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June 17 (UPI) -- Americans living with physical and intellectual disabilities need to stay at home as much as possible to minimize their risk from COVID-19 even as many states reopen from lockdown, experts said Wednesday. That's because the challenges posed by the new coronavirus, SARS-CoV-2, aren't limited to concerns over health and prognosis, according to Dr. Lisa Iezzoni, director of the Mongan Institute for Health Policy at Massachusetts General Hospital.
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In some states, people with intellectual disabilities are considered "poor candidates" for ventilators and intensive care unit admission when resources need to be rationed, as they have in many parts of the country since the COVID-19 outbreak reached the United States in March, Iezonni said during a conference call with reporters hosted by the Robert Wood Johnson Foundation.
In addition, those with hearing problems or intellectual disabilities may have difficulty communicating their needs to healthcare workers, particularly since many hospitals have restricted access to facilities for family members and caregivers as part of infection control during the pandemic, she said.
For these and other reasons, "staying home is the safest thing for them because there are going to be risks," said Iezzoni, who has multiple sclerosis and has been using a wheelchair since 1988.
Just as COVID-19 has highlighted inequities in healthcare along racial lines, it has also exposed long-standing issues faced by those living with disabilities.
Roughly one in four American adults -- 61 million people -- have physical or intellectual disabilities. Rates of disability are higher, however, among those who are Native American, African American or Latinx, at 30 to 40 percent, compared to those who are white, at 24 percent, according to Iezzoni, citing U.S. census data.
In all, 13 percent of Americans have a mobility disability and 2 million use wheelchairs, making it difficult for them to get to a doctor or hospital for care, she said.
Those in long-term care facilities or confined to their homes because of disabilities are even more vulnerable, Iezzoni said. To date, 60 percent of the more than 7,600 deaths in Iezzoni's home state of Massachusetts were residents of nursing homes, mirroring trends in other parts of the country, she said.
Still, the exact scope of COVID-19 among those with disabilities remains largely unknown, as cases haven't been tracked in these populations on either the state or national level, she added.
To ensure that those with disabilities receive care during the pandemic, national, state and local officials need to ensure that long-term care facilities are adequately staffed, and that the staff and residents have access to COVID-19 testing and personal protective equipment, Iezzoni said.
Similarly, more resources need to be provided to home healthcare agencies so that paid home caregivers get tested for the virus and have protective equipment when caring for clients with disabilities, she said.
Policymakers also need to realize that standard practices such as hand washing may be anything but for those who use wheelchairs, she said.
"I use a wheelchair with a joystick," Iezzoni said. "What happens if I get on an elevator and push a button? I can wash my hands as soon as I get off the elevator, but how do I clean the joystick?"
Which serves to highlight that there is no one-size-fits-all approach to addressing this issue, according to Iezzoni.
"The disabled population is so diverse, and not everyone has a visible disability," she said. "And [COVID-19] infections themselves may result in long-term disability, in the form of heart and lung complications. We just don't know. This may be a growing issue as the pandemic goes on."
