had longer stays and elevated readmission risk than those without disabilities. Disability-related needs should be addressed to support these patients in hospital and after discharge.

Deaths involving COVID-19 by self-reported disability status during the first two waves of the COVID-19 pandemic in England: a retrospective, population-based cohort study.

BACKGROUND: People with learning disabilities are at substantially increased risk of COVID-19 mortality, but evidence on risks of COVID-19 mortality for disabled people more generally is limited. We aimed to use population-level data to estimate the association between self-reported disability and death involving COVID-19 during the first two waves of the COVID-19 pandemic in England. METHODS: We conducted a retrospective, population-based cohort study of adults aged 30-100 years living in private households or communal establishments in England, using data from the Office for National Statistics Public Health Data Asset. Participants were present at the 2011 Census and alive on Jan 24, 2020. Participants reported being limited a lot in their daily activities, limited a little, or not limited at all, in response to a question from the 2011 Census. The outcome was death involving COVID-19, occurring between Jan 24, 2020, and Feb 28, 2021. We used Cox proportional hazards regression to calculate hazard ratios (HRs) for the association between disability and death involving COVID-19, sequentially adjusting for age, residence type (private household, care home, or other communal establishment), geographical characteristics (local authority district and population density), sociodemographic characteristics (ethnicity, highest qualification, Index of Multiple Deprivation decile, household characteristics [National Statistics Socio-economic Classification of the household reference person, tenure of household, household size, family status, household composition, and key worker in household], key worker type, individual and household exposure to disease, and individual and household proximity to others), and health status (pre-existing health conditions, body-mass index, and number of admissions to hospital and days spent in hospital over the previous 3 years). FINDINGS: 29 293 845 adults were included in the study (13 806 623 [47%] men, 15 487 222 [53%] women), of whom 3 038 772 (10%) reported being limited a little and 2 011 576 (7%) reported being limited a lot. During follow-up, 105 213 people died from causes involving COVID-19 in England, 61 416 (58%) of whom were disabled. Age-adjusted analyses showed higher mortality involving COVID-19 among disabled people who were limited a lot (HR 3·05 [95% CI 2·98-3·11] for men; 3·48 [3·41-3·56] for women) and disabled people who were limited a little (HR 1·88 [1·84-1·92] for men; 2·03 [1·98-2·08] for women) than among non-disabled people. Adjustment for residence type, geography, sociodemographics, and health conditions reduced but did not eliminate the associations between disability and death involving COVID-19 (HR 1·35 [1·32-1·38] for men who were limited a lot; 1·21 [1·18-1·23] for men who were limited a little; 1·55 [1·51-1·59] for women who were limited a lot; and 1·28 [1·25-1·31] for women who were limited a little). INTERPRETATION: Given the association between disability and mortality involving COVID-19, verification of these findings and consideration of recommendations for protective measures are now required. FUNDING: None.

Inequalities in population health loss by multiple deprivation: COVID-19 and pre-pandemic all-cause disability-adjusted life years (DALYs) in Scotland.

BACKGROUND: COVID-19 has caused almost unprecedented change across health, education, the economy and social interaction. It is widely understood that the existing mechanisms which shape health inequalities have resulted in COVID-19 outcomes following this same, familiar, pattern. Our aim was to estimate inequalities in the population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020. Our secondary aim was to scale overall, and inequalities in, COVID-19 DALYs against the level of pre-pandemic inequalities in all-cause DALYs, derived from the Scottish Burden of Disease (SBoD) study. METHODS: National deaths and daily case data were input into the European Burden of Disease Network consensus model to estimate DALYs. Total Years of Life Lost (YLL) were estimated for each area-based deprivation quintile of the Scottish population. Years Lived with Disability were proportionately distributed to deprivation quintiles, based on YLL estimates. Inequalities were measured by: the range, Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. RESULTS: Marked inequalities were observed across several measures. The SII range was 2048 to 2289 COVID-19 DALYs per 100,000 population. The rate in the most deprived areas was around 58% higher than the mean population rate (RII = 1.16), with 40% of COVID-19 DALYs attributed to differences in area-based deprivation. Overall DALYs due to COVID-19 ranged from 7 to 20% of the annual pre-pandemic impact of inequalities in health loss combined across all causes. CONCLUSION: The substantial population health impact of COVID-19 in Scotland was not shared equally across areas experiencing different levels of deprivation. The extent of inequality due to COVID-19 was similar to averting all annual DALYs due to diabetes. In the wider context of population health loss, overall ill-health and mortality due to COVID-19 was, at most, a fifth of the annual population health loss due to inequalities in multiple deprivation. Implementing effective policy interventions to reduce health inequalities must be at the forefront of plans to recover and improve population health.

