COVID-19: How do blind people get infected, Challenges experienced by the visually impaired and mobilization for vaccinations and vaccination certificates

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Introduction

 

Nearly 261.5 million people around the world had been diagnosed with COVID-19 as of yesterday and nearly 5.2 million people have died. On Nov. 28, there were 422,051 new cases and 4,447 new deaths confirmed globally. (1)

 

The Coronavirus, an often spoken word but, potentially meaningless to those who are living in rural settings or who are illiterate, has caused much anxiety and upended our lives in many ways.

 

What Is COVID-19?

A coronavirus is a kind of common virus that causes an infection in your nose, sinuses, or upper throat. Most coronaviruses aren’t dangerous.

 

In early 2020, after a December 2019 outbreak in China, the World Health Organization identified SARS-CoV-2 as a new type of coronavirus. The outbreak quickly spread around the world.

 

COVID-19 is a disease caused by SARS-CoV-2 that can trigger what doctors call a respiratory tract infection. It can affect your upper respiratory tract (sinuses, nose, and throat) or lower respiratory tract (windpipe and lungs).

 

It spreads the same way other coronaviruses do, mainly through person-to-person contact. Infections range from mild to deadly.

 

SARS-CoV-2 is one of seven types of coronavirus, including the ones that cause severe diseases like Middle East respiratory syndrome (MERS) and sudden acute respiratory syndrome (SARS). The other coronaviruses cause most of the colds that affect us during the year but aren’t a serious threat for otherwise healthy people.

 

How does the coronavirus spread?

 

SARS-CoV-2, the virus, mainly spreads from person to person.

 

Most of the time, it spreads when a sick person coughs or sneezes. They can spray aerosol droplets 6 feet away or even further. If you breathe them in or swallow them, the virus can get into your body. Some people who have the virus don’t have symptoms, but they can still spread the virus.

 

While less likely, you can also get the virus from touching a surface or object the virus is on, then touching your mouth, nose, or possibly your eyes. Most viruses can live for several hours on a surface that they land on. A study shows that SARS-CoV-2 can last for several hours on various types of surfaces:

 

  • Copper (pennies, teakettles, cookware): 4 hours
  • Cardboard (shipping boxes): up to 24 hours
  • Plastic (milk containers, detergent bottles, subway and bus seats, elevator buttons):2 to 3 days
  • Stainless steel (refrigerators, pots and pans, sinks, some water bottles): 2 to 3 days

 

That’s why it’s important to wash or sanitize your hands regularly and disinfect surfaces to get rid of the virus.

 

Coronavirus and the blind

To slow the spread of COVID-19, the World Health Organization (WHO) recommended preventive strategies such as wearing face masks, washing hands regularly, social distancing, avoiding touching surfaces, and staying at home (WHO, 2020). These strategies have been effective in slowing the spread of COVID-19 (e.g., Cheng et al., 2020; Ortega-Garcia et al., 2020).

 

In the COVID-19 pandemic, people with visual impairments (i.e., people who are blind or have low vision) have several additional complications: (1) they may be more vulnerable to be infected by the disease, (2) they have more difficulties implementing the preventive strategies against COVID-19 and also need to implement additional strategies, and (3) they may have more mental health problems due to COVID-19 and its consequences. Thus, more than 253 million people with visual impairments throughout the world are at an increased risk regarding COVID-19 and its consequences (WHO, 2019).

 

Virus prevention measures were developed without regard for those who have low vision or are blind in South Africa.

 

Touching surfaces while walking is a basic skill that visually impaired people use to ground themselves and find their way around, but it has become increasingly dangerous due to the spread of Covid-19 in the country.

 

Previous research has shown that people with visual impairments have higher rates of medical illnesses compared to the general population (i.e., Lieberman et al., 2019).

 

According to the WHO (2019), two-thirds of people with visual impairments live in low- and middle-income countries that have limited health care resources, which may result in delayed or insufficient health care. In addition, research has indicated that people with visual impairments practice positive health behaviours to a lesser extent compared to the general population (i.e., Dunbar & Ozsoy, 2020; Solanski et al., 2013), which may also be true for health behaviours related to COVID-19.

