COVID-19 and Disability

COVID-19 and Disability

The Disability Pandemic: What COVID Revealed About Who Gets to Live

News

Jun 1, 2022

The pandemic has been a brutal reminder that disabled people don’t matter. Living through this, as a disabled person with a wonky immune system, has been a reminder that my life doesn’t matter to most.

Where I do matter is in my disability community, the community of people at such risk of this deadly disease who have rallied and worked together to protect ourselves. After two years of lockdowns, fear, forgetting, and being ignored, my nerves are sanded raw. A new variant is announced. Restrictions for me creep back in. I’m left wondering if this is how it will be from now on: no more music, no more crowds, no more indoor anything really, and maybe no more footy. For the rest of my life.

The past two years, and the many before them, showed me that I can build a life in four walls. I can survive terrible things. But isolation is not neutral. It wears you down. And what the disability pandemic has shown is that survival often depends less on government systems and more on each other.

What Is “The Disability Pandemic”?

The disability pandemic refers to the disproportionate risk, neglect, and systemic exclusion experienced by disabled people during COVID-19—especially in access to healthcare, vaccination, social supports, and public policy decisions.

While COVID-19 was a global crisis, its impact was not evenly distributed. In Britain, 60 per cent of those who died from COVID were disabled people. In Australia, that data isn’t properly collected. We aren’t counted.

Instead, we are hidden behind phrases like “underlying health conditions.”

Who is valued?
Whose life is worth saving?
Who gets the ventilator?
Who is triaged out?

These questions were not abstract for disabled people. They were immediate and terrifying.

“You Would Die”: Locking Down Before the World Did

In February 2020, my GP was kind but blunt.

You have to go into lockdown now, she told me. This virus is very serious for you. With all your…and she waved her hands to indicate my entire body. You can’t get this. You would die.

I walked home along Katoomba Street, my stick pressing into the pavement, navigating around people suddenly rendered dangerous. I closed the door to my flat and would not go out again for five months.

A few years earlier, my heart had failed. Doctors stood at the end of my hospital bed and told me I was about to die. It turned out I didn’t want to.

I did everything they told me: restricted fluids, cardiac rehab, and medication. I would place my hand over my heart and whisper to it, willing it to keep beating. Eventually, it did.

During COVID, that same adrenaline-fuelled panic returned. Every surge in cases meant locking down weeks before everyone else. Checking supplies. Preparing to disappear again. This time, I could only control my small part. The rest depended on whether everyone else also didn’t want me to die.

I wasn’t entirely confident.

Living in Two Worlds During COVID

The disability pandemic created a strange split reality.

In one world, things became more accessible than ever. Meetings moved online. Arts events went virtual. I could give evidence to a royal commission without having to navigate inaccessible spaces. For once, everyone was on screen, not just me stuck on someone’s phone in the corner.

In the other world, my supports collapsed. I didn’t see another person for months. Gym and physio disappeared. My arthritis tightened its grip. When I couldn’t get food, I cobbled together strange cupboard meals. When I was lonely, I didn’t say it out loud.

On screen, no one saw my disfigured skin or wonky hands. They didn’t see me limping. In screen-land, I looked like everyone else. That virtual erasure made it harder to explain what was happening behind the camera.

The social model of disability tells us that when environments become accessible, we become less disabled. But during COVID, accessibility sometimes masked a crisis.

Triage Fears and the Shadow of Eugenics

Early reports from overwhelmed health systems overseas raised another fear: rationed care.

Disabled people around the world spoke about being triaged out. Alice Wong imagined a doctor reading her chart and deciding she was a waste of precious resources.

Those fears were not paranoia. They were rooted in history.

Australia has a long record of institutionalizing disabled people. Eugenics found fertile ground here. The Immigration Restriction Act of 1901 excluded people based not only on race, but also on mental and physical health.

Writer Amanda Tink observed that eugenic thinking did not end with World War II; it mutated.

During COVID, people across the political spectrum argued for policies that placed disabled people at higher risk of dying, then shouted at us when we objected.

If disabled people are the ones dying, then the pandemic can feel like it’s happening somewhere else, to someone else.

That is the quiet logic of the disability pandemic.

Government Failure and Community Response

When the pandemic hit, disabled people began making frantic calls:

  • I can’t get food.

  • My supports have stopped.

  • I can’t afford essential medication.

  • What are the rules?

  • What is Telehealth?

Fifteen to twenty per cent of the population was effectively forgotten.

Advocacy organizations (many run by disabled people) scrambled to respond while facing the same barriers themselves. Governments stonewalled. Complaints were redirected. Concerns were minimized.

The Disability Royal Commission later found that failure to consult disabled people in early pandemic planning led to neglect of our needs during an unprecedented emergency.

The vaccine rollout repeated the pattern. Disabled people were told we were prioritized. In practice, many could not access vaccines. Some group homes were among the last to receive them.