Disparities in COVID-19 Vaccination Status, Intent, and Perceived Access for Noninstitutionalized Adults, by Disability Status - National Immunization Survey Adult COVID Module, United States, May 30-June 26, 2021.

Estimates from the 2019 American Community Survey (ACS) indicated that 15.2% of adults aged ≥18 years had at least one reported functional disability (1). Persons with disabilities are more likely than are those without disabilities to have chronic health conditions (2) and also face barriers to accessing health care (3). These and other health and social inequities have placed persons with disabilities at increased risk for COVID-19-related illness and death, yet they face unique barriers to receipt of vaccination (4,5). Although CDC encourages that considerations be made when expanding vaccine access to persons with disabilities,* few public health surveillance systems measure disability status. To describe COVID-19 vaccination status and intent, as well as perceived vaccine access among adults by disability status, data from the National Immunization Survey Adult COVID Module (NIS-ACM) were analyzed. Adults with a disability were less likely than were those without a disability to report having received ≥1 dose of COVID-19 vaccine (age-adjusted prevalence ratio [aPR] = 0.88; 95% confidence interval [CI] = 0.84-0.93) but more likely to report they would definitely get vaccinated (aPR = 1.86; 95% CI = 1.43-2.42). Among unvaccinated adults, those with a disability were more likely to report higher endorsement of vaccine as protection (aPR = 1.29; 95% CI = 1.16-1.44), yet more likely to report it would be or was difficult to get vaccinated than did adults without a disability (aPR = 2.69; 95% CI = 2.16-3.34). Reducing barriers to vaccine scheduling and making vaccination sites more accessible might improve vaccination rates among persons with disabilities.

Burden of COVID-19: Disability-Adjusted Life Years (DALYs) across 16 European countries.

OBJECTIVE: The aim of this study is to measure and compare the burden of disease of COVID-19 pandemic in 16 EU/EEA countries through the estimation of Disability-Adjusted Life Years (DALYs) over a long period of time. MATERIALS AND METHODS: The observational study was based on data from ECDC and WHO databases collected from 27 January 2020 to 15 November 2020. In addition to the absolute number of DALYs, a weekly trend of DALYs/100,000 inhabitants was computed for each country to assess the evolution of the pandemic burden over time. A cluster analysis and Kolmogorov-Smirnov (KS) test were performed to allow for a country-to-country comparison. RESULTS: The total DALYs amount to 4,354 per 100.000 inhabitants. YLLs were accountable for 98% of total DALYs.  Italy, Czechia and Sweden had the highest values of DALYs/100,000 while Finland, Estonia and Slovakia had the lowest. The latter three countries differed significantly from the others - in terms of DALYs trend over time - as shown by KS test. The cluster analysis allowed for the identification of three clusters of countries sharing similar trends of DALYs during the assessed period of time. These results show that notable differences were observed among different countries, with most of the disease burden attributable to YLLs. CONCLUSIONS: DALYs have proven to be an effective measure of the burden of disease. Public health and policy actions, as well as demographic, epidemiological and cultural features of each country, may be responsible for the wide variations in the health impact that were observed among the countries analyzed.

Mental Health and Substance Use Among Adults with Disabilities During the COVID-19 Pandemic - United States, February-March 2021.