 

As you may know, touching a contaminated surface or object and then touching one’s face can result in Covid-19 infection, and the visually impaired and blind community is acutely aware of this increased risk factor.

 

However, some blind and visually impaired persons are also at a higher risk due to incorrect orientation and mobility practices, such as holding people’s hands when walking in public spaces, as opposed to using  a white cane.

 

Touching items and surfaces in our immediate environment is a usual practice and helps us to orientate ourselves, sort of the equivalent of a sighted person looking around their environment in order to move around or to execute tasks.

 

Concerns about mental health

The COVID-19 pandemic has negatively influenced the mental health of all individuals (Pfefferbaum & North, 2020). However, several potential factors may place people with visual impairments at an increased risk of stress, anxiety, and depression, an issue that is highly concerning because these mental health problems can weaken the immune system and lead to more susceptibility to COVID-19 (Kim & Su, 2020). According to a survey led by the American Foundation for the Blind (Rosenblum et al., 2020), some people with visual impairments felt stress because they thought they may be barred from treatment if there were not sufficient health care resources (e.g., lack of ventilators), a fear that could be rooted in the fact that society devalues people with disabilities.

 

People with visual impairments often need the support of others for daily living activities (Senjam, 2020). These support systems have been affected by government policies regarding COVID-19 (e.g., social distancing, quarantine, and lockdown), which has the potential to elevate stress levels in people with visual impairments. In addition, organizations, institutions, banks, transportation systems, education systems, and so many other aspects of daily life have been altered by COVID-19 policies, which may lead to difficulties for people with visual impairments, even when they are in familiar places. Adjusting to these changes, combined with less support from others, may cause additional stress to people with visual impairments. Regular eye examinations and care by ophthalmologists is critical for people with visual impairments, but COVID-19 restrictions have limited access to eye health care (Gegúndez-Fernández et al., 2020), which can lead to vision loss and stress. Unfortunately, additional vision loss may lead people with visual impairments to lose their sense of control over their lives (Abbasi Jondani, 2021).

 

How to mitigate the spread of Covid-19 amongst the blind and visually impaired

 

  1. Social restrictions

A study on the impact of a social distancing measure on COVID-19 transmission found a significant reduction in COVID-19 transmission.

Blind and visually impaired persons are encouraged to maintain social or physical distance, avoid crowded areas, limit social movement, and stay at home during the COVID-19 pandemic.

 

If a blind or visually impaired person needs to go outside, the mobility long cane can be used to maintain the social distance norm, or if he or she needs a sighted guide for a short distance, requesting the sighted person to hold the other end of the cane (not at the tip) is a better option than direct body contact.

 

They should be well informed and educated about the increased risk of infection due to COVID-19, as well as having the awareness and knowledge of the symptoms of the disease and what to do when one gets infected.

 

  1. Personal factors

As the South African government and the world health organisation advised us, it is in our interest to where face masks and to wash our hands regularly, limiting physical contact with others and limiting touching potentially infected surfaces and objects.

For this reason, it is in the interest of the blind and visually impaired community to adhere to these restrictions however, it is recommended that this be done through proper education, counselling and training.

 

  1. Environmental factors

Article 25 of the UN Convention on the Rights of Persons with Disabilities reaffirms the right of people with disabilities to the highest possible standard of healthcare, free of any form of discrimination based on disability. [3]

 

As a result, in accordance with the UN convention, blind and partially sighted persons should not be ignored or left behind in terms of their needs during the nationwide lockdown due to the COVID-19 pandemic.

 

The optimization of environmental factors to improve the overall outcome of blind and visually impaired persons during the emergency lockdown requires collaborative efforts from the blind and visually impaired community, caregivers, family members, healthcare and rehabilitation professionals, and other stakeholders.

 

Blind and visually impaired  persons often rely on caretakers or assistants to perform their basic Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL).

 

These routine tasks can be managed through collaboration and coordination among these core groups. The government has responsibilities for streamlining such an inclusive approach during the pandemic.