“Everything’s fine,” governments said.

Everything bloody well was not.

Disabled Mutual Aid: Webs of Care That Kept Us Alive

While governments faltered, disabled people organized.

Online groups became information clearinghouses. People translated public health orders. Shared state-by-state updates. Explained income support changes. Crowdfunded emergency funds. The Disability Justice Network of Australia distributed over $40,000 (mostly raised by disabled people for disabled people).

Writer Leah Lakshmi Piepzna-Samarasinha calls these networks “webs of care.” The ways we kept each other alive during COVID, they argue, were nothing short of heroic.

This is what the disability pandemic revealed most clearly: we survive because we build each other’s safety nets.

Not as charity. As solidarity.

First Peoples With Disability and Vaccine Inequity

The failures were even sharper for First Peoples with disabilities.

Damian Griffis, CEO of First Peoples Disability Network, warned that First Nations people with disabilities were at risk of being triaged out or receiving inadequate support. Vaccine access required centre-based appointments, which were not accessible to many.

The fear was justified. The rollout repeatedly failed to reach those most vulnerable.

The disability pandemic intersects with colonial history. Australia’s federation was built on exclusion: white, able, male. That foundation shapes who is visible, who is protected, and who is forgotten.

Freedom for Whom?

I watch people chanting about their freedom and think about what I’ve lost.

Will I ever go to the footy again? I’ve been going to AFL games since I was a kid, sneaking into Princes Park, singing “We are the Navy Blues,” watching my grandmother yell at Hawthorn.

The idea that I might never sit in a crowd again is unbearable.

I have had three vaccine doses. But the people in the ICU, while vaccinated, the ones dying, are people like me. People with “underlying health conditions.”

Friends make complicated plans to see me. Rapid tests. Isolation before visits. Carefully rationed social contact.

Is this how it will be now?

Flavia Dzodan asks what it means to protest public health measures in a country built on occupying space by obliterating others. The question lingers.

Freedom, during the disability pandemic, often meant freedom from considering us.

The Small Things That Are Everything

Leah Lakshmi Piepzna-Samarasinha writes that sometimes we think we must save the world, and anything less is nothing.

But we, in our small crip circles, are the world.

The small, low-key things we do to keep each other alive are nothing. They are everything.

That is the quiet lesson of the disability pandemic.

Disabled people have always built networks of care. We will continue to. These webs will endure beyond COVID, beyond the next crisis, beyond the next wave of forgetting.

We survive because we refuse to let each other disappear.

About the Author
El Gibbs is an award-winning writer and disability advocate. Her work has featured in Growing up Disabled in Australia, Overland, Eureka Street, and Croakey.

Welcoming New Members

Welcoming New Members

Welcoming New Members

News

May 24, 2022

On May 19, 2022, during the General Assembly of the World Federation of Public Health Associations, member organizations have welcomed 3 new members; the Eastern Mediterranean Public Health Network (EMPHNET), the European Network of Medical Residents in Public Health (EuroNet MRPH), and World Patients Alliance.

We look forward to working together towards our shared goals of protecting and promoting health & wellbeing worldwide.

Welcoming New President

Welcoming New President

Welcoming New President

News

May 23, 2022

On May 19, 2022, the WFPHA formally welcomes its new President Prof. Luis Eugenio de Souza. He will hold the role of President for the next two years.

Luis is a professor at the Federal University of Bahia and a leader in health equity and sustainable development!

Meet Our New President-elect, Emma Rawson-Te Patu

Meet Our New President-elect, Emma Rawson-Te Patu

News

May 20, 2022

On May 19, 2022, during the General Assembly of the World Federation of Public Health Associations, member organizations have elected Emma Rawson-Te Patu as President-elect. She will be the first Indigenous president of the WFPHA.

Emma is of the Māori tribal groups of Ngāti Ranginui, Ngai te Rangi, Raukawa and Ngāti Haua of New Zealand. She has been involved in Public Health, Hauora Māori (Māori health) for over 18 years.

Provision of Oral Health Care for the Institutionalized Elderly

Provision of Oral Health Care for the Institutionalized Elderly

Oral Health Care for the Institutionalized Elderly

News

May 18, 2022

Life expectancy has risen significantly across most countries over the past two decades, according to the World Health Organization Global Health Estimates. At the same time, older adults (particularly in countries such as the United States) are far more likely to retain their natural teeth into later life.

While this reflects progress in preventive dentistry, it also introduces new clinical and public health challenges. Without consistent and effective oral hygiene support, poor oral health can intensify systemic conditions and increase health risks, especially among residents of long-term care facilities.

This makes oral health care for the institutionalized elderly a growing global priority.

When Oral Health Declines, Overall Health Follows

For elderly individuals in residential care, oral health is not a cosmetic issue; it is directly connected to chronic disease management and survival outcomes.

