frequently asked Questions
COVID-19 & Special needs
How do I prepare for COVID-19 in the disability community?
People with Intellectual & Developmental Disabilities (IDD) are a vulnerable population and are more likely to suffer from complications up to and including death from the coronavirus — this is especially true for those with underlying health problems such as heart or lung disease. Additionally, people with IDD are in frequent contact with one another in residential and day program settings, making it very easy to spread the virus within the population. It’s important to have a well-thought-out plan of emergency to limit the spread and complications.
Remember the Basics:
Prevent infection with good hand hygiene and household cleanliness - Read CDC’s Guidelines here.
Keep up-to-date with the risk in your community through your local public health department.
Familiarize yourself with the symptoms of COVID-19 (fever, cough, shortness of breath).
High risk clients/ patients (with underlying health conditions - especially heart & lung) should practice social distancing & stay at least 6 feet away from others early (now).
Keep high risk clients/patients home from day programs and community events.
For high risk clients/ patients, consider contacting their primary care provider to ensure they are up to date on all vaccines. Specifically, ask about the pneumonia vaccine. Pneumococcal vaccine (also called “pneumonia vaccine”) helps to prevent pneumonia from some bacteria that can complicate the COVID-19 infection, although it does not protect against COVID-19 itself.
If you have questions about a clients’ risk level, call their primary care provider.
Have a Plan for Community-Spread:
Have at least a 90 day supply of all medications on hand
Have at least a 90 day supply of any other medical equipment on hand
Prepare for clients to have an increased amount of time at the home in the case that day programs close, etc.
Have a Plan for Different Scenarios:
If someone under your care has symptoms or confirmed coronavirus
If you (caregiver, HHP, etc) have symptoms or confirmed coronavirus
Specific plans for specific residential settings
What to do when and if day programs close
What if someone under my care has symptoms of COVID-19?
Contact your physician’s office. Determine if/ where the patient needs to be seen for further evaluation. It is important they know ahead of time about the patient’s symptoms to take steps to limit the spread to other patients being seen there. Unless it is a medical emergency, avoid going to the ER and contact your primary care provider’s office first.
Practice home isolation. Follow any direction provided by your healthcare provider. Until given direction otherwise, practice home isolation measures. Home isolation means the affected patient must:
Remain isolated in their own room.
Stay home except to get medical care.
Use their own bathroom, if possible. If this is not possible, the bathroom should be cleaned after each use, especially surfaces with any contact with bodily fluid.
Avoid sharing household products.
Wear a face mask during any necessary interactions with other household members.
Prohibit visitors.
Limit contact with any pets or animals in the home.
Consult healthcare provider to determine when home isolation precautions can be discontinued.
Closely monitor symptoms. If there is any concern that the affected person’s condition is worsening, contact their healthcare provider immediately or call emergency personnel if needed.
Give instructions to all household members.
Practice good hand hygiene.
Clean all shared surfaces (at least) daily.
Closely monitor symptoms of everyone else who resides in the home.
Everyone should limit time outside of the home. All people who share the same host home should stay home from day program, work, or other community outside activities for at least 2 weeks after the last known exposure, assuming they do not develop symptoms.
If additional household members develop symptoms- follow the above instructions.
What if someone refuses to follow home isolation precautions?
Notify the case manager and agency immediately.
If you have other clients living in your home, restrict the affected person to their room while in the process of formally addressing rights restrictions as needed.
If you do not have any other clients in the home, it is important that you still restrict their access to community and day program.
What if I (caregiver, HHP, etc) have symptoms of COVID-19?
DO NOT provide direct care to any unaffected clients even though they have likely been exposed. Further/ongoing exposure still increases their chance of getting infected.
Follow all home isolation precautions as recommended above and for the general population.
Let other caregivers in the home take over all care of any unaffected clients unless they start to develop symptoms as well.
If all available caregivers in the home have symptoms concerning for coronavirus, they should NOT be caring for any clients as above if possible. Develop a plan ahead of time of back up options should this occur. Examples may include family members or outside caregivers that come into the home. Note that if an outside caregiver comes in, they should not go to other host homes that do not have any affected or exposed individuals. Start thinking of this situation now.
If none of the above options are available, then practice home isolation measures. All members of the household should stay home except to go to doctor’s visits. Practice all of the above hygiene measures.
What should I do about day programs?
STRONGLY consider closing for precautionary measures. We serve a very high-risk population, and social distancing is key in preventing the spread and associated complications. Follow CDC, public health, and WHO closely for the latest information.
When in operation, develop strict guidelines for when participants and staff need to stay home or be sent home. Familiarize yourself with the symptoms.
Step up hygiene practices and cleaning above normal. Read CDC’s cleaning & disinfecting recommendations.
What should I do for my specific residential setting?
Host homes: see above
Personal care alternatives & community settings:
Have a plan in place for people living independently or with a non-caregiver roommate if additional supports will be needed should symptoms develop. The plan should be put into place at the time symptoms develop and not be delayed until a diagnosis is confirmed. The emergency plan should take into consideration all of the above recommendations as well as plans for more frequent monitoring to ensure symptoms are not worsening.
People living with caregivers or family members should follow the above standard recommendations.
Any caregiver that enters the home on an intermittent basis needs to follow strict hygiene practices detailed above and on the CDC website. That caregiver should limit time with other people who are not affected or exposed. Ideally, they would only care for that patient. If this is not possible, strict infection control/hygiene measures need to be practiced.
Group homes:
Limit the number of staff in contact with the affected individual, including anyone with only symptoms and not a confirmed diagnosis. Ideally, the staff in contact with that individual should have little to no contact with other residents.
If anyone in the home is affected, no resident should attend day program, work, or community events for at least two weeks after last known exposure.
There should be strict rules for staff on when not to come to work. If a staff member has any symptoms potentially suggestive of COVID-19, they should stay home. They should only return to work once cleared by their physician.
If a staff member is found to have COVID-19, residents should stay home from day program, work, or community events for at least two weeks after the last known exposure.
Alternative care facilities:
Have an emergency plan in place for each resident including any additional care or supervision that will be required in the case of an infection. This plan should be put into place at the time of symptom development and not be put off until a diagnosis is confirmed. The emergency plan should take into consideration all of the above recommendations as well as plans for more frequent monitoring to ensure symptoms are not worsening.
There should be a plan in place to rapidly address any affected resident who is not following isolation precautions.
Any caregiver that enters the home on an intermittent basis needs to follow strict hygiene practices detailed above and on the CDC website. That caregiver should limit time with other people who are not affected or exposed. Ideally, they would only care for that patient. If this is not possible, strict infection control/hygiene measures need to be practiced.
Regional centers:
Have an emergency plan in place for each resident including any additional care or supervision that will be required in the case of an infection. This plan should be put into place at the time of symptom development and not be put off until a diagnosis is confirmed. The emergency plan should take into consideration all of the above recommendations as well as plans for more frequent monitoring to ensure symptoms are not worsening.
There should be a plan in place to rapidly address any affected resident who is not following isolation precautions.
Limit the number of staff in contact with the affected individual, including anyone with only symptoms and not a confirmed diagnosis. Ideally, the staff in contact with that individual should have little to no contact with other residents.
There should be strict rules for staff on when not to come to work. If a staff member has any symptoms potentially suggestive of COVID-19, they should stay home. They should only return to work once cleared by their physician.
If a staff member is found to have COVID-19, residents should stay home from day program, work, or community events for at least two weeks after the last known exposure.
Have an emergency plan for staffing and prepare for the event that far fewer than normal staff will be able to come to work.
Submitted by AADMD member Emily Johnson, MD