There is empirical evidence that people with intellectual and developmental disabilities (IDD) in the US experienced comparatively higher Covid-19 case and case fatality rates than the general population during the first year of the pandemic.1, 2, 3, 4 This was especially the case for people with IDD living in residential group homes.5, 6, 7, 8 While informative, each of the Covid-19 studies on people with IDD to date have focused on cumulative Covid-19 outcomes through one interval. None examined patterns of Covid-19 case rates and case fatality rates across the first year of the pandemic, which could also possibly allow for a view of the temporal effects of policies and practice changes.
The aim of this brief report is to compare Covid-19 case rates and case fatality rates among people with IDD living in residential group homes and the general population across the first year of the pandemic. This longitudinal perspective allows for better discrimination of patterns in case and case fatality rates, data that is necessary in understanding: 1) whether variation in case and case fatality rates among people with IDD during the first year of the pandemic were/were not in tandem with the general population; and 2) whether disparities in Covid-19 outcomes experienced by people with IDD varied or were consistent during the first year of the pandemic.
To accomplish this task, we focused on data from New York State (NYS). This decision is due to a working relationship with an IDD residential provider coalition in the state that tracked Covid-19 case and case fatality outcomes among all adults in their residential homes during the early part of the pandemic. Covid-19 outcomes were more severe in NYS than the rest of the country during the early part of the pandemic and policies, executive orders, and changes to routines were implemented in response to this severity (not necessarily considering outcomes9), a fact that limits the generalizability of the findings in this study. Yet, over time, it was recognized that in this aspect NYS was not an outlier, but a harbinger for the rest of the country. Thus, while results are only applicable to NYS, they provide information that may be informative to better understanding the disproportionate Covid-19 burden experienced by people with IDD, the first step in ensuring that history is not repeated.
Based on prior evidence, we predicted that case and case-fatality rates would be higher among people with IDD than the general population in NYS, and that this disparity would persist across the first year of the pandemic. As there is no prior evidence to date on variation in case or case fatality rates among people with IDD over time, there were no specific predictions in these patterns; but based on reported disparities, there was the expectation of some variation.
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