 

I propose the following recommendations while responding to the pandemic in the context of environmental factors:

 

  • Supportive environment to meet the daily living requirements to the best possible means within the context of choices made by the blind and visually impaired with the involvement of the public, non-profit or the private sector.

 

  • Creating an enabling environment for caregivers or community members in providing essential services to visually disabled people during the lockdown, for example, special permission to commute

 

  • Education and training about safety, social distancing, and personal protective measures to blind and visually impaired persons, caregivers, and family members for example, how to where a mask correctly.

 

  • Creating an easily accessible environment and infrastructure e.g., water source for hand washing, outdoor movement

 

  • Assisting in accessing healthcare services and support for the blind and visually impaired during the pandemic for testing and after potentially having contracted covid-19.

 

  • Sensitization of the service providers/health workers about affording dignity and showing respect to beneficiaries while rendering services

 

  • Accessible formats (simple and easy to understand) for information about COVID-19 disease. The Government websites which have all information about COVID-19 are not accessible to blind and visually impaired people to read with a screen reader software or difficult to comprehend among PwVDs. To avoid the potential misinformation and misconceptions about COVID-19, catering PwVDs in the dissemination on COVID-19 information with correct and appropriate formats or programs is of paramount importance. Such information will also help to reduce the fear and anxiety. Therefore, suitable formats for COVID-19 are essential through which PwVDs can access the information at any time. Of the many existing examples, one is Braille handbook for HIV and AIDS in Odisha[28]

 

  • Financial aid to blind and visual impaired persons during the lockdown period either from government or any other external funding, e.g., Non-government Organisations

 

  • Online consultation to improve the awareness, knowledge and training to any of the family members or caregivers or community volunteers

 

Arranging special services for students with visual disabilities stranded in schools for the blind. Lockdown also results in closure of many residential schools for the blind with shutting down the transportation. Students stranded in these schools need psychological counselling to relieve anxiety and fear about the COVID-19 and appropriate information about the emergency lockdown and the pandemic. They need to be supported in accessing health care services if required, educated on all safety and precaution measures in the correct way. During the lockdown periods, special educators or teachers are not able to commute to the schools to educate and train students.

 

Vaccination certificates

 

Blind and visually impaired persons are now able to retrieve their digital vaccination certificates from the department of health’s website.

 

South Africans can now access their Covid-19 vaccination certificate digitally

 

digital vaccination certificate portal:

https://vaccine.certificate.health.gov.za/

 

 

Conclusion

The COVID-19 pandemic has affected all of us. However, people with visual impairments are facing more difficulties regarding COVID-19 and its consequences, making them a high-risk group. According to United Nations (2006) guidelines, providing standard health care for all groups of society without any discrimination is the duty of governments and communities. To achieve this goal, they must consider the special needs and health conditions of people with visual impairments during the COVID-19 pandemic. Recently, Haug and colleagues (2020) analyzed the effectiveness of many different governments’ interventions against COVID-19 across 79 territories worldwide. They found that the provision of governmental assistance to vulnerable

populations (e.g., people with visual impairments) is one of the most effective ways to mitigate the spread of COVID-19. We hope that this call to action regarding the special needs of people with visual impairments during this pandemic allows for institutions to make changes that will allow people with visual impairments to enjoy the highest possible quality of life.

 

 

 

References:

  • Johns Hopkins University Center for Systems Science and Engineering. Retrieved Nov. 29, 12 a.m. E.T.
  • Jarvis CI, Van Zandvoort K, Gimma A, Prem K, Klepac P, Rubin GJ, et al. Quantifying the impact of physical distance measures on the transmission of COVID-19 in the UK. BMC Med. 2020;18:124. [PMC free article] [PubMed] [Google Scholar]
  • Implementation of the United Nations Convention on the Rights of Persons with Disabilities. 2017. [Last accessed on 2020 May 24]. Available from: http://inclusionscotland.org/wp-content/uploads/2017/01/CRPD-shadow-report-GBJan-2017-PDF-1.pdf .

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