A Second Wave? How Parents of Kids with Cognitive Disabilities Can Prepare

Disability Tribune, July 2020

By Dr. Craig Escudé, MD, FAAFP, FAADM

Should we fear a second wave of COVID-19? I’d suggest preparing but keeping fear to a minimum. There are a few good reasons why we may be less likely to have an intense second wave than we were in past pandemics:

1. Near instantaneous transfer of information. The lightning speed at which new cases can be identified, pinpointed and contacts traced will help reduce the likelihood of a quick spread to a large group.
2. The widespread availably of testing will help to identify cases rapidly and isolate them.
3. Better sanitation procedures including hand washing and the availability of hand sanitizers. The importance of cleanliness and the availability of cleaning supplies and sanitizers compared to past pandemics will certainly help.
4. Greater understanding of the disease itself, the early symptoms and the risks of transmission will help to focus our efforts to stay healthy where they have the most benefit.

Remember that numbers can be misleading. When looking at the numbers of cases that are being reported, focus on the trends and not just the number itself, because the more testing that’s done, the higher the number of positive cases that will be reported. It’s a better indicator to look at the percentage of positive tests rather than just total number of positive ones.

Kids with a cognitive disability and COVID-19

Nonetheless, people with cognitive disabilities, also known as intellectual and developmental disabilities (IDDs), are at greater risk of death from a COVID-19 infection according to a new study. People with IDD had higher prevalence of specific comorbidities associated with poorer COVID-19 outcomes. Distinct age-related differences in COVID-19 trends were present among those with IDD, with a higher concentration of COVID-19 cases at younger ages. In addition, while the overall case-fatality rate was similar for those with IDD (5.1%) and without IDD (5.4%), these rates differed by age: ages ≤17 – IDD 1.6%, without IDD <0.01%; ages 18–74 – IDD 4.5%, without IDD 2.7%; ages ≥75– IDD 21.1%, without IDD, 20.7%. The study concluded that, though of concern for all individuals, COVID-19 appears to present a greater risk to people with IDD, especially at younger ages.

What can you do to stay healthy?

1. Practice good hygiene. Wash your hands regularly and teach your loved ones to do the same. Modeling behavior that we want others to do is an important, non-verbal way to communicate healthy practices.
2. Have a supply of hand-sanitizer available. Use ones that are at least 60% alcohol and use them regularly. Take care to prevent ingestion by those who love to “sample” new things.
3. Ensure an adequate supply of a person’s medications in the event that trips to a pharmacy become difficult.
4. Fortify supplies of household items, personal care items and cleaning supplies before a shortage might present itself.
5. Encourage appropriate mask-wearing. For those that might have difficulty wearing one, there are a few tips below.
6. Strengthen your support network to provide assistance with daily life in the event that members of your usual support system become ill or affected by a new quarantine.
7. Expand the availability of activities and entertainment should the need for social distancing or quarantine become necessary. This might include online visits with friends, web-based group activities and outdoor activities that can be done during these times.

Masks can play a role in reducing the spread of infection. They seem to be better at keeping someone who is infected from unknowingly spreading disease than the other way around. Regardless, some places require a mask to be worn and some people with disabilities may be strongly resistant to the practice.  Here are a few ways to encourage mask-wearing:

1. Model it. When people see others wearing a mask, they are more likely to feel comfortable doing it themselves.
2. Make it fun. Let them help in either picking out or designing their own mask. If a person likes superhero movies, find one that wears a mask and show them that it can be pretty cool! Many old western movies show mask-wearers, as well.
3. If they have a favorite stuffed animal, put a mask on them, too!
4. Let them carry a mask around, even if they don’t want to wear it. It may help them feel comfortable having one around and later they may decide it’s OK to wear.

For more mask-wearing tips check this out.

Many of the suggestions in this article are good practices regardless of the presence of a pandemic. They could come to serve you well for pandemics, natural disasters or other emergency situations. Remember the old Boy Scout motto: Be Prepared!

Dr. Escude is a board-certified family physician and one of the few Fellows of the American Academy of Developmental Medicine. His is the president of Health Risk Screening, Inc. which specializes in risk identification and prevention in people with IDD and other vulnerabilities

Published by the Disability Tribune