Risk Factors Associated With COVID-19 Outcomes Among People With Intellectual and Developmental Disabilities Receiving Residential Services

Landes, Scott D.; Turk, Margaret A.; Damiani, Marco R.; Proctor, Philip; Baier, Sarah

doi:10.1001/jamanetworkopen.2021.12862

Cited by 27 publications

(25 citation statements)

References 55 publications

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“…In the overall model, congregate setting, age, aggression, and limited mobility were significantly associated with testing positive for COVID-19. That congregate setting was associated with COVID-19 aligns with previous studies ( Landes et al, 2020 ; Landes, Turk, Damiani, Proctor, & Baier, 2021 ), demonstrating similarity in trends in Ontario and the USA. As seen in long-term care and nursing homes, it is difficult to maintain social distance when providing support with activities of daily living to multiple people living in close quarters ( Landes et al, 2020 ; Ouslander & Grabowski, 2020 ) and distancing is further complicated by the need for mobility support.…”

Section: Discussionsupporting

confidence: 88%

Short Report: The influence of congregate setting on positive COVID-19 tests among a high-risk sample of adults with intellectual and developmental disability in Ontario

Hansford

Ouellette‐Kuntz

Martin

2022

Research in Developmental Disabilities

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Background For a number of reasons, persons with intellectual and developmental disability (IDD) are at increased risk of contracting COVID-19. Aims This study explored the influence of congregate setting on testing positive for COVID-19 among adults with IDD in Ontario. Methods and procedures 833 home care recipients with IDD were included, 204 were tested at least once for COVID-19. These data were linked to the homecare assessment data. The association between living in a congregate setting and receiving a positive COVID-19 test was explored using a logistic regression model among the total sample and those tested for COVID-19. Outcomes and results 77 individuals tested positive for COVID-19 (9.24 %). Congregate setting, age, aggression, and mobility were significantly associated with receiving a positive COVID-19 test in the total sample. Among the subgroup, congregate setting and age were significant. Conclusion and implications Adults with IDD have an increased risk for positive COVID-19 tests at younger ages than other high-risk populations, such as elderly persons. These findings confirm the vulnerability of adults with IDD living in group settings to COVID-19. As such, they should be prioritized when COVID-19 prevention and public health strategies, including vaccination and boosters, are introduced.

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Section: Discussionsupporting

confidence: 88%

Short Report: The influence of congregate setting on positive COVID-19 tests among a high-risk sample of adults with intellectual and developmental disability in Ontario

Hansford

Ouellette‐Kuntz

Martin

2022

Research in Developmental Disabilities

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“…Living with multiple comorbidities (especially diabetes and dementia) was also strongly predictive of COVID-mortality in our group [8,10,[28][29][30][31][32]. The negative effects of understaffing (seen as sick leave or AWAS in our data) were similar to those reported in the United States [8], Spain [32], and the United Kingdom [33][34], and constitute a vicious cycle: during periods of high transmission, more staff needed sick leave. Yet, the medical and staffing needs of residents were simultaneously surging, forcing many sick (and infectious) caregivers back into the workplace.…”

Section: Discussionsupporting

confidence: 78%

COVID-19 in French Nursing Homes during the Second Pandemic Wave: A Mixed-Methods Cross-Sectional Study

