Prepare to serve students with COVID‐19‐related long‐term disabilities

Abstract

Due to the prevalence and seriousness of COVID‐19, colleges and universities are encountering health, safety, and educational challenges requiring rapid development of innovative on‐campus and remote learning and living conditions. In this unfamiliar environment, disability services providers must prepare by expanding their knowledge of COVID‐19 infection and its aftermath, being alert to resulting disabilities, and adapting service delivery.

It is important that DS providers keep abreast of rapidly growing knowledge involving the acute symptoms of COVID‐19, as well as the lesser‐known aftereffects. You can find well‐publicized symptoms of infection identified by the Centers for Disease Control and Prevention at https://bit.ly/2Uq0DWC.

COVID‐19 insights are rapidly expanding, and nationally known professionals like Dr. Anthony Fauci are warning of verified but less publicized evidence of its long‐term health effects. In late July 2020, the CDC reported that 39% of nonhospitalized people, most under 49, experienced lingering effects two to three weeks after testing positive, and projected that as many as one‐third of COVID‐19 patients will have even longer‐term symptoms, including young, healthy people and nonhospitalized patients. Fauci urged close monitoring of survivors.

DS offices are likely to see students with long‐term COVID‐19 effects, often called “long haulers,” needing disability assessment, documentation, accommodation, and possible referral to other campus or community resources.

Aggressive immune reactions were a suspected cause of both short‐ and long‐term effects. Emerging hypotheses now suggest that infection and inflammation of the heart and blood vessels contribute to subsequent widespread organ involvement and failure. The devastating effects, however, are not limited just to the period of active infection. Increasing evidence indicates long‐term disabling effects that are just now starting to be recognized.

Here are some of the currently identified, lingering COVID‐19 symptoms and conditions to remain alert and prepared for:

• ➤ Encephalomyelitis/chronic fatigue syndrome. This is the most common long‐term symptom associated with viral infections, often characterized by extreme and chronic fatigue. Frequently called “brain fog,” it significantly interferes with daily activities and may include depression, sleep problems, and cognition and memory deficits, and it does not improve with rest. A devastating and chronic neuroimmune disease, 75% of those affected are women, and 20% are 18–34.
• ➤ Post‐traumatic stress disorder, anxiety, and depression. PTSD develops in some who have experienced or witnessed a shocking, frightening, or dangerous event, like being unable to breathe, or from “fight‐or‐flight” reactions from other COVID‐19 medical incidents. Even the fear of contracting the disease may cause some to develop PTSD. Of those discharged from intensive care units, 40% report anxiety, 30% report depression, and 20% report PTSD. Early intervention is critical in minimizing progression of the disorders.
• ➤ Post‐intensive care syndrome. PICS, affecting 20% of COVID‐19 patients, consists of assorted symptoms, including loss of physical strength, cognitive decline, and various mental health problems, and continues for a protracted length of time after ICU release.
• ➤ Muscle and body aches. Often in the lower back and usually sharp, but not resulting from injury, these aches, typically accompanied by fatigue and other symptoms, are common.
• ➤ Respiratory issues. Up to 77% of survivors in a Chinese study had continued lung problems, one‐third of them permanent, characterized by shortness of breath and breathing difficulty from lung damage and scarring. Lung damage may cause kidney, heart, or brain dysfunction.
• ➤ Heart issues. Unrelated to illness severity, survivors often exhibit shortness of breath and fatigue from heart damage, causing oxygen deprivation, inflammation (myocarditis), or stress cardiomyopathy.
• ➤ Blood clots. One study found that 31% of those with COVID‐19‐related pneumonia had blockages in veins and arteries caused by blood clots. Even those given blood thinners still developed deep vein thrombosis and serious blood clots in their legs, lungs, and cerebral arteries.

Because lingering effects of COVID‐19 are varied and sometimes unidentified, it is especially important that DS providers engage in the interactive process to determine the full range of functional limitations. Remember that symptom duration is currently unknown and may vary, so carefully explore the barriers and potential accommodations, remembering that these limitations are probably new for the student. Request supporting documentation as needed.

In these unprecedented times, DS professionals must recognize the long‐term effects of COVID‐19 and its impact on students, then actively disseminate relevant disability support services information. Encourage, engage, and evaluate self‐identifying students who may have recently acquired COVID‐19‐related disabilities, and thoughtfully accommodate both virtual and on‐campus students through the interactive process.

About the author

LOUISE BEDROSSIAN, ED.S., L.P.C.

Louise Bedrossian, Ed.S., L.P.C., is the retired Director of the Disability Resource Center at Clayton State University in Georgia. She is also engaged in consulting and private coaching and counseling. Email her at [email protected].