Adults with disabilities, a group including >25% of U.S. adults (1), experience higher levels of mental health and substance use conditions and lower treatment rates than do adults without disabilities* (2,3). Survey data collected during April-September 2020 revealed elevated adverse mental health symptoms among adults with disabilities (4) compared with the general adult population (5). Despite disproportionate risk for infection with SARS-CoV-2, the virus that causes COVID-19, and COVID-19-associated hospitalization and mortality among some adults with disabilities (6), information about mental health and substance use in this population during the pandemic is limited. To identify factors associated with adverse mental health symptoms and substance use among adults with disabilities, the COVID-19 Outbreak Public Evaluation (COPE) Initiative† administered nonprobability-based Internet surveys to 5,256 U.S. adults during February-March 2021 (response rate = 62.1%). Among 5,119 respondents who completed a two-item disability screener, nearly one third (1,648; 32.2%) screened as adults with disabilities. These adults more frequently experienced symptoms of anxiety or depression (56.6% versus 28.7%, respectively), new or increased substance use (38.8% versus 17.5%), and suicidal ideation (30.6% versus 8.3%) than did adults without disabilities. Among all adults who had received a diagnosis of mental health or substance use conditions, adults with disabilities more frequently (42.6% versus 35.3%; p <0.001) reported that the pandemic made it harder for them to access related care or medication. Enhanced mental health and substance use screening among adults with disabilities and improved access to medical services are critical during public health emergencies such as the COVID-19 pandemic.

The Burden of Hormonal Disorders: A Worldwide Overview With a Particular Look in Italy.

Endocrine diseases have a considerable impact on public health from an epidemiological point of view and because they may cause long-term disability, alteration of the quality-of-life of the affected patients, and are the fifth leading cause of death. In this extensive review of the literature, we have evaluated the prevalence of the different disorders of endocrine interest in the world and Italy, highlighting their epidemiological, clinical, and economic impact.

Access to healthcare for people with disabilities in South Africa: Bad at any time, worse during COVID-19?

People with disabilities, especially those living in low- and middle-income countries, experience significant challenges in accessing healthcare services and support. At times of disasters and emergencies, people with disabilities are further marginalised and excluded. During the coronavirus disease 2019 (COVID-19) pandemic, many people with disabilities are unable to access healthcare facilities, receive therapeutic interventions or rehabilitation, or gain access to medication. Of those who are able to access facilities, many experience challenges, and at times direct discrimination, accessing life-saving treatment such as intensive care unit admission and ventilator support. In addition, research has shown that people with disabilities are at higher risk of contracting the virus because of factors that include the need for interpersonal caregivers and living in residential facilities. We explore some of the challenges that people with disabilities residing in South Africa currently experience in relation to accessing healthcare facilities.

The need for adaptable global guidance in health systems strengthening for musculoskeletal health: a qualitative study of international key informants.

BACKGROUND: Musculoskeletal (MSK) conditions, MSK pain and MSK injury/trauma are the largest contributors to the global burden of disability, yet global guidance to arrest the rising disability burden is lacking. We aimed to explore contemporary context, challenges and opportunities at a global level and relevant to health systems strengthening for MSK health, as identified by international key informants (KIs) to inform a global MSK health strategic response. METHODS: An in-depth qualitative study was undertaken with international KIs, purposively sampled across high-income and low and middle-income countries (LMICs). KIs identified as representatives of peak global and international organisations (clinical/professional, advocacy, national government and the World Health Organization), thought leaders, and people with lived experience in advocacy roles. Verbatim transcripts of individual semi-structured interviews were analysed inductively using a grounded theory method. Data were organised into categories describing 1) contemporary context; 2) goals; 3) guiding principles; 4) accelerators for action; and 5) strategic priority areas (pillars), to build a data-driven logic model. Here, we report on categories 1-4 of the logic model. RESULTS: Thirty-one KIs from 20 countries (40% LMICs) affiliated with 25 organisations participated. Six themes described contemporary context (category 1): 1) MSK health is afforded relatively lower priority status compared with other health conditions and is poorly legitimised; 2) improving MSK health is more than just healthcare; 3) global guidance for country-level system strengthening is needed; 4) impact of COVID-19 on MSK health; 5) multiple inequities associated with MSK health; and 6) complexity in health service delivery for MSK health. Five guiding principles (category 3) focussed on adaptability; inclusiveness through co-design; prevention and reducing disability; a lifecourse approach; and equity and value-based care. Goals (category 2) and seven accelerators for action (category 4) were also derived. CONCLUSION: KIs strongly supported the creation of an adaptable global strategy to catalyse and steward country-level health systems strengthening responses for MSK health. The data-driven logic model provides a blueprint for global agencies and countries to initiate appropriate whole-of-health system reforms to improve population-level prevention and management of MSK health. Contextual considerations about MSK health and accelerators for action should be considered in reform activities.