Research has linked inadequate oral hygiene with:

  • Worsening Type 2 diabetes

  • Increased risk and progression of dementia

  • Higher incidence of hospital-acquired and aspiration pneumonia

  • Greater levels of frailty

Residents in care homes are particularly vulnerable. Many depend on carers for daily hygiene routines, and compromised immune systems amplify the consequences of neglected oral care.

Featured Snippet Summary

Why is oral health care important for institutionalized elderly people?
Poor oral hygiene can worsen diabetes, increase dementia risk, raise the likelihood of pneumonia, and contribute to frailty, particularly among elderly residents who rely on caregivers for daily support.

Recognition at Policy Level: Governments Begin to Respond

Several countries have formally acknowledged the gap in oral health provision within aged care systems.

In England, the National Institute for Health and Care Excellence published guidelines addressing oral health for adults in care homes. This was followed by a review by the Care Quality Commission, which found that many care home owners and staff were unaware of how to ensure that residents’ daily oral hygiene met acceptable standards.

Subsequently, NHS England introduced the Framework for Enhanced Health in Care Homes, followed by a government-issued oral health toolkit for adults in care homes.

In the United States, the comprehensive Smiles for Life curriculum, developed by Smiles for Life, includes a geriatric dentistry module designed to strengthen clinical knowledge.

Earlier pilot initiatives had already demonstrated that structured intervention could improve outcomes. However, scaling those efforts remains an ongoing challenge.

Access Barriers: When Residents Need a Dentist

Daily hygiene is only one component. Access to professional dental services remains a persistent obstacle in many care facilities.

Transport limitations, workforce shortages, and medical complexity often delay in-person dental visits. In response, teledentistry has emerged as a promising solution.

Recent implementations in:

  • France

  • Japan

  • Australia

have demonstrated that remote consultations can support preliminary diagnosis and clinical advice. Digital tools reduce unnecessary transfers while improving timely assessment.

Featured Snippet Summary

How can teledentistry support oral health care for older adults in institutional settings?
Teledentistry enables remote consultation, preliminary diagnosis, and professional advice without requiring residents to travel, improving access and reducing delays in care.

Technology as a Force Multiplier

Emerging technologies are further expanding possibilities.

Research on the evaluation of mobile phone images by off-site dental practitioners has demonstrated effectiveness in screening schoolchildren. Similar approaches can be adapted for aged care settings.

Additionally, real-time artificial intelligence tools, such as Smilio.ai, offer innovative, cost-efficient, and person-centred opportunities to screen for oral diseases in institutional settings.

These tools do not replace clinicians. Instead, they enhance early detection, streamline referrals, and make oral health care for institutionalized older adults more scalable.

Workforce Integration: Training Beyond Dentistry

Sustainable improvement depends on empowering those already providing daily care.

In the United Kingdom, Knowledge Oral Healthcare delivers oral health training to nurses, allied health professionals, and carers in the aged and disability sectors. In Australia, Seniors Dental Care Australia provides similar programs.

A notable systems-level intervention occurred within the U.S. Department of Veterans Affairs, where oral health care was integrated into inpatient services via the nursing workforce. Translating research into clinical practice resulted in measurable improvements in oral hygiene and significant reductions in hospital-acquired pneumonia.

This model demonstrates that embedding oral health responsibilities into existing care frameworks can yield substantial public health gains.

Advocacy and Public Accountability

Policy reform is often accelerated through coordinated advocacy.

In Australia, twelve key stakeholder organizations (including the Public Health Association of Australia and the Australian Dental Association) issued a joint media release on World Oral Health Day, prior to the federal election, calling for stronger aged-care oral health strategies.

The Australian Dental Association’s “Stop the Rot” campaign further highlights the need for systemic reform in aged care.

Media engagement has also played a role. The Australian Health Journal released a World Oral Health Day video advocating for the prioritisation of oral health in aged care and disability services.

The Demographic Reality We Cannot Ignore

As life expectancy increases and more older adults retain their natural dentition, oral health demands will intensify rather than decline.

Improving oral health care for the institutionalized elderly requires coordinated effort from:

  • Governments

  • Aged care providers

  • Dental practitioners

  • Nurses and allied health professionals

  • Consumer and advocacy organizations

Innovation in teledentistry, mobile imaging, and artificial intelligence offers meaningful opportunities. However, technology alone cannot resolve systemic gaps. Policy alignment, workforce training, and sustained political commitment remain essential.

Closing Perspective

The evidence is clear: oral health is inseparable from general health. For elderly residents in institutional care, neglecting the mouth risks compromising the whole person.

Ensuring high-quality oral health care for the institutionalized elderly is fundamental to maintaining dignity, preventing disease, and achieving equitable health outcomes in ageing societies.

By Kenneth Eaton & Leonie Short