Dujmovic¹,

Roederer²,

Frison³

et al. 2021

Preprint

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Introduction French nursing homes were deeply affected by the first wave of the COVID-19 pandemic, with 38% of all residents infected and 5% dying. Yet, little was done to prepare these facilities for the second pandemic wave, and subsequent outbreak response strategies largely duplicated what had been done in the spring of 2020, regardless of the unique needs of the care home environment. Methods A cross-sectional, mixed-methods study using retrospective, quantitative data from residents of 14 nursing homes between November 2020 and mid-January 2021. Four facilities were purposively selected as qualitative study sites for additional in-person, in-depth interviews in January and February 2021. Results The average attack rate in the 14 participating nursing facilities was 39% among staff and 61% among residents. One-fifth (20) of infected residents ultimately died from COVID-19 and its complications. Failure-to-Thrive-Syndrome (FTTS) was diagnosed in 23% of COVID-positive residents. Those at highest risk of death were men (HR=1.78; IC95: 1.18 - 2.70; p=0.006) with FTTS (HR=4.04; IC95: 1.93 - 8.48; p<0.001) in facilities with delayed implementation of universal FFP2 masking policies (HR=1.05; IC95: 1.02 - 1.07; p<0.001). The lowest mortality was found in residents of facilities with a partial (HR=0.30; IC95: 0.18 - 0.51; p<0.001) or full-time physician on staff (HR=0.20; IC95: 0.08 - 0.53; p=0.001). Significant themes emerging from qualitative analysis centered on (i) the structural, chronic neglect of nursing homes, (ii) the negative effects of the top-down, bureaucratic nature of COVID-19 crisis response, and (iii) the counterproductive effects of lockdowns on both residents and staff. Conclusion Despite high resident mortality during the first pandemic wave, French nursing homes were ill-prepared for the second, with risk factors (especially staffing, lack of medical support, isolation/quarantine policy etc) that affected case fatality and residents' and caregivers' overall well-being and mental health.

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“…Disability support workers (DSWs) are at significant risk of being infected and transmitting SARS‐CoV‐2 (hereto referred to as COVID‐19) due to the nature of their work, which often involves close physical contact with numerous people with disability 1-3 . Furthermore, the people with disability they support may be at greater risk of getting a more severe case of COVID‐19 or dying if they become infected with COVID‐19, sometimes because of underlying health conditions 4-8 . The COVID‐19 vaccine would mitigate these risks.…”

Section: The Covid‐19 Pandemic In Australiamentioning

confidence: 99%

“… 1 , 2 , 3 Furthermore, the people with disability they support may be at greater risk of getting a more severe case of COVID‐19 or dying if they become infected with COVID‐19, sometimes because of underlying health conditions. 4 , 5 , 6 , 7 , 8 The COVID‐19 vaccine would mitigate these risks. This study explores DSW's COVID‐19 perceptions and vaccine intentions.…”

mentioning

confidence: 99%

The COVID‐19 vaccine intentions of Australian disability support workers

Kavanagh

Dickinson²,

Dimov

et al. 2022

Australian and New Zealand Journal of Public Health

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Objectives : Describe perceptions of COVID‐19, COVID‐19 vaccines, information sources, and levels and reasons for vaccine hesitancy among disability support workers (DSWs). Methods : Cross‐sectional survey of 252 DSWs from across Australia, between early March and early April 2021. Perceptions of risk of COVID‐19; government and media representations; vaccination status (Y/N); vaccine intentions (when offered, delayed vaccinators, vaccine refusers); reasons for hesitancy; confidence in safety and efficacy of vaccine; and information sources. Results : At the time of the survey, fewer than 1% of DSWs had been vaccinated and 17% had been offered vaccination. Of those who had not had the vaccine, 47% said they would get it as soon as it was offered; 19% would not get the vaccine; 12% would have if required; 13% hadn't decided; and 8% would wait until it was available for a while. Reasons for hesitancy included inadequate safety data (70% delayed vaccinators, 79% vaccine refusers), side effects (63% delayed vaccinators, 58% refusers), and distrust in the government (17% delayed vaccinators, 52% refusers). DSWs most trusted sources of information were their own doctor, Chief Medical Officers, and governments. 61% believed that COVID‐19 will only stop if most of the community is vaccinated and 53% agreed the chances of them or their clients getting COVID‐19 would be reduced if they were vaccinated. Conclusions : Tailored information is needed to reduce vaccine hesitancy and increase confidence in COVID‐19 vaccines among DSWs. The importance of getting vaccinated to prevent COVID‐19 among people with disability should be emphasised.

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Risk Factors Associated With COVID-19 Outcomes Among People With Intellectual and Developmental Disabilities Receiving Residential Services

Cited by 27 publications

References 55 publications

Short Report: The influence of congregate setting on positive COVID-19 tests among a high-risk sample of adults with intellectual and developmental disability in Ontario

Short Report: The influence of congregate setting on positive COVID-19 tests among a high-risk sample of adults with intellectual and developmental disability in Ontario

COVID-19 in French Nursing Homes during the Second Pandemic Wave: A Mixed-Methods Cross-Sectional Study

The COVID‐19 vaccine intentions of Australian disability support workers

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