Guidance for the treatment and management of COVID-19 amongst people with intellectual disabilities

Issues: The current COVID-19 pandemic is a pressing world crisis and people with intellectual disabilities are vulnerable due to disparity in healthcare provision and physical and mental health multi-morbidity. Whilst most people will develop mild symptoms upon contracting SARS-CoV-2, some will develop serious complications. There are no current data about the impact of COVID-19 for people with intellectual disabilities. Position: The aim of this paper is to present guidelines for the care and treatment of people with intellectual disabilities during the COVID-19 pandemic for both community teams providing care to people with intellectual disabilities and inpatient psychiatric settings. The guidelines cover specific issues associated with hospital passports, individual COVID-19 care plans, the important role of families and carers, capacity to make decisions, issues associated with social distancing, ceiling of care/treatment escalation plans, mental health and challenging behaviour, and caring for someone suspected of contracting or has contracted SARS-CoV-2 within community or inpatient psychiatric settings. We have proposed that the included conditions recommended by Public Health England to categorise someone as high risk of severe illness due to COVID-19 should also include mental health and challenging behaviour. Conclusions: There are specific issues associated with providing care to people with intellectual disabilities and appropriate action must be taken by care providers to ensure that disparity of healthcare is addressed during the COVID-19 pandemic. We recognise that our guidance is focused upon healthcare delivery in England and invite others to augment our guidance for use in other jurisdictions