Reported health and social consequences of the COVID-19 pandemic on vulnerable populations and implemented solutions in six West African countries: A media content analysis.

Coronavirus has spread worldwide with over 140 million cases and resulting in more than 3 million deaths between November 2019 to April 2021, threatening the socio-economic and psychosocial stability of many families and communities. There has been limited research to understand the consequences of COVID-19 on vulnerable populations in West Africa, and whether such consequences differ by countries' previous experience with Ebola. Using a media analysis of leading online news sources, this study identified the populations particularly vulnerable to the threats of the COVID-19 pandemic, described the consequences of COVID-19 experienced by these populations, and reported on the solutions to address them. All articles from the selected news sources published between January 1 and June 30, 2020 on 6 West African countries were imported into Dedoose. A total of 4,388 news articles were coded for excerpts on vulnerable populations, only 285 excerpts of which mentioned the existing effects of COVID-19 on vulnerable populations or implemented solutions. News articles from countries with past experience with Ebola were more likely to mention the pandemic's effects on vulnerable populations, especially on incarcerated people. Vulnerable groups were reported to have experienced a range of effects including economic disruptions, heightened domestic and sexual abuse, arbitrary arrests, health care inaccessibility, and educational challenges throughout the pandemic. With implications for the achievement of the Sustainable Development Goals (SDG) for 2030 in West Africa, these countries should consider and focus more strategic efforts on vulnerable populations to overcome their fight against the COVID-19 pandemic and to achieve the SDG for 2030.

The Influence of the COVID-19 Pandemic on Physical Activity and New Incidence of Frailty among Initially Non-Frail Older Adults in Japan: A Follow-Up Online Survey.

OBJECTIVES: The objective of this study was to investigate the influence of the COVID-19 pandemic on physical activity (PA) and the incidence of frailty among initially non-frail older adults in Japan. DESIGN: A follow-up online survey. SETTING AND SUBJECTS: Among the 1,600 baseline online survey participants, 388 adults were already frail, and 275 older adults did not respond to the follow-up survey. Thus, the final number of participants in this study was 937 (follow-up rate: 77.3%). METHODS: We assessed the total PA time at four time points according to the COVID-19 waves in Japan: January 2020 (before the pandemic), April 2020 (during the first wave), August 2020 (during the second wave), and January 2021 (during the third wave). We then investigated the incidence of frailty during a one-year follow-up period (during the pandemic). RESULTS: The total PA time during the first, second, and third waves of the pandemic decreased from the pre-pandemic PA time by 33.3%, 28.3%, and 40.0%, respectively. In particular, the total PA time of older adults who were living alone and socially inactive decreased significantly: 42.9% (first wave), 50.0% (second wave), and 61.9% (third wave) less than before the pandemic, respectively. Additionally, they were at a significantly higher risk of incident frailty than those who were not living alone and were socially active (adjusted odds ratio: 2.04 [95% confidence interval: 1.01-4.10]). CONCLUSION: Our findings suggest that older adults who live alone and are socially inactive are more likely to experience incident frailty/disability due to decreased PA during the pandemic. Understanding this mechanism may be crucial for maintaining the health status of older adults.

Midterm functional sequelae and implications in rehabilitation after COVID-19: a cross-sectional study.

