EARLIER this week, England's newly appointed Health Secretary Thérèse Coffey said her immediate priorities to fix the ailing NHS were A, B, C, D: ambulances, backlog, care, doctors and dentists.
All areas in urgent need of help and reform, yes. But something else probably deserves to be included under the 'D' umbrella: disability.
From the onset of the Covid pandemic to the current cost of living crisis, those with disabilities have been hit harder than most.
There was further disappointment again on Tuesday when campaigners evaluating the SNP-Greens 'Programme for Government' found "nothing"new or meaningful to help struggling disabled people and their carers.
The anger is understandable when you consider what the past two and a half years has meant for people with disabilities.
READ MORE: Increase in patients waiting over a year for NHS operations
According to updated analysis by the King's Fund, a leading health think tank, between January 2020 and March 2022 the risk of dying from Covid-19 was three to four times higher in "more disabled" men and women compared to non-disabled adults (people were classed as "more" disabled if they reported that their day to day activities were "limited a lot" by their conditions).
Even after adjusting for demographic, socio-economic and health-related factors, the risk of dying remained around 1.5 times higher for those with a physical disability, while those with a medically-diagnosed learning disability were 3.7 times more likely to have died as a result of Covid compared to people without a learning disability.
The most significant risk factor appeared to be that people with severe learning difficulties were more likely to be in residentital facilities. However, even after adjusting for the risk associated with communal living, their risk of dying from the disease remained 1.7 times higher.
Overall, nearly 60 per cent of all Covid deaths in the UK occurred in people with some form of disability.
Earlier this week, 13 organisations which represent disabled people - including Inclusion Scotland - applied for 'Core Participant Status' in the UK's Covid Public Inquiry, a move that would grant them access to relevant documents as well as permission to make open and closing submissions and put forward questions for witnesses.
Disability Rights UK, one of organisations behind the application, said disabled people were "left high and dry by statutory agencies" during the pandemic, with failings ranging from poor access to healthcare, inadequate access to social care, lack of accessible communication and information, and disproportionate barriers to education, retail and transport.
Concerns have also been raised around unfair discrimination, stretching from the earliest days of the pandemic to the so-called 'post-Covid' recovery period.
READ MORE: Questions over 'discriminatory' guidance issued to clinicians at start of pandemic
In June this year, the Herald reported on questions raised around "potentially discriminatory" guidance issued to clinicians in March and April of 2020 which experts warned may have led to elderly and disabled people wrongly being denied access to ventilators and intensive care.
Academics tasked with analysing the documents and providing evidence to guide the Scottish Covid Inquiry found that some of the advice issued to medics early in the pandemic detailing what to do if demand for ICU beds exceeded capacity was "problematic in terms of human rights and the law, and could potentially have led to discriminatory care".
They also pointed to guidance urging doctors to consider factors such as whether a patient depended on help for daily activities or was a nursing home resident "with the clear implication that these factors, whatever their cause, weigh against access to critical care".
In the end, lockdown slowed the spread of the virus and Scotland's ICU surge capacity exceeded demand during the first wave.
However, the researchers said it remains unclear whether the guidance had "a real world effect" in terms of some people being "wrongly denied access to treatment".
They also raised concerns around "significant anecdotal evidence" of vulnerable individuals "feeling pressurised" to agree to do not resuscitate (DNR) orders and suggestions that particular groups, such as people with learning disabilities in care settings, had been placed on DNRs "when this was not clinically justified".
READ MORE: Clinically vulenrable treated like 'modern day lepers', says former Government advisor
Dr Sally Witcher - a former senior advisor to the Scottish Government on social security - has also criticised the exclusion of thousands of clinically vulnerable disabled people who were previously on the shielding list from access to Covid antivirals and Spring boosters at a time when restrictions were being lifted, and the spread of Omicron pushed virus rates to their highest levels since the pandemic began.
Dr Witcher, herself disabled from childhood, said the situation had left her and thousands of others with “no prospect of leaving [the] house safely in the foreseeable future" at a time when the healthy population was embracing a return to normality.
More recently, campaigners have hit back at the decision in August by the UK Government not to procure Evusheld , a Covid-19 drug already used in countries including Canada, France, Israel, and the US, and which has been approved by UK regulators for use in patients with health conditions, such as blood cancer, which mean they are unlikely to mount an immune response from vaccination.
Data from Israel during the BA.1 and BA.2 Omicron waves found that immunocompromised people who took Evusheld were half as likely to become infected with Covid, and 92% less likely to be hospitalised and/or die.
As if the impact of Covid wasn't bad enough, disabled households now face a disproportionate burden from rocketing energy bills due to higher requirements for heating and electricity needed to charge wheelchairs or operate everything from home dialysis and oxygen machines to feed pumps.
Perhaps it is actually an 'E' that should be added to the list of priorities: equality. For disabled people this remains far off.
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