People with learning disabilities in England are eight times more likely to die from Covid than the general population, according to research that highlights a “hidden calamity” of the coronavirus crisis.
The study from the London School of Hygiene & Tropical Medicine, Oxford University and Public Health England found risks were particularly high for those with profound learning disabilities linked to Down’s syndrome and cerebral palsy. Among Covid patients with Down’s syndrome, for example, the risk of dying from the infection was 36 times higher than in the general population.
“This is really stark. I was shocked at the increased death rates for people with learning disabilities and particularly for people with Down’s syndrome,” said Prof Hannah Kuper, director of the International Centre for Evidence in Disability at the LSHTM.
Previous studies have highlighted the increased threat that Covid poses to people with learning disabilities but the latest study published in the British Medical Journal is the first to analyse hospitalisation and death rates among people on the GP learning disability register through both major waves of infection in England. It shows that people with learning disabilities are five times more likely to end up in hospital after infection.
The findings are based on more than 17m NHS electronic health records analysed through Oxford University’s OpenSafely platform. Of 90,307 adults on the learning disability register, 538 (0.6%) were admitted to hospital with Covid, and 222 (0.25%) were recorded as Covid-related deaths.
Why people with learning disabilities are at such greater risk is not fully understood but major factors appear to be poorer treatment and access to healthcare throughout their lives. On average, people with learning disabilities die more than 20 years younger than the general population.
Kuper said discrimination, exclusion and living in residential care homes probably added to the risk for those with learning disabilities, while people who have Down’s syndrome may have additional biological risks such as underlying heart conditions and immune system dysfunction.
The results highlight the importance of ensuring that people on the learning disability register are prioritised for vaccines, but Kuper said more measures are needed, including better disease prevention in care homes, more training for carers and supporters, and clearer information on Covid for people with learning disabilities.
Few studies have looked at the increased risk that Covid poses to people with other disabilities, in part because comprehensive registers like the one for learning disabilities do not exist. “It’s shocking what we find for learning disabilities and it shows that people with learning disabilities should be prioritised for Covid vaccination, but it highlights that we don’t know much about people with disabilities more broadly who may be just as vulnerable,” said Kuper.
“With the arrival of Covid-19, families and specialist services knew people with learning disabilities were particularly vulnerable but were uncertain how to protect them,” wrote Ken Courtenay at the Royal College of Psychiatrists and Vivien Cooper at the Challenging Behaviour Foundation in an accompanying editorial. “While the focus was on older adults, whose mortality rates shocked the nation, a hidden calamity was also taking place among people with learning disabilities.”
They added that it is essential to understand the risks faced by people with learning disabilities and how best to protect them, writing: “People with learning disabilities have the same rights as everyone else, including the right to good health and to be safe from harm.”
A spokesperson for the Down’s Syndrome Association said the organisation has worked closely with researchers in the UK and globally to swiftly share information that will keep people safe, including “easy read” resources.
“We are currently pressing the Joint Committee on Vaccination and Immunisation to recommend that young people aged 12 to 15 who have Down’s syndrome will also be vaccinated and await any announcement with anticipation,” they added.