BACKGROUND: COVID-19 has been mainly investigated concerning the acute and subacute phase implications and management. Meanwhile, few studies focused on the midterm sequelae, which still remain largely unknown. AIM: To assess the physical performance of COVID-19 survivors at 3 to 6 months from Hospital discharge. DESIGN: A cross-sectional study focused on mid-term functional outcomes evaluation in COVID-19 survivors. SETTING: Outpatients who had been previously hospitalized due to COVID-19 from March to May 2020 at the University Hospital of Novara, Italy. POPULATION: We enrolled 204 patients, of which 60% were men, with the mean age of 57.9 years. METHODS: Patients firstly underwent the short physical performance battery test (SPPB), which is composed of a series of physical tests assessing the lower limb function and the functional status of the subjects. Subsequently, based on SPPB results, patients' cardiorespiratory fitness performance was further investigated. Patients with normal SPPB score (SPPB>10) underwent the 2-minute walking test (2MWT) whereas, in order to safely test the cardiorespiratory function, in patients with abnormal SPPB score (SPPB≤10) the 1-minute sit-to-stand test (1MSTST) was performed. It should be noted that the 1MSTST can be safely performed even by subjects with compromised walking ability. RESULTS: Overall, 66 patients (32% of our sample) showed an impaired physical performance at 3 to 6 months after hospital discharge. In particular, 29 patients presented an SPPB score ≤10, and the 1MSTST confirmed this status in the whole group (100%) compared to the reference values for age and sex. Besides, among patients with a normal SPPB score, 37 showed a lower sex- and age-matched 2MWT score. Finally, a significant association between Intensive Care Unit hospitalization or mechanical ventilation and physical impairment was observed together with a significant association between the walking ability (measured with SPPB and 2MWT) and the number of comorbidities. CONCLUSIONS: A residual physical and functional impairment was observed in COVID-19 survivors at mid-term evaluation after hospitalization. CLINICAL REHABILITATION IMPACT: Considering the current COVID-19 epidemiology, we might expect a tremendous burden of disability in the next future. Thus, an appropriate clinical rehabilitation pathway must be implemented.

Mental health and social interactions of older people with physical disabilities in England during the COVID-19 pandemic: a longitudinal cohort study.

BACKGROUND: The COVID-19 pandemic has affected mental health, psychological wellbeing, and social interactions. People with physical disabilities might be particularly likely to be negatively affected, but evidence is scarce. Our aim was to evaluate the emotional and social experience of older people with physical disabilities during the early months of the COVID-19 pandemic in England. METHODS: In this longitudinal cohort study, we analysed data from the English Longitudinal Study of Ageing collected in 2018-19 and June-July, 2020, from participants aged 52 years and older and living in England. Physical disability was defined as impairment in basic and instrumental activities of daily living (ADL) and impaired mobility. Depression, anxiety, loneliness, quality of life, sleep quality, and amount of real-time and written social contact were assessed online or by computer-assisted telephone interviews. Comparisons of experiences during the COVID-19 pandemic of people with and without a physical disability were adjusted statistically for pre-pandemic outcome measures, age, sex, wealth, ethnicity, presence of a spouse or partner, number of people in the household, and chronic pain. All participants with full data available for both surveys were included in the analyses. FINDINGS: Between June 3 and July 26, 2020, 5820 participants responded, 4887 of whom had full data available for both the pre-pandemic measures and the COVID-19 survey and were included in the analysis. During the COVID-19 pandemic, significantly more people with ADL impairment had clinically significant symptoms of depression (odds ratio 1·78 [95% CI 1·44-2·19]; p<0·0001), anxiety (2·23 [1·72-2·89]; p<0·0001), and loneliness (1·52 [1·26-1·84]; p<0·0001) than people without ADL impairment. Significantly more people with ADL impairment also had impaired sleep quality (1·44 [1·20-1·72]; p<0·0001) and poor quality of life than people without ADL impairment. The results were similar when disability was defined by impaired mobility. People with ADL impairment had less frequent real-time contact (0·70 [0·55-0·89]; p=0·0037) and written social contact (0·54 [0·45-0·64]; p<0·0001) with family than people without ADL impairment. Results for social contact were similar when disability was defined by impaired mobility. INTERPRETATION: People with physical disability might be at particular risk for emotional distress, poor quality of life, and low wellbeing during the COVID-19 pandemic, highlighting the need for additional support and targeted mental health services. FUNDING: Economic and Social Research Council/UK Research and Innovation, National Institute on Aging, National Institute for Health Research.

