This is a version of a post, revised by the author, that originally appeared earlier this week.
The covid-19 pandemic has highlighted the unacceptable health inequalities faced by people with a learning (or intellectual) disability. This has been brought home by the JCVI decision not to prioritise them adequately during the vaccination programme and has been highlighted in an article in the British Medical Journal on which this blog draws heavily for the benefit of a lay readership.
It is estimated that only about 250,000 adults are registered as having a learning disability with their GP’s, although there are estimated to be c.1.5 million people in this country with this particular diagnosis. One of the serious indications of learning disability is an inability or difficulty in reading the written word, a difficulty shared by many more who don’t meet all the criteria to have a learning disability, including for example, over 50% of those in prison in the UK. Inability to read is often accompanied by other limitations on comprehension, which helps to explain why people with learning disability are slow to understand when they are ill and to seek or be offered medical care. The result is reduced life expectancy – people with learning disability die on average 25 years earlier than the general population.
The charity Beyond Words produces books and leaflets that tell stories with pictures to help people with learning disability lead their lives. It has produced a series of books since the outbreak of COVID to explain about COVID – the symptoms, how to keep safe, vaccinations etc.
In spite of Beyond Words’ efforts, and those of other LD charities, last year Public Health England found that, between the ages of 18-34, the death rate of people with LD from COVID -19 was 30 times higher than for people in the same age group without a disability. The overall death rate for people with LD was estimated to be up to 6.3 times higher than the general population. The application of blanket “do not attempt cardiopulmonary resuscitation” orders on people with LD during the pandemic made matters worse in some places, and yet this group is so far still not being prioritised for vaccination.
The Joint Committee on Vaccination and Immunisation (JCVI) considers that prioritisation should “maximise benefit and reduce harm” and “mitigate health inequalities.” As the BMJ article points out:
People living in care homes for older adults have been made the first priority, yet people with ID, despite sharing many of the same risks as this group from living in congregate settings, have been treated in a more haphazard way. People with Down’s syndrome are deemed “extremely clinically vulnerable” and appear fourth on the vaccine priority list, alongside adults aged 70 years and over. People aged 16-64 with underlying health conditions that put them at higher risk of serious disease and mortality are ranked sixth—this includes people with a severe or profound ID, but not those with mild or moderate ID.
Even before the pandemic, fewer than two in five people with ID lived beyond 65 years of age. We now know that people with ID who are affected by COVID 19 die at a younger age than those in the general population. A vaccine policy which does not account for this is discriminatory; it has failed to make reasonable adjustments as required under the Equality Act 2010, with an overemphasis on chronological age.
As in so many other aspects of handling the pandemic, I support the view of the authors of the BMJ article that the government should follow the example of Germany and offer vaccination to people with learning disability as a priority.
* John Kelly is a member in Warwick District, Secretary of the Lib Dem Friends of Palestine, and a member of the Federal International Relations Committee.