Mortality of people with intellectual disabilities during the 2017/2018 influenza epidemic in the Netherlands: potential implications for the COVID‐19 pandemic

Abstract

Background Data on the development of Covid‐19 among people with intellectual disabilities (IDs) are scarce and it is uncertain to what extent general population data applies to people with ID. To give an indication of possible implications, this study investigated excess mortality patterns during a previous influenza epidemic. Methods Using Dutch population and mortality registers, a historical cohort study was designed to compare mortality during the 2017–2018 influenza epidemic with mortality in the same period in the three previous years. People with ID were identified by entitlements to residential ID‐care services as retrieved from a national database. Results Data covered the entire adult Dutch population (12.6 million; GenPop), of which 91 064 individuals were identified with an ID. During the influenza epidemic, mortality among people with ID increased almost three times as much than in the GenPop (15.2% vs. 5.4%), and more among male individuals with ID (+19.5%) than among female individuals with ID (+10.6%), as compared with baseline. In both cohorts, comparable increases in mortality within older age groups and due to respiratory causes were seen. Particularly in the ID‐cohort, excess deaths also occurred in younger age groups, due to endocrine diseases and ID‐specific causes. Conclusions During the 2017–2018 influenza epidemic, excess mortality among people with ID was three times higher than in the general Dutch population, appeared more often at young age and with a broader range of underlying causes. These findings suggest that a pandemic may disproportionally affect people with ID while population data may not immediately raise warnings. Early detection of diverging patterns and faster implementation of tailored strategies therefore require collection of good quality data.

Effect of the COVID‐19 pandemic on the mental health of carers of people with intellectual disabilities

“…People with intellectual disabilities are a group at specific risk during the COVID‐19 coronavirus pandemic because of marked mental and physical health multimorbidity (Cuypers et al., 2020; Turk, Landes, Formica, & Goss, 2020). The social distancing and isolation measures implemented to manage the pandemic are known to impair mental health (Brooks et al., 2020; Torales, O'Higgins, Castaldelli‐Maia, & Ventriglio, 2020), and this burden is also likely to be greater for people with intellectual disabilities, because they have generally poorer coping abilities (Courtenay & Perera, 2020).…”

The importance of seasonal influenza vaccination for people with disabilities during the COVID-19 pandemic

“…Additionally, a Dutch study of the 2017–2018 influenza season showed excess mortality related to influenza among people with intellectual disabilities to be three times higher than the general population. 12 People with intellectual disabilities may live in congregate settings where they have more close contact with the public putting them at higher risk for exposure. In addition, many people with intellectual disabilities have co-occurring chronic conditions which put them at higher risk for complications from influenza.…”

Mental Health and Wellbeing Implications of the COVID-19 Quarantine for Disabled and Disadvantaged Children and Young People: Evidence from a Cross-cultural Study in Zambia and Sierra Leone

“…It has been broadly represented that, compared to adults, the prolonged pandemic and its restrictions may lead to short-term as well as long-term physical, psychosocial, educational and mental health implications for children and young people [13][14][15][16][17]. In particular, vulnerable paediatric populations (including those who are struggling with homelessness, pre-existing psychiatric conditions, developmental disabilities, special educational needs (SENs), substance use and abuse, and domestic violence) necessitate more support through their family and healthcare services because of their noticeable mental and physical health multimorbidity [18][19][20]. The ndings of research conducted during the pandemic on CYP with disabilities highlight drastic negative impacts of lockdown on varied aspects of their life, and di culties for their caregivers [21][22][23].…”