Changes in the Employment Status of People With and Without Disabilities in the United States During the COVID-19 Pandemic.

OBJECTIVE: Using data from the monthly Current Population Survey, this paper provides monthly employment and unemployment statistics for people with and without disabilities in the United States before and during the coronavirus disease 2019 pandemic to date (January 2021). DESIGN: Cross-sectional analysis of the Current Population Survey. SETTING: The United States. PARTICIPANTS: People with and without disabilities ages 16-64 years. INTERVENTION: N/A MAIN OUTCOME MEASURES: Percentage employed, percentage unemployed, percentage not in labor force, percentage on temporary layoff, percentage looking for work. RESULTS: Estimates show that, like workers without disabilities, workers with disabilities experienced increases in unemployment at the beginning of the pandemic but continued to remain engaged in the labor force. Our analysis finds that employment rates dropped from 74.8% to 63.2% for those without disabilities and from 31.1% to 26.4% for those with disabilities between February 2020 and April 2020 but gradually improved in the succeeding months. CONCLUSIONS: As the pandemic continued, the percentage of unemployed people with and without disabilities on temporary layoff decreased and those looking for work increased.

Actual versus perceived infection rates of COVID-19: Impact on distress, behavior and disability.

OBJECTIVE: Accurate threat appraisal is central to survival. In the case of the coronavirus pandemic, accurate threat appraisal is difficult due to incomplete medical knowledge as well as complex social factors (e.g., mixed public health messages). The purpose of this study was to evaluate the degree to which individuals accurately perceive COVID-19 infection rates and to explore the role of COVID-19 threat perception on emotional and behavioral responses both cross sectionally and prospectively. METHODS: A community sample (N = 249) was assessed using online crowdsourcing and followed for one month. COVID-19 threat appraisal was compared with actual COVID-19 infection rates and deaths at the time of data collection in each participant's county and state. It was predicted that actual versus perceived COVID-19 infection rates would only be modestly associated. Relative to actual infection rates, perceived infection rates were hypothesized to be a better predictor of COVID-related behaviors, distress, and impairment. RESULTS: Findings indicated that relative to actual infection, perceived infection was a better predictor of COVID-related outcomes cross sectionally and longitudinally. Interestingly, actual infection rates were negatively related to behaviors cross sectionally (e.g., less stockpiling). Prospectively, these variables interacted to predict avoidance behaviors over time such that the relationship between perceived infection and avoidance was stronger as actual infection increased. CONCLUSIONS: These data suggest that perceived COVID-19 infection is significantly associated with COVID-related behaviors, distress and impairment whereas actual infection rates have a less important and perhaps even paradoxical influence on behavioral responses to the pandemic.

The COVID-19 pandemic, stress, and trauma in the disability community: A call to action.

PURPOSE: To inform the field of rehabilitation psychology about the impacts of the 2019 novel coronavirus (COVID-19) on the disability community in the United States and the additional sources of stress and trauma disabled people face during these times. METHOD: A review of the literature on disability and COVID-19 is provided, with an emphasis on sources of trauma and stress that disproportionately impact the disability community and the ways in which disability intersects with other marginalized identities in the context of trauma and the pandemic. We also reflect on the potential impacts on the field of psychology and the ways in which psychologists, led by rehabilitation psychologists, can support disabled clients and the broader disability community at both the individual client and systemic levels. RESULTS: The COVID-19 pandemic introduces unique potential sources of trauma and stress within the disability community, including concerns about health care rationing and ableism in health care, isolation, and the deaths and illnesses of loved ones and community members. CONCLUSIONS/IMPLICATIONS: Rehabilitation psychologists and other professionals should be aware of the potential for trauma and stress among disabled clients and work with them to mitigate its effects. Additionally, psychologists should also work with the disability community and disabled colleagues to address systemic and institutional ableism and its intersections with other forms of oppression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).