Covid-19 vaccination policy: People with disabilities should get priority
We need to rethink our vaccine allocation infrastructure for people with disabilities
There are more than one billion people - 15 percent of the world's population - living with some form of disabilities in the world. In Bangladesh, it is nearly 10 percent of the country's total population. We feel that they have been ignored in the ongoing vaccination allocation campaign.
It is accepted that healthcare workers should get priority in vaccination programmes. But the question is - who should get the vaccine next? If we want to say 'Majority Must', why are young adults not prioritised over elder people, being the majority?
We could say, this is not the scientific way. Scholars could say that we have to consider vulnerability. So, why are the disabled not included in the vaccination allocation strategy when they are vulnerable? Why are third genders and sex workers enlisted, but not the disabled?
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On the other hand, when the central goal is to reduce morbidity and mortality, why are males not getting any priority over the female, when the mortality rate in male is higher? Why are scientists or researchers not counted, when sportspersons are enlisted? Why are prisoners getting preference over lots of youngsters?
We know till now there is no golden standard intervention for Covid-19. In this article, we will talk about the issue of vulnerability. We will also try to find out the ethical justification for preferentially enlisting people with disabilities.
In the case of vulnerability, the question is - who are the actually vulnerable people? Elderly people are vulnerable, it is commonly understood, but what happens in the case of people with disabilities (PwD)? We need to remind that this is a specific minority group that is vulnerable to discrimination and marginalisation not only during the Covid time, but also in the non-pandemic time.
A feature published by The Atlantic mentioned a story of 50-year old lawyer Daniel Florio who was born with spinal muscular atrophy that makes him disabled. His fear is, if he ends up in the hospital with a serious case of Covid-19, what will happen? Intubated people cannot speak, and Florio would not be able to use gestures or otherwise communicate with his doctors.
This condition makes him more vulnerable to the virus than most people. The other fear of Florio is that if he contracts the virus, he could be denied life-saving treatment by the authority because of his disability, due to their implicit bias. His doubt is not wrong because in the past we saw a few cases like that.
For example - in Austin in Texas, a quadriplegic patient, Michael Hickson, tested positive for Covid-19 in June and he died because the doctors stopped his treatment due to his disability.
Some disabled people are not able to maintain the physical distance because they need help eating and bathing, some cannot tolerate masks, and they often have medical conditions that make them vulnerable to Covid-19.
According to the UNDP "People with disabilities are vulnerable because of the many barriers they face: attitudinal, physical, and financial". Recently, USA today reported that New York prioritises people with disabilities who live in group homes, even if they don't need full-time nursing care.
According to the Hindustan Times the directorate of persons with disabilities, social welfare department, at Bihar in India, has requested to consider the disabled as a vulnerable group and vaccinate them on a priority basis.
Also, in the study report of NASEM, The Committee on Equitable Allocation of Vaccine for the Novel Coronavirus, it is recommended, "in each population group, vaccine access should be prioritised for geographic areas identified through CDC's Social Vulnerability Index or another more specific index".
We need to rethink our vaccine allocation infrastructure for the people with disabilities.
Dr. Gausul Azam Ranju is Physiotherapist & In-charge, BGC Trust Medical College & Hospital (BGCTMCH), Chittagong.
Dr. Zahid Hossain is Faculty, Department of Physiotherapy and Rehabilitation, Jessore University of Science and Technology (JUST).
Dr. Rajib Hasan, PhD is Deputy Director (Planning), Jatiyo Protibondhi Unnayan Foundation (JPUF), Ministry of Social Welfare.
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.
